Inside Mental Health Podcast: Adoption and Mental Health Issues

Episode Description

Adoption isn’t an unfamiliar concept in the United States. Popular culture has represented both realistic and unrealistic views of adopted children, adoptive parents, and families that differ from the “traditional.”

However, our knowledge and discussions of the mental health needs of the children involved seem to take a backseat. Concepts such as abandonment and trust issues, as well as the acknowledgment of trauma, often go unaddressed.

In this episode, we hear from two experts with over 40 years of combined experience in the adoption field. Together, they’ll help us understand the mental health needs for children — and adults — who have been adopted or are currently in foster care.

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Guest Bio

Debbie B. Riley, LCMFT is CEO and co-founder of The Center for Adoption Support and Education (C.A.S.E.), a nonprofit adoptive family support center in the Baltimore-Washington area. A nationally recognized adoption expert and dynamic public speaker, Riley is a licensed marriage and family therapist with 40 years of professional experience, including extensive expertise in designing and developing nationally acclaimed adoption-competent programs.

Riley received her Bachelor of Science in Family and Community Development and Master of Science in Marital and Family Therapy from the University of Maryland, College Park. She’s a co-author of the book, “Beneath the Mask: Understanding Adopted Teens” and “Adoption Specific Therapy, A Guide to Helping Adopted Children and Their Families Thrive”.

Rita Soronen has led the Dave Thomas Foundation for Adoption, a national nonprofit public charity, since 2001, and the Dave Thomas Foundation for Adoption-Canada since 2004. Soronen is a founding board member and past vice president of the Congressional Coalition on Adoption Institute and is a current member of the advisory board.

Soronen is a recipient of the Angels in Adoption Award from the Congressional Coalition on Adoption Institute, the National CASA Association Kappa Alpha Theta Program Director of the Year Award, the Ohio CASA/GAL Association Statewide Leadership Award, and was a 2013 recipient of WSNY’s 20 Outstanding Women You Should Know.

She’s a fellow of the Jefferson Fellowship for Executive Leadership, was awarded an honorary Doctorate of Community Leadership from Franklin University in 2016, was named a YWCA Woman of Achievement in 2017, was named a National Number One by the Columbus Foundation in 2018, and was honored with Smart Business Network’s 2019 Smart 50 Program Award for Impact, Giving Back to the Community.

A graduate of the University of Louisville, Soronen resides in Columbus, Ohio.

Inside Mental Health Podcast Host

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from the author.

To learn more about Gabe, please visit his website, gabehoward.com.

Episode Transcript

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.

Gabe Howard: Hello, everyone, and welcome to this week’s episode of the Inside Mental Health podcast, formerly The Psych Central Podcast. I’m your host, Gabe Howard, and I want to thank our sponsor. Better Help. You can save 10 percent and get a free week simply by visiting BetterHelp.com/PsychCentral. And calling into the show today, we have Debbie B. Riley and Rita Soronen. Ms. Riley is the CEO and co-founder of the Center for Adoption Support and Education (C.A.S.E.), and is a licensed marriage and family therapist with 40 years of professional experience. Ms. Soronen is a nationally recognized child welfare advocate who has worked for more than 30 years on behalf of abused, neglected and vulnerable children. Since 2001, she has led the Dave Thomas Foundation for Adoption and since 2004, the Dave Thomas Foundation for Adoption Canada. Debbie and Rita, welcome to the show.

Rita L. Soronen: Thank you.

Debbie B. Riley, LCMFT: Thank you.

Rita L. Soronen: We’re delighted to be here.

Gabe Howard: Longtime listeners of the show know that mental health issues affect everyone, but our individual life circumstances contribute to the impact of those issues and, well, how they manifest. Today, we are going to talk about adoption and the unique mental health challenges people who have been adopted face. Debbie, can you tell our listeners what unique mental health needs those who have been adopted have?

Debbie B. Riley, LCMFT: A lot has to do with the experience of their adoption, the age that they’re placed and earlier circumstances. But in general, we’ll see children struggle with loss and grief issues that then can lead to some form of depression. There could be anxiety when we are supporting children that have had a lot of moves in their lives, children who have entered foster care, children who have been placed internationally and living in orphanages. We also tend to see symptoms of trauma related to child abuse, whether it be physical or sexual abuse. So those are just a few to start the conversation.

