Research shows that 12% to 14% of adopted of all adopted children in the United States between ages 8 to 18years of age are diagnosed with a mental health disorder each year. (Guarino, 2017). Within the U.S. children in the 2.5 percent margin are adopt by family members, while 1.5 percent of the adopters are not related to the child (Sadock et al., 2014). The implications of adoption for the emotional and behavioral adjustment of children have been an issue in child welfare for many years. (Brand & Brinch, 2014).
                                                Psychological issues associated with Adoption
There is a psychological toll of adoption on everyone involved in the adoption process. “Adopted children are almost twice as likely as children brought up with their biological parents to suffer from mood disorders like anxiety, depression, and behavioral issues.” (Guarino, 2017)
Past research has suggested that adopted children are over-represented in mental health settings. (Brand & Brinch, 2014). However, there is an increase in mental health disorders among adopted children and this may be because of a lack of preparation on the part of both the adopted parent and the child involved. “Some studies have suggested that adopted and nonadopted children differ on measures of social, emotional, behavioral, and cognitive functioning.” (Brand & Brinch, 2014). Accommodating and adjustment factors in the adopters and the adoptees, have been known to have an effect on the emotions of both parties.
Most effective assessment measure that could be used, and explain why
The most effective assessment measure that can be used in reducing the incidence and prevalence of mental health disorders among adopted children is involving the whole family in the adoption process. The family if involved is able to detect any signs of mental health issues in the adopted child. Also, if the family is involved, they are able to help with the treatment process and the support the child and or adolescent may need.  There are other assessment tools that have been can be used in assessing the mental health of adopted children and this includes The Narrative Story Stem NSSTs and the Diagnostic Interview for Children and Adolescents (DICA-R). An assessment that can give a more thorough unmasking of a child’s experiences and personal issues is the NSSTs (The Narrative Story Stem). In this assessment, a child is asked to finish story arcs given by the conductor of the interview (Tang, et al., 2018).
                                      Treatment options available for children and adolescents in adoption
There are different treatment options available for children and adolescents who have been adopted. Depending on the severity of the disorder, the children can have psychotherapy or Pharmacotherapeutics treatment and in some instances, both treatments. Careful assessment, diagnoses, and treatment are important when it comes to these children as they may need more emotional help than the average child.
                                                         Influence of culture on treatments in Adoption
Culture appears to influence every area of one’s life. There are different attitudes and perceptions when it comes to mental disorders in different cultures. Cultures play a major role in who people are and are a very strong thing to eradicate or change. Depending on the culture from which the child is adopted and the culture into which they are going, mental health disorders can occur. As PMHNP, it’s important to carefully evaluate adopted children and adolescents with mental health disorders to ascertain whether it’s the effect of the culture that is causing the disorder or its organic and or other causes.
As PMHNP, it important our values and beliefs are not projected onto our patients. Our culture and perceptions about what a family is should not impair our judgment and also on how we view our clients. We should be opened in our practice and in cases where we are uncomfortable with issues at stake, can refer our client to another provider. Our goal is to cause no harm and to provide the best that we can for our clients.
Brand, A.E., & Brinch, P.M., (2014) Behavior Problems and mental health contacts in
            Adopted, foster, and nonadopted children.
Guarino, G., (2017) Adopted Children often face Mental Health Struggles as Young Adults

Adopted Children Often Face Mental Health Struggles as Young Adults

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry:
 Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Tang, E., Bleys, D., & Vliegen, N. (2018). Making Sense of Adopted Children’s Internal Reality
Using Narrative Story Stem Techniques: A Mixed-Methods Synthesis. Frontiers  Psychology, 9, 1189. doi:10.3389/fpsyg.2018.01189

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