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What is Adoption-Competent Therapy?

Updated: Mar 27, 2023

"You mean there could be therapists who have studied exactly what it's like to be me because they were taught by people like me?" I imagine I would have thought something like this as a teenager had I ever had a chance to meet with an adoption competent therapist. Not only had I never had a teacher, counselor, coach, pastor, or any other professional in my life who was adopted or knew a lot about being adopted - I didn't even know very many other adopted children.

Perhaps this is why much of my adult life and career has focused on setting out to prove that adopted people have needs created by being adopted that should be met. Our experiences through adoption and our adoptive identity cannot be overlooked as unimportant or as irrelevant to the rest of our life. We have thoughts, feelings, concerns, and needs stemming from being adopted that make perfect sense. The problem is, not enough folks around us understand how to help us make sense of those thoughts, feelings, concerns, and needs. When this happens, we feel weird. We feel like we're the only ones.

What happens to young bodies, minds, and nervous systems when they feel alone and like needs they have trouble expressing can't be met? It's a lot for them to try to contain all by themselves. Sometimes they get loud. They act out. They have big emotions they can't explain. They do impulsive things and don't know why. They lash out. Sometimes they get quiet. They keep to themselves. They don't want anyone to know they're struggling. They grow up into adults who sometimes feel too complicated and hard-to-love when nothing could be further from the truth.

Although therapy specifically for adopted people and their families is not new, the concept of adoption competence is new and still developing. At my private practice, with my business partner and co-conspirator who is also adopted, we're really proud to be a part of this conversation. We're really proud to offer adoption-competent therapy, consultations, and coaching that are informed by the work of others and based on our own expertise.

So, what is adoption-competence?

Some of our adopted youth and adult clients have gone through as many as 10-12 therapists before finding one with adoption competency.

Adoption competence can be thought of like cultural competence. We think of adoption as a system and an institution that has a culture of its own. Culture can be thought of as the way a community of people (like people with shared identity or experiences) create meaning from being who they are. As such, we could say that culture then provides us with a lens to understand that meaning. Culture is a way of knowing. Adoption competence is a way of knowing and understanding the culture of adopted people and adoption itself.

Our version of adoption competence helps us know adopted people (and their families) and to competently act upon what we know in ways that are respectful, helpful, and empowering to adoptees and their loved ones.

As a side note, if you're struggling to think of adoption as having a culture, start with asking yourself what assumptions you might make (or that you hear other people make) when they hear words like "orphan" or "adopted child." What images, movie titles, characters, news stories, or stereotypes come to mind? How a community (e.g. the adoptee community or adoption community) comes together to handle those assumptions and the meaning other people make of adoption, for example, is part of how they form their own culture, sub-culture, or counter-culture.

Competent "ways of knowing" an adoptee client and demonstrating to them that we see them go hand-in-hand. For example, many adopted youth and adults have had experiences with therapists who have no idea how to communicate with them. The therapist had no cultural understanding of how to really hear and speak in response to the adopted person in ways that were the most important. Some of our adopted youth and adult clients have gone through as many as 10-12 therapists before finding one with adoption competency. Adoption competent therapists can speak works that align with strength, calm, liberation, healing, validation, and support. They've learned how to put important experiences, emotions, and thoughts into words that, when spoken, allow adopted people and their families to feel heard and understood.

Another example, adoption competence gives us a way of using our own similar emotions and memories to create true empathy with the adopted person who sits before us. We understand that the typical "ways of knowing" provided by the broader culture in the United States are inadequate - which is why adoption competence is necessary. Popular concepts from incompetent "knowing" of adoption often result in folks saying things like, "You have no loss. You gained a family," or "You could have been aborted or abused instead," or "You're so lucky." These phrases hurt, alienate, and make adoptees feel weird.

If you as the reader of this article are not adopted, think of any time in your life when you've had multiple conflicting thoughts, feelings, and needs that were heavy and distressing to you. How much would it have helped for someone to communicate to you that your situation is (to them) quite simple? How much would you have felt helped by someone refusing to see and know you because they preferred to "look at the bright side" instead? It hurts, it's alienating, and it makes you feel like you're weird.

