Supporting Your Adopted Child's Mental Health: A Guide for Families
You love your child completely. You've built a home, a life, a family together. And yet — something sometimes feels complicated in ways you weren't fully prepared for. Maybe your child has big emotions that seem to come out of nowhere. Maybe they pull away when you try to get close. Maybe they ask questions about their birth family that you don't know how to answer, or go quiet in ways that worry you.
If any of this sounds familiar, you're not alone — and you're not doing anything wrong.
Adoptive and foster families are built on profound love. They're also built on profound loss — and understanding both truths at the same time is one of the most important things a parent can do for their child.
This guide is for every kind of adoptive and foster family. Whatever your child's story, whatever your path to becoming a family, the emotions explored here are real, valid, and navigable — with the right support.
Understanding What Your Child May Be Carrying
Before we talk about what to do, it helps to understand what adopted and foster children are often experiencing beneath the surface.
Adoptees often experience uncertainty regarding their identity, stemming from their biological lineage, adoptive family dynamics, and cultural backgrounds. Common emotional challenges include ambiguous loss, disenfranchised grief, and adverse childhood experiences, which can manifest as attachment difficulties and various mental health conditions such as anxiety and depression. Newport Institute
None of this reflects a failure of love. Behavioral strategies used for biological children may not be appropriate for a child with a history of childhood trauma and adoption. Each adopted child and family benefits from individualized assessment and support. Children's Hospital of Philadelphia
It's also worth knowing that the range of experiences is wide. Adopted children are a very broad and varied group, including kids adopted at birth, kids adopted after experiencing abuse, kids who were exposed prenatally to alcohol and drugs, and kids who had excellent prenatal care. Creating a Family There is no single adopted child experience — there is only your child's experience, which deserves to be understood on its own terms.
The Reality of Adoption Loss and Grief
One of the most important — and often least discussed — aspects of adoption is grief. Not because adoption is a sad story, but because it is a complex one.
Every adoption exists due to a profound, impactful separation from a child and their birth family. Even in the most loving, ethical, and intentional adoptions, something important was lost: familiar voices, sensory experiences, rhythms, genetic mirrors, cultural continuity, or imagined futures. C.A.S.E.
Therapists and researchers use the term ambiguous loss to describe this particular kind of grief. Ambiguous loss — a feeling of grief or distress combined with confusion about the lost person or relationship — is a normal aspect of adoption. Families Rising It's called ambiguous because unlike the loss of death, there is no clear ritual, no acknowledged mourning period, and often no social permission to grieve at all.
The lack of recognition from others of adoption loss leads to what is called disenfranchised grief — a loss that's not openly acknowledged, socially mourned, or publicly supported. The adoption constellation — adoptees, birth parents, adoptive parents — are often suffering from disenfranchised grief to varying degrees. National Council For Adoption
This matters because when children receive the message that their loss should be minimized, they try to hold it in instead — and grief will always come out in one way or another. National Council For Adoption Children who don't have space to grieve may express that grief through behavior: withdrawal, anger, anxiety, or testing the limits of your relationship with them.
What Grief Can Look Like at Different Ages
Adoption grief doesn't always look like sadness. It shifts and resurfaces across development in ways that can catch families off guard.
Children may not have the words to explain their loss, and they may express it indirectly — through anger, sadness, withdrawal, anxiety, questions about identity, or big feelings that seem to come "out of nowhere." These expressions don't mean that anything is wrong. C.A.S.E.
Even children adopted before age one, who have no conscious memory of their birth parents, may experience symptoms of ambiguous loss as they approach their teens Families Rising — a time when identity becomes a central developmental task. Questions that seemed settled in childhood often resurface with new urgency in adolescence.
This is not regression. It is growth — and it is an invitation to go deeper together.
What the Research Tells Us About What Helps
Here is something the research makes very clear, and it is worth reading twice: your warmth as a parent is one of the most powerful protective factors available to your child.
