Adoption-Specific Therapy in Practice
For individuals in the U.S. & U.S. territories
The process for adopting children, especially older children, can often bring a mix of feelings for both parents and child: happiness, anxiety, confusion, sadness and loss, and children may experience significant behavioral and emotional distress. Adoptive families can be helped by adoption-specific therapy that takes into account the child's past trauma and placement history, recognizing that current behavioral issues may have been adaptive in a previous traumatic, chaotic, or neglectful context.
In this program, Dr. Jill Waterman demonstrates the initial parent session of ADAPT, a manualized therapeutic approach that combines evidence-based treatments for children and families with best practices from the attachment and adoption literature. In ADAPT, both parents and children are seen for treatment individually and jointly.
In this video, Dr. Waterman demonstrates this approach with a young mother who has a 5-year-old adopted son.
ADAPT: Adoption-specific psychotherapy is a manualized treatment of about 24 sessions intended to help adopted children and their families by combining what we know about evidence-based treatments for children and families with the lens of the child's history and adoption dynamics culled from best practices and the adoption literature.
To best serve adopted children, especially those most at risk for serious behavioral and emotional distress, a treatment protocol that uses a trauma-informed adoption lens, and addresses behavioral, developmental, and attachment-related concerns while building on the child's natural resilience, coping, and competence is most useful.
These are some basic principles that underlie this approach to working with adopted children and their families:
- Adoptive families face unique challenges inherent in adoption and different from those in birth families.
- Adoption and reactions to it are not pathological. Loss is unique and pervasive in all adoption adjustment.
- Children must grieve their losses to form healthy new attachments.
- Adoptive parents need to respect and honor the child's previous attachments; children should not be asked to forget.
- Parents need to understand their child and the child's behavior in light of their previous history.
- Talking about adoption is positive and creates a healthy adjustment.
- Adoption is processed within a developmental framework.
- Adopted children need to feel accepted for who they are, with help in finding their own unique strengths.
- Adoptive families need all available information on the child.
- Children have the right to all information about themselves and their past, including difficult information, as is developmentally appropriate.
Jill Waterman is Adjunct Professor Emerita in the UCLA Psychology Department, and former coordinator of the UCLA Psychology Clinic, the training clinic for UCLA's top-ranked Clinical Psychology PhD program (Assistant Coordinator, 1981–1995; Coordinator, 1995–2013). After her retirement in 2013, she has been recalled and continues to work about 40%.
She was one of the initial developers of UCLA TIES for Adoption, an interdisciplinary program to support successful adoption from foster care of children with prenatal substance exposure and other high-risk conditions, and currently is the director of infant mental health at TIES (now called UCLA TIES for Families).
Dr. Waterman's research involves various aspects of adoption and child trauma, and she recently completed data collection for an online survey of adolescents and young adults who first entered the study 10–15 years ago and were followed intensively for 5 years after placement for adoption from foster care, and their adoptive parents.
Dr. Waterman founded and leads the TIES for Families Infant Mental Health project, a clinical and research program for infants and resource parents in concurrent planning.
Currently, Dr. Waterman is the lead author (along with colleagues Audra Langley, Jeanne Miranda and Debbie Riley) on ADAPT, an adoption-specific psychotherapy manual for older foster children and their adopting or adoptive parents that will be published by APA Books. The manual combines evidence-based therapy techniques with best practices in adoption treatment. The team recently finished collecting pilot data and has received funding for a trial of this modularized approach in North Carolina.
Additionally, Dr. Waterman is the author of 2 books on child sexual abuse as well as an evidence-based group treatment manual for at-risk middle school students and many journal articles.
Dr. Waterman co-chaired 21 dissertations through the department of psychology, and has provided clinical and research mentorship and consultation to hundreds of students over her 41-year career. She continues to provide clinical supervision to PhD students and postdoctoral fellows on psychotherapy with children and families, infant assessment, and parent-infant mental health treatment.
- Attachment Based Family Therapy
Guy S. Diamond
- Family Therapy Over Time
Susan H. McDaniel
- Functional Family Therapy for High-Risk Adolescents
James F. Alexander
- Helping Children Understand Adoption
Marc A. Nemiroff
- Individual Therapy From a Family Systems Perspective
Florence W. Kaslow
- Integrative Family Therapy
- Stepfamily Therapy in Practice
- Attachment-Based Family Therapy for Depressed Adolescents
Guy S. Diamond, Gary M. Diamond, and Suzanne A. Levy
- Family Therapy
William J. Doherty and Susan H. McDaniel
- Functional Family Therapy for Adolescent Behavior Problems
James F. Alexander, Holly Barrett Waldron, Michael S. Robbins, and Andrea A. Neeb
- Intervening in Children's Lives: An Ecological, Family-Centered Approach to Mental Health Care
Thomas J. Dishion and Elizabeth A. Stormshak
- Primary Care Psychology
Edited by Robert G. Frank, Susan H. McDaniel, James H. Bray, and Margaret Heldring
- Stepfamily Therapy: A 10-Step Clinical Approach
Scott Browning and Elise Artelt