Rita L. Soronen: Yeah, and I’ll just add as well that there are different kinds of adoption and the result of those different kinds of adoptions sometimes have different impacts on a child’s sense of self, a child’s connectedness to family and other relationships. So when you think about those really three kinds of adoption, domestic infant adoption, international infant or older youth adoption, and then adoption from foster care for those children who have been placed in care because of particular dynamics in their family, abuse, neglect or abandonment, all of those issues of questioning, where do I belong? Why did my family hurt me? Why did my family abandon me? What is my identity if I don’t know my birth parents? What is my identity if I do know my birth parents and I’m not allowed to live with them because in some way that home wasn’t safe? So all of those, when you think about the ages and stages of development of children, have profound impacts on each stage of how they think about themselves and how they connect to the world.

Gabe Howard: Rita, you mentioned that there were different types of adoptions, now I imagine that there’s probably just an infinite number of adoptions. Are those that you just mentioned, the main three, and do the mental health challenges differ? Do they have commonalities or is it just kind of a mixed bag?

Rita L. Soronen: I think the vast majority of those three we talked about, although you can also add to that step-parent adoption, certainly some families come together through that means. There is overlap in the impacts, but there are unique differences as well. Children who have been adopted internationally and they have lived for a certain period of time in an orphanage or children in the foster care system who perhaps in utero were exposed to substances and have issues in their early development that are impacting the workings of their brain or the trauma impact of abuse or the trauma impact of multiple moves. They all have unique to the child differences, but some commonality between those issues of neglect or abandonment or trauma or grief or loss. Probably those issues of grief and loss are most profound and most consistent across the kinds of adoption.

Gabe Howard: Debbie and Rita, I believe that I fall under step-parent adoption, it’s a little weird for me to consider my dad a stepparent. My mother was pregnant in high school and that relationship didn’t work out. When I was about two, she remarried and that man adopted me. And I always say he’s not my biological father, he’s my real father. And they went on to have two more kids who I don’t consider half brothers and sisters. There’s no steps in my family. And I feel, and I know this is a weird thing to say, I feel that I had the best case scenario in all of this. My mother is my biological mother, and I was adopted by a wonderful man who I consider 100 percent my father when I was two and is the only father that I know. All that to say, I still have abandonment issues, I still struggle with why did this man not want me? My question in all of this is, does anybody come out unscathed? Is everybody who’s put up for adoption, do they have these lingering trauma effects or mental health impact that we need to be aware of and ensure that we address?

Debbie B. Riley, LCMFT: We can’t ignore the emotional sort of significance of being adopted. The connections, where we came from, who we are. And, Gabe, you ask the question about, well, is anybody not impacted by adoption? And I would say that each person’s story is so unique and their experiences are unique. And how they manage that experience is unique. But what’s most important is that we acknowledge that there are the joys and challenges and that we need to provide a safe space for youth as they develop who are adopted to explore the issues that come along developmentally as well as for their families and others that are impacted by adoption. At C.A.S.E., we really try to normalize a lot of these issues. They’re just a part of being adopted.

Rita L. Soronen: I think the key is that we are aware of it and that there’s always that blood, that emotional, that psychological connection to who and where did I come from? And it’s not a negative. It’s how we’re wired as humans. And so that awareness of it, as well as access and acknowledging it and honoring that, rather than saying, oh, no, no, look, you’re in a good family. Ignore that. Forget about that father that you didn’t know. I think that’s probably not what we should do. I think if we acknowledge it, honor it, and then if there’s more work to be done, find appropriate resources and services so that it can simply become a part of who we are rather than a constant negative drag on our souls.

Gabe Howard: Up until now, we’ve been talking about my experience, right, the step-parent adoption, but there’s also foster care adoption and that’s much different. You spent time with another family and then you may move on to yet another family or another family before you’re adopted. What is that like? What needs do those children have?

Rita L. Soronen: Depending on the age at which they experience the reasons why they went into foster care, because children are when they’re going through the normal development stages of growth and maturation and brain development, different kinds of abuse can have different impacts on a child, depending on how old they are. The public may see, oh, look, foster care saves children from harmful families and we feel good about that at one level. But when you think about what the child is experiencing, no matter what that family is like, and we know that the majority of children go into foster care because of neglect, not because of physical or sexual abuse, but because of neglect, their needs aren’t being met. Their basic needs aren’t being met. But that’s what that child knows. And so when you take that child out of that home, there’s that first trauma, right. They may not have the best care in that home, but it’s the home that they know. And then they go into a stranger’s home and depending on their age and how conscious they are of all the things that are happening, it’s a very foreign environment with different rules and maybe a different school and a different set of friends. And then if that doesn’t work out because children can naturally act out, look, they’ve been put in a very strange circumstance.

