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Abstract In the past two decades, social casework personnel, clinicians, and researchers alike have begun to pay increased attention to the psychological complications associated with adoption. Their attention has been prompted by numerous reports of high rates of referral of adopted children and youth to outpatient and inpatient mental health facilities. For example, although adopted children constitute approximately 2% of the total population of children in the United States (Zill, 1985), they represent between 4 and 5% of the children referred to outpatient mental health facilities (Kadushin, 1980; Mech, 1973) and between 10 and 15% of the children in residential care facilities (R. Colburn, personal communication, 1986; K. Donley, personal communication, 1986).
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