1st Edition

Handbook on the Clinical Treatment of Adopted Adolescents and Young Adults

Edited By Doris Bertocci, Christopher Deeg, Linda A. Mayers Copyright 2024
    364 Pages 4 B/W Illustrations
    by Routledge

    364 Pages 4 B/W Illustrations
    by Routledge

    This collection bridges the voices of international scholars and adopted persons to share knowledge about clinical practice with adopted people in adolescence and early adulthood.

    Coming at a time when countries are beginning to focus on adoption reform, this handbook is the first to address not only the external, systemic contributions to their developmental complexities but also the underlying, internal meanings of being adopted as children become adolescents and mature into adulthood. It explains how adopted clients differ from those not adopted and emphasizes the need for clinical research on adopted people in this older age group. Exploring how clinicians can understand their client’s clinical needs, it offers specific protocols and frameworks for assessment and necessary modifications in language and treatment. With a foreword by Miriam Steele, chapters examine the legal and sociopolitical cultures, policies, and practices in which adoption is embedded, calling for broad systemic change.

    Embracing theoretical, conceptual, and global perspectives, this handbook is written for clinicians in all disciplines, at all tiers of practice, administration, and training, identifying the key roles they can potentially play in expanding and better focusing our understanding of the psychology of being adopted.


    Miriam Steele, PhD

    Part I: Introduction- The Impact of the Adoption, Legal, and Mental Health Systems on the

    Development of Adopted Adolescents and Young Adults

    Doris Bertocci, Christopher Deeg, and Linda Mayers, Editors

    1. The Larger Context of the Systemic Contributions from Adoption, Family Law, and

    Mental Health: How They Relate to Clinical Practice

    Doris Bertocci and Linda Mayers

    2.Where are We Now? Trends and Observations After Five Decades of Adoption Study

    in the Netherlands

    Rene Hoksbergen

    3. Challenging Adoption Narratives: Adult Adoptees Write Remembrances – Four Australian Case Studies

    Catherine Lynch, Sue Green, and Alison Ingram

    Part II Developmental Complexities and Necessary Modifications for the Assessment

    4. Life Begins Before Adoption: The Primary Subsets of Adopted Persons as a Guide

    to Considerations for Assessment and Treatment

    Doris Bertocci

    5. The Adoptive Family Narrative and Its Effects on the Adopted Person’s Development

    Steven Nickman

    6. On the Inner World of the Adopted Person: A Psychoanalytic Conception of the

    Psychology of Adoption

    Christopher F. Deeg

    7. Shedding Light on Birth Fathers in Adoption: A Personal, Professional, and

    Academic Perspective.

    Gary Clapton

    8. The Ecology of Growing Up Adopted in India and Ireland: Measures of Mental Health with Implications for Clinical Practice

    Meera Oke, Sahana Mitra, and Valerie O’Brien

    III Considerations in Medical Care

    9. Adoption Medicine: Special Considerations in Pediatric and Adolescent Medicine

    and Young Adult Medical Care

    Elaine Schulte and Laurie Miller

    IV The Spectrum of Search and Reunion

    10. Revisiting the Meaning of the Search

    Doris Bertocci

    V Complexities of Psychotherapeutic Treatment

    11. Observations on Clinical Problems and the Need for Shifts in Perspectives

    Doris Bertocci and Linda Mayers

    12. Notes on the Psychoanalytic Treatment of the Adopted Person

    Christopher F. Deeg

    13. From Fragmented to Firm Foundations in Identity Formation: A Neurosequential

    Approach to the Treatment of Adopted Adolescents and Young Adults with Early

    Developmental Trauma

    Alan John Burnell and Jay Vaughan

    14. Similarities and Differences in Attachment Representations between Late-Placed

    Adopted and Non-Adopted Adolescents: A Study from Italy

    Cecelia Pace, Stefania Muzi, Fabiola Bizzi, and Donatella Cavanna,

    15. Countertransference Challenges in Working with Adopted Adolescents: Notes of An Analyst in Private Practice

    Anna Balas

    VI Epilogue The Editors


    Doris Bertocci, LCSW, is in private practice in New York after a long career in college mental health treating young adults at Columbia University. She had previously worked with birth mothers and adoption agencies and, in recent years, has been active in adoption reform. She continues to work in the interface of mental health, adoption, family law, and child custody litigation.

    Christopher F. Deeg, PhD, is a licensed clinical psychologist with over 30 years’ experience treating adopted persons of all ages and those related to them. He is trained in cognitive behavioral treatment, interpersonal therapy, psychoanalysis, and psychoanalytic psychotherapy. He has several publications on the psychology and treatment of adopted persons.

    Linda Mayers, PhD, is a licensed clinical psychologist and psychoanalyst in private practice in New York City and has worked for most of her career with adoptive families and adopted people of all ages. She is an adjunct associate professor at LaGuardia Community College, City University of New York. An ongoing interest is in the developmental complexities of adopted individuals throughout the life span.