Rita L. Soronen: They’re fearful, they’re angry. They’re wondering what the heck is going on. And so they push back and things don’t work out and they get moved again. And then we start compounding this trauma from the original abuse or the reason the child has left their biological home, we begin to compound the trauma.

Gabe Howard: Now, due to that trauma that you just discussed that many youth in foster care have endured, can you tell us like what mental and behavioral health issues there might be specifically so that the foster families or the adoptive family can get ahead of it and provide adequate mental health care for their new child?

Debbie B. Riley, LCMFT: Some of the children, obviously, because of what has occurred and the trauma might be going into the relationship with trepidation, fear, lack of trust, uncertainty, because bad things kept happening over and over again, they couldn’t trust adults to keep them safe. They respond to our interactions in a very different way. So there’s a sort of a skill set that then we call sort of therapeutic parenting skills that align with children who have experienced a great deal of trauma. Our job is to create a safety net, to be consistent, to be able to be with them when negative behaviors occur. People understand about giving kids time outs. We give time in, where we want the child to be with the primary caretaker, not be separated from them, because that’s what’s happened in the past.

Gabe Howard: Do adoptees struggle more with trust and abandonment issues than the rest of the population?

Debbie B. Riley, LCMFT: That’s a question that we get asked a lot. I think that trust is a primary issue for a lot of individuals that we treat. And it goes back to that discussion that we’ve been having around somebody didn’t want me. I was given away. I was taken away. I’m not worthy. And so future relationships at times become very compromised. There’s a fear for some that people will leave again. So there’s this holding back in formulating very intensive relationships, interpersonal relationships, or we’ll often see with some young adults where they may sabotage a relationship or terminate it early in fear that someone’s going to terminate before they do to protect themselves.

Gabe Howard: Along the same lines of the previous question, do adoptees have more feelings of isolation or not being accepted by their families? And I do imagine that it’s different person to person and each type of adoption. But where does that fall in?

Debbie B. Riley, LCMFT: Your question is about being accepted by the family? Feeling left out the family. Gabe, is that what you’re asking?

Gabe Howard: Yeah, it seems like the adoptees would feel more isolated and not a member of the family.

Debbie B. Riley, LCMFT: I think it’s careful not to generalize. Are there some situations where relationships need a lot more shoring up and attention given the early life experiences? Again, the child not feeling trusting in this situation? There’s a really interesting dynamic that we talk about and we actually teach families about this. It’s called claiming. So I do think that in adoptive families, particularly when you’re embracing older children, who’ve joined your family a little bit later and maybe there are other biological children in the family, that we work to help our children feel claimed. And an example of that would be, and it happens in all families. If you think about Thanksgiving dinner, what happens at that table where people might say you’re just like your Aunt Ruth, you love spicy food or you’re just like your dad, you leave your wet towels on the floor or you’re just like your mother when she gets nervous. You curl your hair with your finger. Those are things that our children need to hear more of to feel claimed. To really help the child feel that we are claiming you. You are our family. You are part of our family.

Gabe Howard: We’ll be right back after a word from our sponsors.

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Gabe Howard: And we’re back discussing the unique mental health challenges of adoptees with Debbie C. Riley and Rita Soronen. I think about my own situation, I’m a giant man, I’m six foot three, I have bright red hair and my father is a short little guy. He’s five foot three. He’s got black hair, small frame. And my mom is equally tiny with blond hair. When I was out in public, everybody looked at me and the first question they would ask me is, where did you get your beautiful red hair? I always struggled with answering that question. So when you say claiming somebody, that really speaks to me in a really big way. Is there more that can be done by the adoptive parents to ensure that they get that history? Because you can’t invent history, right. If you’re adopted and you’ve been in the family a month, it’s not like you can rely on the last vacation or well, when I used to change your diapers. Whew. You know, you think of all the stories that parents tell you to embarrass you when you start dating. How can we speed up that process?

Debbie B. Riley, LCMFT: It does take time, but it’s building new stories. You’re moving forward, but you’re also integrating. It’s like in any relationship, how do you merge aspects of each person’s history? And so it’s also very important that the prospective adoptive families try their best to learn as much as they can about their child’s history. Tell me more of your stories that become our story. So I look at as a very complicated, beautiful tapestry where we’re taking these threads and we’re weaving them all together to create this beautiful tapestry together.