Warm adoptive parenting at 21 months post-placement was associated with fewer emotional and behavioral difficulties at three years post-placement. Higher levels of parental warmth were associated with a meaningful reduction in both internalizing and externalizing problems — and this positive effect remained consistent over time. PubMed Central
Quality of family relationships, warm parenting, and family cohesion have been found to reduce the impact of pre-adoptive risk factors — including age at time of adoption, maltreatment history, and adverse childhood experiences — on adopted children's adjustment. PubMed Central
This doesn't mean being perfect. It means being present. Consistent. Curious about your child. Willing to sit with hard questions without trying to fix them immediately.
How to Support Your Child Day to Day
Make Space for the Full Story
Open communication builds trust. This means letting adoptees know — explicitly and repeatedly — that their questions, feelings, and mixed emotions are welcome. It also means being willing to revisit conversations as children grow and their understanding deepens. C.A.S.E.
Your child doesn't need you to have all the answers. They need to know the questions are safe.
Honor What They've Lost
Parents can help their children identify what they have lost: people and things in their lives, including birth family members, but also the loss of a birth name or surname, a hometown or birth country, the loss of a language, the loss of family resemblance. pact Naming the losses — rather than avoiding them — gives children permission to grieve and, through grieving, to heal.
Don't Ask Them to Choose Between Gratitude and Grief
Adopted children are sometimes told they should be grateful for their new life — but this is an unfair burden to place on them, expecting only joy and gratitude without recognition of the sadness and loss. National Council For Adoption Joy and grief can coexist. In fact, in adoption, they almost always do.
Do Your Own Emotional Work
When parents take responsibility for their own processing — whether through reflection, adoption-competent therapy, or a supportive community — they create more room to truly see and support their child. C.A.S.E. Your emotional capacity directly shapes the space your child has to feel safe.
Consider Specialized Support
One of the most valuable things a therapist can do when working with an adopted child is to work with the family as a unit — building and strengthening the connections between members and fostering stronger attachments. National Council For Adoption Not all therapists have training in adoption-specific experiences, so seeking someone adoption-competent makes a meaningful difference.
A Note to Foster Families
Everything above applies to you, too — and then some. Children in the foster system often carry compounded losses: multiple placements, repeated disruptions, the particular grief of family separation without permanency. For children placed in foster care, ambiguous loss tends to happen over and over again, and is incredibly hard to process. Families Rising
Your consistency, your calm, and your willingness to show up again after hard moments — these things matter more than you may realize.
You Don't Have to Figure This Out Alone
Parenting an adopted or foster child is one of the most meaningful things a person can do. It is also, at times, one of the most disorienting. The feelings you carry as a parent — confusion, exhaustion, love, grief of your own — are real and valid too.
Supporting adoption grief is not about choosing between gratitude and grief, love and loss, joy and sadness. It is about holding the full story with compassion and grace. When adoptive parents validate their child's experience, stay attuned, honor birth family connections, and keep communication open, they send a powerful message: You are allowed to be fully yourself here. All of you belongs. C.A.S.E.
That message — all of you belongs — may be the most healing thing your child ever receives.
And it starts with you believing it first.
At Dachtler Therapy, we offer trauma-sensitive, culturally humble support for adoptive and foster families in North Dakota and Minnesota — in person and via telehealth. Rooted in healing, growing together.
Sources
Children's Hospital of Philadelphia — Behavioral and Emotional Issues in Adopted and Foster Children
Newport Institute — The Mental Health Effects of Being Adopted
Creating a Family — Will My Adopted Child Have All Sorts of Emotional Problems?
Center for Adoption Support and Education (C.A.S.E.) — Supporting a Child's Adoption Grief and Loss
Families Rising — Ambiguous Loss Haunts Foster and Adopted Children
PACT: An Adoption Alliance — Ambiguous Loss
Nightlight Christian Adoptions — Ambiguous Loss and Adopted Children
National Adoption Council — Acknowledging and Dealing with the Impact of Loss and Adoption
Brandt et al., Development and Psychopathology (2021) — Charting the Trajectories of Adopted Children's Emotional and Behavioral Problems: The Impact of Early Adversity and Postadoptive Parental Warmth
Dalgaard et al., Campbell Systematic Reviews (2022) — Parenting Interventions to Support Parent/Child Attachment in Foster and Adoptive Families