    "This volume is a long awaited, expert and updated series of scholarly efforts to inform clinicians and other stakeholders regarding the painfully neglected population of adopted individuals. I particularly appreciate the in-depth attention to the often disruptive psychological sequelae of adoption as these individuals face the separation/loss experiences associated with the challenges of emerging adulthood. Individuals with adoption histories are over-represented in the emerging adult population seeking and needing residential and other forms of intensive treatment."

    Jesse Viner, MD, CEO & Chief Medical Officer, Yellowbrick Consultation & Treatment Center for Young Adults (Chicago, Ill.)

    "The Routledge Handbook on the Clinical Treatment of Adopted Adolescents and Young Adults is a unique and wide-ranging exploration of the challenges faced by adoptees negotiating the critical developmental stages of Adolescence and Young Adulthood. Unusual in scope, it critiques historic, systemic, and legal aspects of adoption, all of which integrate with life histories and personal biology to impact identity development in adopted persons. Chapters illuminating the internal, experiential world of adoptees provide perspective on developmental issues faced by all adopted persons, whether clinically presenting or not. Advocating for a sorely needed "psychology of being adopted" and for expanded training in this specialized field, this volume is a must-read for any mental health clinician or health care practitioner who sees patients with an adoption history."

    Susan C. Warshaw, EdD, ABPP, Editor in Chief of the Journal of Infant, Child and Adolescent Psychotherapy

    "There has been so much written about adoption that it is a striking scholarly accomplishment when a book brings a perspective that freshens the field and delivers on its promise to enhance assessment and treatment. Bertocci and colleagues weave their social work and psychological expertise and deep understanding of the field into an exploration of psychodynamic and systemic factors, simultaneously challenging the mental health of adoptees, using interdisciplinary and international research to bring new insights to bear on our understanding of adoptees’ needs over time and place. Perhaps most important, they center the experience of adolescence and young adulthood, bridging the more common focus in research on early childhood trauma and challenge with an insistence on the well-trained clinicians’ capacity to make a difference over the longer arc of youth."

    Marsha Kline Pruett, PhD, M.S.L., ABPP, Maconda Brown O’Connor Professor, Smith College School for Social Work, Northampton, Mass.

    "This groundbreaking book addresses a crucial gap in our understanding of the intersection of adoption and adolescent development. The authors illuminate the critical challenges posed for mental health, healthcare, and social service professionals and organizations by the psychological dilemmas experienced by adopted youths and young adults as they attempt to consolidate their sense of self while coming to terms with the loss of their original parents and uncertainty about whether they can accept, and be accepted by, their adoptive parents and family. The book also highlights the parallel process of fragmentation that must be reckoned by service providers and organizations when their clients are youths who have been adopted, and essential implications that the combination of psychological and systemic fragmentation poses for psychotherapists across a variety of theoretical orientations. By bringing these complex issues to light, and making these often invisible adopted youths and their families fully visible, this book does them, and the professionals who work with them, a vital service."

    Julian D. Ford, PhD, A.B.P.P., Professor of Psychiatry and Law, Dir. Center for the Treatment of Developmental Trauma Disorders, University of Connecticut Health Center

    "This long overdue Handbook highlights how adopted individuals have unique presentations, needs, and experiences compared with their non-adopted peers. Focusing largely on the adolescent through early adulthood cohort, the authors stress that, as a group, these individuals are also extremely heterogeneous. In this context, their profiles cannot be easily summarized or generalized. From various perspectives, the authors set forth the premise that clinicians and professionals who work with this population need to have a comprehensive understanding of potential influences – e.g., developmental, familial, social, etc. – on these individuals’ presentation during adolescence through early adulthood. In addition, they stress that adoptee-specific needs and experiences warrant consideration within larger systemic and societal domains so that adopted persons are able to be adequately assessed and receive appropriate care during the potentially turbulent 13-30 years of age and throughout their lives. The clinical and psychodynamic perspective of this Handbook is entirely consistent with my own lifelong experience providing comprehensive psychological evaluations using neuropsychological and projective instruments in hospital and private practice settings where adopted children, adolescents, and adults are seen. This is a must-read for those in the adoption, health and mental health fields."

    James L. Rebeta, PhD, Clinical Assistant Professor of Psychology in Psychiatry, New York-Presbyterian/Weill Cornell Medicine

    "Adopted adolescents often have a difficult journey to adulthood with a desire to know who they are and the need to reconcile their experience of not being with their birth parents and being raised in a family that feels different. As they seek to grow into their genuine selves thay are confronted by a therapeutic and legal system that fails to understand their needs and their challenges. Bertocci, Deeg, and Mayers’ Handbook of Clinical Treatment of Adopted Adolescents and Young Adults provides a guide expressly developed to address their inner struggles of these teens and young adults. It is rich in clinical approaches and the voices of these overlooked and poorly served young people. Those of us who care for them and the treatment programs they utilize need to learn from them and the dedicated and thoughtful authors in this volume so that we can truly understand and help these young people become the adults they can be."

    John Sargent, MD, Professor of Psychiatry and Pediatrics, Tufts University School of Medicine