Rita L. Soronen: And I would only add that it’s an ongoing education effort, too. So that teachers, when they say, hey, this week we’re going to do our family tree. And for those children who were adopted in that class, that family tree becomes a sticky and maybe trigger point. So making sure that the teachers understand that the language they use or the activities that they have may have an impact beyond what they thought was just a simple exercise. Or for our families that adopt across cultures, across races, they’re on the street, and someone looks at a black infant with a white family and says something insensitive about that. It’s that ongoing continuing education that the families are as diverse as the individual in this world. And to call out something different isn’t necessarily a good thing to do. And yet it’s also an educational opportunity that puts, unfortunately, a burden on families to help educate others around them that we are just a family. We may look different. We may have started differently than your family, but at the heart of it, we’re a family that’s come together.

Debbie B. Riley, LCMFT: Circling back to, Gabe, your experience of the red hair. And, Rita is right about the fact that there’s an education aspect here. And years ago we would see kids coming into therapy and we would start asking them questions about did anybody ever ask you anything about adoption? And the parents would shake their heads no. And the kids would shake their heads yes. And we began to hear exactly what you’ve described or what Rita was describing about people seeing the difference and calling it out and kids feeling really stuck on the spot. Like where did you get your red hair? And often the answer is, you know, I’m adopted. And there goes more to that. And I think under that is the world is very curious about adoption because at the core, they know that, and I want the audience to take this as I’m saying it, adoption doesn’t happen because of good things. There’s a story there.

Gabe Howard: I believe that a lot of these insensitive comments are due to misunderstanding or ignorance. What’s the best way to educate people without making them defensive, putting them on the spot, getting them angry or shutting down the conversation? Because I do believe we want people to ask more questions. That way we can educate them to what our lives are like or but I imagine it’s tough to also be the brand ambassador for adoption when you’re just trying to, you know, have dinner in public with your family.

Debbie B. Riley, LCMFT: You know, I didn’t have time to describe this program called W.I.S.E. Up!, which is an empowerment program we created because there was a void that we had children out there are being asked things that they either weren’t prepared to answer, they couldn’t answer or didn’t need to answer and didn’t know what to do. We teach parents and families and it really helps them deal with some of the adversity. And some of it is just out of people just don’t know what they don’t know. They don’t mean harm. Questions like how much did they pay for you? Why are you with this white woman? Is that your mother or is that your babysitter? Was your birth mom a, their language would be was your birth mother a whore? And that’s why you were adopted? So very insensitive questions that can really hurt the individual if we don’t empower them of how to manage it. There are four parts to this. It’s walk away, so a child can just walk away and not answer the question. You can say that’s private. I don’t want to talk about it or you can share something about your story. And the E stands for Educate. Somebody might say something really negative about foster care and I don’t have to share my own story, but we’re empowering our community, our foster care and adoption community, particularly the children, to be able to say some things back, to educate them about. Let me tell you about foster care or let me tell you what adoption means or let me tell you a little bit about who my family is. So you’re right, Gabe. I think education is just key to address some of the biases and misperceptions.

Rita L. Soronen: And from the Dave Thomas Foundation for Adoption from its inception in 1992, the first thing that we started was simply raising awareness, normalizing the conversation, giving people the tools to talk about, look, we know 60 percent of Americans are touched in some way by adoption, either personally through extended family, through close family, friends and colleagues. It happens a lot, but we don’t have the way to talk about it that everyone finds consistent or that understands. And so I think it’s on our shoulders, on C.A.S.E. and the Dave Thomas Foundation for Adoption and podcasts like this to open up the conversation, to help everyone understand the dynamics that, frankly, impact the majority of us in this country and how to do that with grace on behalf of the child and with joy on behalf of families, but not carpet it over and just ignore it as a conversation, but have it as much a part of a conversation as COVID is, as politics are, as anything else. We’re all going to bring different experiences to the table. But I think just the awareness and the increased awareness and the increased conversation about adoption, adoptive families, while recognizing and respecting that there are times that families just want to be private about what they are and who they are.

Gabe Howard: Now, Rita, you’ve led the Dave Thomas Foundation for Adoption since 2001, but the organization has existed a lot longer and it provides resources for adoptive parents and adoptees all over the country and into Canada. Can you talk about some of those resources in case our listeners need access to them?

