Adoption practices have changed significantly over the course of the 20th century, with each new movement labeled, in some way, as reform.[152] Beginning in the 1970s, efforts to improve adoption became associated with opening records and encouraging family preservation. These ideas arose from suggestions that the secrecy inherent in modern adoption may influence the process of forming an identity,[153][154] create confusion regarding genealogy,[155] and provide little in the way of medical history.
Adoption is the legal process through which a child joins a family different from his or her birth parents. Adoption is a permanent, lifelong commitment to a child. In CPS cases, adoption becomes an option if CPS and the child's birth parents cannot resolve issues that made it unsafe for the child to live at home. Then, CPS may ask the court to end the parents' rights to the child and place the child with another family permanently. A child can also become legally free for adoption if both birth parents agree to give up their parental rights.

Adopting older children presents other parenting issues.[101] Some children from foster care have histories of maltreatment, such as physical and psychological neglect, physical abuse, and sexual abuse, and are at risk of developing psychiatric problems.[102][103] Such children are at risk of developing a disorganized attachment.[104][105][106] Studies by Cicchetti et al. (1990, 1995) found that 80% of abused and maltreated infants in their sample exhibited disorganized attachment styles.[107][108] Disorganized attachment is associated with a number of developmental problems, including dissociative symptoms,[109] as well as depressive, anxiety, and acting-out symptoms.[110][111] "Attachment is an active process- it can be secure or insecure, maladaptive or productive."[112] In the UK some adoptions fail because the adoptive parents do not get sufficient support to deal with difficult, traumatized children. This is a false economy as local authority care for these children is extremely expensive.[113]
Family plays a vital role in identity formation. This is not only true in childhood but also in adolescence. Identity (gender/sexual/ethnic/religious/family) is still forming during adolescence and family holds a vital key to this. The research seems to be unanimous; a stable, secure, loving, honest and supportive family in which all members feel safe to explore their identity is necessary for the formation of a sound identity. Transracial and International adoptions are some factors that play a significant role in the identity construction of adoptees. Many tensions arise from relationships built between the adoptee(s) and their family. These include being "different" from the parent(s), developing a positive racial identity, and dealing with racial/ethnic discrimination.[130] It has been found that multicultural and transnational youth tend to identify with their parents origin of culture and ethnicity rather than their residing location, yet it is sometimes hard to balance an identity between the two because school environments tend to lack diversity and acknowledgment regarding such topics.[131] These tensions also tend to create questions for the adoptee, as well as the family, to contemplate. Some common questions include what will happen if the family is more naïve to the ways of socially constructed life? Will tensions arise if this is the case? What if the very people that are supposed to be modeling a sound identity are in fact riddled with insecurities? Ginni Snodgrass answers these questions in the following way. The secrecy in an adoptive family and the denial that the adoptive family is different builds dysfunction into it. "... social workers and insecure adoptive parents have structured a family relationship that is based on dishonesty, evasions and exploitation. To believe that good relationships will develop on such a foundation is psychologically unsound" (Lawrence). Secrecy erects barriers to forming a healthy identity.[132]
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