Chaitra Wirta-Leiker, PsyD, had been part of a group practice for several years when she discovered a niche she felt compelled to pursue: adoption-related services.

The idea began percolating in 2011, when she was in the process of adopting a boy from Ethiopia. She realized she had a perspective that few others have: Not only was she an expert on childhood attachment and trauma issues, she was also an adoptee herself, born in India and raised by adoptive parents in Maplewood, Minnesota, and then Littleton, Colorado.

As she navigated the two-year adoption process, Wirta-Leiker realized that many parents needed more professional guidance on the issues involved in adoption. With this in mind, she began spreading the word about the services she could provide, including counseling, pre-adoption evaluations and parent coaching. To promote her services, she visited 20 adoption and home study agencies in Denver, handing out information about her new business, Beyond Words Psychological Services. She also offered adoptive parent education workshops that covered such topics as building healthy attachment with a child.

"The workshops were packed," she says. "Now I have a waiting list and my schedule is always full." All of her clients pay out of pocket.

Connecting with families

Families come to Wirta-Leiker with a variety of needs. Some, for example, need guidance on how to talk about difficult birth histories, such as biological parents who were incarcerated or abusive. "It's important that children not feel shame about their birth history or feel that they have to choose between their biological and adoptive families," she says. "Acknowledging that parts of the story are unfair or hard can help them begin to feel comfortable building a narrative of their story."

Other families work with Wirta-Leiker on the issue of white privilege. About 75 percent of her clients are adopting children from countries such as Korea, China, Ethiopia and Colombia, and the vast majority of these prospective parents are white. She talks to parents about how their children may feel, for example, if they can't find a bandage in their skin color or if they see primarily Caucasians in higher-level jobs. In the last year, Wirta-Leiker provided counseling to several transracial families who decided to move to more ethnically diverse areas so their adopted children would not feel like outsiders.

Wirta-Leiker's graduate work in counseling psychology laid the foundation for her understanding of these issues, but she has supplemented her training through classes offered by local adoption agencies and the Adoption Exchange, a nonprofit organization with locations in several states. She says she loves connecting with families and giving them the support she didn't have when she was growing up.

"The adoptees feel empowered when they realize that their experience is valid," she says.

When it's clinically relevant, she will disclose her personal experience to parents and adoptees. "For parents, it's helpful because I can give them insight into the struggles their child may be facing when the child is still too young to fully articulate what's going on," she says. For adoptees, sharing her story not only builds trust, but also gives them hope that they, too, can thrive if they learn to cope effectively with the struggles of being an adoptee.

A part-time approach

School psychologist Gary Matloff, PhD, also has personal experience with adoption that informs the adoption-related counseling and evaluation services he provides on a part-time basis.

"My greatest training has been raising my boys," says Matloff, who adopted his 9- and 12-year-old sons seven years ago.

Matloff's children were born in Brazil, where they were raised in extreme poverty, and were neglected and abused. Those stressors later manifested in such behaviors as lying, stealing and food hoarding once they moved in with Matloff. "I knew the behaviors were attachment-based, which made it easier to understand and problem-solve," he says. "By targeting their problem behavior early on, I could build trust by not reacting in the damaging and hurtful ways they'd experienced as young children."

Today, through his private practice Psyched4Kids, in Coral Springs, Florida, Matloff works with children, teens, prospective parents and existing parents on a range of issues, from pre- to postadoption, seeing clients after school or on Saturdays.

He tailors his treatments to each family's needs. For parents of younger children, for example, he counsels them to avoid certain types of consequences, such as "time-outs." These children have had "more than a lifetime worth of exclusion, so a better approach may be ‘time-ins' where the child helps the parent with a chore, like preparing dinner, to enhance bonding," he says.

He also consults with couples who are considering adoption. "I love those parents because they are interested in properly preparing to adopt," he says. "They will ask about the different types of adoption, such as whether they should adopt a baby rather than an older child, and whether an open adoption is a viable option."

Assessing prospective parents

Matloff also provides assessments for prospective parents who are pursuing international adoptions in countries that require these evaluations. After reviewing findings from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) and his own clinical interviews, he assesses the parents' suitability to parent a child through adoption.

Richmond, Virginia, psychologist Debbie Daniels-Mohring, PhD, also offers assessments for prospective parents, but her work is focused primarily on people who adopt from the foster-care system. She also trains these parents through classes offered by local social service agencies. Daniels-Mohring's adoption work makes up about 10 percent of her private practice.

She was introduced to adoption as an intern in graduate school at the Medical College of Virginia, where she was specializing in child clinical psychology and family systems. At the time, one of her professors was moving and asked if she was interested in taking over her adoption evaluations.

Soon after, Catholic Charities started sending Daniels-Mohring couples who needed to complete a psychological assessment as part of the adoption process. She uses the Beck Depression Inventory and a clinical interview to screen these couples.

"I'm trying to identify any patterns in families of origin that could become issues when parenting," says Daniels-Mohring, who honed her skills through training offered by APA and the nonprofit North American Council on Adoptable Children.

"For example, I may flag people with a long history of traumatic loss who wanted to adopt to resolve their grief."

She says she enjoys interacting with parents because so many of them want to help kids in need. "It also feels good to help parents gain some understanding about their adopted children. In the past, people who were adopting often felt like they were on their own. I can give them some tools and insights so that the process can go more smoothly," she says.

"No Insurance Required" is a Monitor series exploring practice niches that require no reimbursement from insurance companies. To read previous articles in this series, go to www.apa.org/monitor and search for "No Insurance Required."

Adoption by the numbers

  • 135,000
    Estimated number of U.S. adoptions in 2015
  • 53,000+
    Number of those from the foster-care system
  • 5,647
    Number adopted from other countries

Sources: U.S. Department of Health and Human Services; U.S. Department of State

Additional reading

Adoption Therapy: Perspectives From Clients and Clinicians on Processing and Healing Post-Adoption Issues
Dennis, L., 2014

The Connected Child: Bring Hope and Healing to Your Adoptive Family
Purvis, K., et al., 2007