Our private practice's adoption competency model takes a slightly different approach from other competency models which focus mostly on the perspectives of professionals or adoptive parents. Our method comes from my partner's and my combined nearly 7 decades of living as adoptees in a society in which most people are not adopted. It comes from witnessing our own first and adoptive parents - some of whom themselves are/were foster youth and/or adopted people. It comes from us having sojourned with hundreds of other adopted youth and adults (and their families) as friends, peers, mentors, activists, advocates, therapists, colleagues, or scholars. It also comes from our educational background, our work experience, our areas of scholarship, and an ongoing deep dive into theories pertaining to adoption, social wellness, and mental health.

Our version of adoption competence comes directly from adopted people as the primary source on adoption as an institution and as a deeply personal experience. It's based on what adopted people say is important to them and how they desire to be seen and understood.

Let's review just one small part of what this looks in our adoption competency model.

Across the Whole Person: We approach every adopted person as a complex and fully wonderful human being. We strive to understand their reality from multiple lenses at once including biological, psychological, social, spiritual, cultural, economic, and legal. We consider how their realities are shaped when these lenses intersect.

We also embed the following considerations into each and every one of these lenses of being human:

Across Time and Space: We approach every adopted person, and every lens looking at their life, thinking about their past, present, and future experiences. Adopted people are whole people from birth forward and every part of their life (whether they have knowledge of it or not) is precious and meaningful because they are precious and meaningful.

Across Axes of Power: We approach every adopted person, and every lens, thinking about their differing experiences of power, influence, and felt safety depending upon when and where they are. For example, a transracial transnational adoptee may have extremely different levels of power, influence, and felt safety within their birth country vs. the United States, within their first family vs. their adoptive family; within their home community vs. an unfamiliar community, so on and so forth. We consider how the internet and social media make these experiences with power even more rich and complex.

Across all Levels of Human Interaction: We approach every adopted person, and every lens, as having the possibility of experiencing support and empowerment - or - discrimination and harm when they interact with others: individually, within relationships and family, within groups and communities, and with national and global political and social worlds.

Across History: We approach every adopted person, and every lens, by understanding that their experiences are part of a long history of adoption across the globe. We learn this history and how it has laid the foundation for an adopted person's present experiences. We seek to understand how other past and present social injustices - such as racism, sexism, queerphobia, colonization, etc. - may intersect in that adopted person's life.

Our version of adoption competence comes directly from adopted people as the primary source on adoption as an institution and as a deeply personal experience.

As I mentioned, these above lenses and considerations are just part of how we work to see and understand the experiences of adopted people so that we can serve them best. The full model of what we do is encompassed in part by my doctoral scholarship and capstone. It's far too much for one introductory blog post and I promise we'll keep touching on this topic into the future.

It's so important to note that adoption competence also guides us in working effectively with first/birth parents, foster parents, donor parents, gestational carriers, donor conceived youth and adults, foster youth and former foster youth, guardians, kinship families, step-families, siblings of adoptees, and more. However, in this introductory post, we wanted to keep our discussion adoptee-centric. Adopted people are the direct recipients of adoption.

You'll notice how much I've spoken about adoption-competence as being a way of seeing, knowing. However, I haven't spoken much about any specific behavior - what does adoption competence look like in action? This was intentional on my part and another way I want to emphasize how adoption-competence is different from past approaches to working with adopted people that historically have not worked. Why?

Adoption-competence is a lens and way of knowing that influences how we interact with adoptees and their families. However, it is not a modality. It is not a step-by-step model in a manual. It is not a special therapy that approaches being adopted as a disease or condition to be treated. There absolutely are anti-oppressive and empowering practice techniques and skills that I think benefit adopted people. We'll save those for future posts and we talk a lot about them in the trainings we offer at Roots Incorporated.

To summarize just the parts of adoption-competence I've introduced here, adoption-competence is a mental framework that helps us build the right approaches for each and every adopted person and family that we meet. That could be adoption-competent EMDR or TFCBT. It could be an entirely customized treatment plan that integrates a variety of approaches that work for that adopted person. Adoption-competence helps us create a safe, warm, empathetic, transformative, liberating, and inviting space where adopted people can include their adoptive identity and adoption-related trauma without fear of being wounded for doing so.


Amanda Woolston, MSS, LCSW, CT is a co-owner, lead therapist, and practice director of Therapy Center for Transformative Growth in Parkesburg, Chester County, Pennsylvania. There, she works with folks with a variety of needs. A significant portion of her professional work is dedicated to post-adoption support and adoption-competent practice. Amanda has worked on a variety of adoption issues for the past 13 years through clinical work, group work, community organizing, scholarship, teaching, and writing. She has written/edited/contributed to one dozen books on adoption.


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