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Treatment Considerations for Adoption-Related Complex Trauma Jessica Reyka

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Treatment Considerations for Adoption-Related Complex Trauma Jessica Reyka National Louis University Digital Commons@NLU Dissertations 6-2019 Treatment Considerations For Adoption-related Complex Trauma Jessica Reyka Follow this and additional works at: https://digitalcommons.nl.edu/diss Part of the Clinical Psychology Commons Recommended Citation Reyka, Jessica, "Treatment Considerations For Adoption-related Complex Trauma" (2019). Dissertations. 377. https://digitalcommons.nl.edu/diss/377 This Dissertation - Public Access is brought to you for free and open access by Digital Commons@NLU. It has been accepted for inclusion in Dissertations by an authorized administrator of Digital Commons@NLU. For more information, please contact [email protected]. Treatment Considerations for Adoption-Related Complex Trauma Jessica A. Reyka, M.A. Florida School of Professional Psychology at National Louis University Christina D. Brown, Psy.D. Chair Marcia E. Pita, Ph.D. Member A Clinical Research Project submitted to the Faculty of the Florida School of Professional Psychology at National Louis University in partial fulfillment of the requirements for the degree of Doctor of Psychology in Clinical Psychology. Tampa, Florida May 9, 2019 The Doctorate Program in Clinical Psychology Florida School of Professional Psychology at National Louis University CERTIFICATE OF APPROVAL ___________________________ Clinical Research Project ___________________________ This is to certify that the Clinical Research Project of Jessica A. Reyka, M.A. has been approved by the CRP Committee on May 9th, 2019 as satisfactory for the CRP requirement for the Doctorate of Psychology degree with a major in Clinical Psychology Examining Committee: ________________________________________ Committee Chair: Christina D. Brown, Psy.D. ________________________________________ Member: Marcia E. Pita, Ph.D. Abstract The western culture holds many assumptions related to adoption; however, it is clear based on the research provided that adoption and the circumstances leading up to being adopted often leave the child traumatized. Many adopted individuals and adoptive families seek mental health services in order to help address some of the symptoms that have manifested through traumatic events. However, the services they are receiving are reportedly lacking in basic knowledge related to adoption and have, at times, done more harm than good. As clinicians, it is important to acknowledge one's scope of clinical competence and to only treat individuals that fall within that scope. Adoption-related training is rare, unless one seeks out specific training to become a certified adoption-competent therapist. There are numerous treatment modalities and interventions that have been and can be adapted to use with the adopted population, however it is highly recommended that therapists become competent in working with adopted individuals and families prior to treating adoption-related complex trauma. i TREATMENT CONSIDERATIONS FOR ADOPTION-RELATED COMPLEX TRAUMA Copyright ©2019 Jessica A. Reyka, M.A. All Rights Reserved ii DEDICATION This dissertation is dedicated to all of the other wolves in the herd of sheep that have remained true to themselves and continue to fight the good fight. This is also dedicated to my parents who have continued to be my biggest fans through all of my endeavors, thank you for always seeing my abilities even when I couldn’t. iii ACKNOWLEDGEMENTS I would like to acknowledge Dr. Christina D. Brown for the continued support throughout my graduate program and for the time and dedication you have put into helping this project come to fruition in the midst of chaos. iv TABLE OF CONTENTS Abstract ................................................................................................................................ i DEDICATION ................................................................................................................... iii ACKNOWLEDGEMENTS ............................................................................................... iv CHAPTER I: INTRODUCTION AND HISTORY OF ADOPTION ................................ 1 Overview of Adoption ............................................................................................ 1 History of Adoption ................................................................................................ 4 Assumptions about Adoption .................................................................................. 7 Adoption is a joyous event for all involved ................................................ 8 Adoption parallels genetic birth experience and a biological family life ............................................................................................................... 8 Once adopted, all of the child’s problems disappear and there will be no additional challenges .............................................................................. 8 Creating a family through adoption is “false,” only biological families are “real ....................................................................................................... 9 The adoptive life is better than the biological life the child had or would have had ......................................................................................... 10 Closed adoptions are in the best interest of the child................................ 10 Challenging Assumptions about Adoption ........................................................... 10 Prenatal trauma/genetic makeup ............................................................... 13 Pre-adoptive risks, effects, and outcomes ................................................. 13 Post-adoptive risks, effects and outcomes ................................................ 15 Protective factors, effects and outcomes ................................................... 15 Overall outcomes of being adopted .......................................................... 16 Long-lasting effects into emerging adulthood and ................................... 16 Statement of the Problem ...................................................................................... 18 v Purpose of the Study ............................................................................................. 18 Research Procedure ............................................................................................... 19 Research Questions ............................................................................................... 20 CHAPTER II: UNDERSTANDING ADOPTION-RELATED COMPLEX TRAUMA . 21 Complex Post-Traumatic Stress Disorder ............................................................. 21 Developmental Trauma Disorder (DTD). ................................................. 21 Adoption-Related Complex Trauma ......................................................... 22 Prenatal Trauma ............................................................................ 23 Neurobiology/Genetics. ................................................................ 25 Pre-adoptive/Post-Natal Risks ...................................................... 27 Post-adoptive Risks ....................................................................... 32 CHAPTER III: EFFECTS OF ADOPTION-RELATED COMPLEX TRAUMA ........... 43 Attachment ............................................................................................................ 43 Internal Working Models ...................................................................................... 47 Identity .................................................................................................................. 48 Biopsychological Effects ...................................................................................... 53 Substance Abuse ................................................................................................... 54 Loss and Grief ....................................................................................................... 55 Shame, Rejection & Guilt ..................................................................................... 57 Symptoms in General ............................................................................................ 59 CHAPTER IV: TREATMENT CONSIDERATIONS FOR ADOPTION-RELATED COMPLEX TRAUMA ......................................................................................................................... 61 Theoretical Perspectives on Adoption .................................................................. 61 Psychodynamic theory .............................................................................. 61 Social role theory ...................................................................................... 62 vi Family systems theory .............................................................................. 62 Attachment theory ..................................................................................... 63 Stress and coping theory ........................................................................... 63 Why Adopted Individuals May Seek Services ..................................................... 64 Adoption Competent Therapy........................................................................................... 67 What is an Adoption-Competent Therapist?......................................................... 67 Assessment considerations........................................................................ 68 Diagnostic considerations ........................................................................
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