A skilled therapist who has never thought carefully about adoption can still get it wrong. Not through carelessness, but because adoption asks questions that general training does not prepare a clinician to hold.
Families across the adoption kinship network use mental health services at high rates. A national survey published in 2025 by C.A.S.E. and PolicyWorks found that 86.2% of respondents across the network, including adoptees, adoptive parents, birth parents, and kinship caregivers, had engaged with mental health services, with rates above 89% among adoptees, adoptive parents, and birth parents. The network engages with services at roughly two and a half to three times the rate of the general United States population.
And yet only about one in five rated their clinician as adoption competent. In the same research, the therapist's specialized training with adoptive families was rated the single most critical factor in choosing a provider.
Earlier research found a similar pattern in usage: 17.71% of adopted people attend therapy compared with 8.76% of non-adopted people (Miller et al., 2000).
The demand is not the problem. The competence is.
Understanding relinquishment as a real event. Separation from a birth parent registers regardless of how early it happened or how loving the adoptive family was. A therapist who treats a good adoption as evidence that there is nothing to grieve has already missed it.
Not requiring gratitude. Many adoptees learn early that complicated feelings about adoption read as ingratitude. A competent therapist does not need the story to resolve into thankfulness.
Holding identity and race together. For transracial adoptees, questions of belonging and racial identity are not separate from the adoption. They are part of it.
Recognizing when adoption is relevant and when it is not. Attributing everything to adoption is its own failure. So is never raising it.
Understanding the whole constellation. Adoptees, adoptive parents, and birth parents each carry something distinct, and each deserves care that does not treat their experience as secondary.
Rachel Forbes, LCSW, founded Root & Return Wellness. As an adoptee, she brings lived experience and deep empathy to the complex layers of identity, belonging, and family systems. Her path to this work is both professional and personal.
That combination is genuinely uncommon, and it is the reason people travel further and wait longer for this kind of care.
Our therapists work with clients located anywhere in Connecticut. Sessions are virtual, with limited in-person availability in Madison, CT. Most clients begin weekly, and you and your therapist will decide together what rhythm supports your capacity. Many of our therapists accept Medicaid/Husky, Aetna, Anthem Blue Cross Blue Shield, and Cigna, and coverage varies by therapist.