Rita L. Soronen: You bet. One of our original resources is a beginner’s guide to adoption, it’s just a wonderful resource that if anyone is thinking about adopting, whether it’s international, domestic, infant or foster care, it can seem daunting dealing with government agencies or thinking about how do I even begin to address adopting a child from China or some other country. The adoption friendly workplace campaign, where we encourage employers, if you give benefits to families that are formed through birth, then you need to think about giving benefits to families that are formed through adoption. They have the same sometimes financial needs. They have the same needs for time off for bonding. Begin to think about how you provide benefits to families who adopt in the workplace. And we have all kinds of tools and resources for employers to do that. We were one of the lead founders and funders of the National Adoption Day initiative, the Saturday before Thanksgiving. Across the country, agencies and courts open up and celebrate this notion of adoption. When there’s press about the Smith family that adopted today in court, it helps normalize that conversation. Oh, look, my neighbor adopted. Maybe I can. I’ve been thinking about it, but maybe I can go ahead and step forward and adopt.

Gabe Howard: And Debbie, your organization, the Center for Adoption Support and Education, equally powerful. Can you tell our listeners about that?

Debbie B. Riley, LCMFT: Sure, we felt pretty strongly that there needed to be a very specialized place for foster and adoptive families to come to and that the support that they needed was different than generalized mental health support and other kinds of support. So C.A.S.E. is really unique in that we’ve built, and Rita termed this adoption competent, mental health services with a very specific lens, with a training of all of our therapists that now is moving national thanks to the Dave Thomas Foundation.

Gabe Howard: My final question is we’ve been talking a lot about mental health issues for adoptees and adoptive parents to handle and manage and work through, an exceptionally important conversation. But let’s talk about the positive side.

Debbie B. Riley, LCMFT: I think there are tremendous positive outcomes, and I think there are always going to be, as you talked about, your own personal journey, Gabe, these normal issues that are inherent in adoption, but the outcomes are so positive. I’m an adoptive parent. I have a 30 year old son doing great, adjusted. I want everyone to hear that adoption is another way to build a family, a beautiful way. The outcomes are really positive.

Rita L. Soronen: I couldn’t agree more. We’ve begun over the past few years at the Foundation of making sure that we video and highlight stories of just families who have come together through foster care adoption specifically for us, that’s our unique mission and focus. And people can see those videos on the website and see that these are just, again, families that absolutely are thriving. Does every family have issues at some point in their journey? Of course, if you had taken a lens to my family growing up and it was a biologically intact family, I guarantee you would have seen the issues of substance abuse and depression and dynamics that we needed to address. And we’re still addressing. Those are the dynamics of families coming together. Of course, they’re unique ones with children who are adopted and families who adopt. But we see such incredible success each and every day. We’re nearing ten thousand adoptions through our child focused recruitment program at the Dave Thomas Foundation for Adoption. We keep in touch with as many of those families as possible. They’re thriving. They’re doing exactly what families should do, dealing with those unique stages of children growing up and moving on to become thriving adults in their own right.

Debbie B. Riley, LCMFT: I know that there are families listening right now that might be considering adoption. And as Gabe said earlier, sometimes there’s misinformation out there. And I’m going to speak for both Rita and I that we want you to keep getting educated and keep considering building your family through adoption. It’s an incredible journey. We’re here as a resource. And all of our children deserve to be in a family.

Gabe Howard: And of course, being aware of the unique mental health challenges of adoptees, getting ahead of it, educating yourself, providing what they need, it sets your child up to lead the best possible life. And I think that’s the whole point of all of this, right? To make sure that we’re not just burying our head in the sand and pretending that adoptees don’t have special mental health needs, but rather addressing them, getting ahead of them and allowing them to lead their best possible life.

Rita L. Soronen: Absolutely, and making sure that we recognize and dispel the myths and misperceptions that do surround children, particularly in foster care, when you’re talking about a 15 year old that needs to be adopted and the public thinks they’re grown, they couldn’t possibly move into a new family. They’ll be fine if we let them age out on their own. We know that’s not the case. So simply addressing all of those core myths and misperceptions that we may have been carrying because of the images that we’ve seen or the stories that we read in the press. It is all about exactly what you said, simply being aware of it, educating ourselves, addressing it and honoring it, and then marching forward and making sure that every child, no matter their age, their circumstance, their journey, has the ability because they have the right to thrive and grow in a family structure.

Gabe Howard: Thank you, Debbie, Rita, so much for being here. I really appreciate it. And to all of our listeners, thank you. We literally can’t do the show without you. Wherever you downloaded this podcast, please subscribe, please rate, rank and review. Take a moment to use your words and tell other people why they should listen. Share us on social media or email us to your mental health loving podcast friends. My name is Gabe Howard and I am the author of Mental Illnesses Is an Asshole. And I’m also a prominent national speaker. You can of course grab my book on Amazon.com, or you can get a signed copy for less money and I’ll throw in some swag simply by visiting gabehoward.com. I’ll see everybody next Thursday.

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