Using the Seven Core Issues in Adoption and Permanency in Therapeutic Practice

What Are the Seven Core Issues in Adoption and Permanency?

Over the past several months we have featured the Seven Core Issues in Adoption and Permanency, exploring each issue in the framework. This article explores how some clinicians use the Seven Core Issues in therapeutic work with the adoptive, foster, and kinship families. I have asked several therapists, a clinical supervisor, a parent coach, and trainer for their input, in addition to my own experience.

As a brief review, the Seven Core Issues are Loss, Rejection, Guilt and Shame, Grief, Identity, Intimacy, and Mastery and Control. Using this framework can help to clarify, normalize, and remove pathology from feelings and behaviors common for constellation members. Goals of therapeutic support using the Seven Core Issues include better communication and connection, establishing synchronicity among family members, understanding underlying causes of feelings and behaviors, recognizing and naming grief due to loss, and recognizing the effects of trauma and broken attachments. It is important for clinicians and other helpers to be well versed in this framework to relate presenting problems to a core issue, correctly diagnose underlying causes and guide interventions.

How the Seven Core Issues Framework Supports Adoption-Competent Therapy

Adoption-Competent therapists agree that introducing parents, children, adult adopted individuals, first parents, and other constellation members the Seven Core Issues framework helps normalize their feelings about adoption, foster, and kinship care, recognizing each issue as being common and normal. This reduces the sense of intimidation that parents might feel about the Seven Core Issues allowing parents to see how they can hold the key to effective guidance for interventions that change or correct perception and reframe experiences. Understanding that each family member may be at a different place on the issues wheel can create space to repair communication and connection, name and grieve losses, and build empathy and support.

Grieving losses can open a pathway toward healing.

Normalizing Feelings and Behaviors in Adoption and Permanency

The Seven Core Issues framework is an effective tool to foster curiosity and self-exploration, validating experiences and providing insight into what may be underlying needs and ways to respond effectively. Creating a loss inventory and an attachment inventory can help with self-reflection and illuminate ways to repair miscommunication based on life experiences, individual perceptions and coping strategies.

The Core Issues are very helpful in working with adult adoptees and first parents, who may have never processed their adoption trauma and losses. Many never sought therapy before, or previously sought help from therapists who were not adoption competent, and the work they did missed the mark. Many didn’t even have words to describe their feelings over the years. Relating their feelings and behaviors to the Core Issues helps name and normalize them, often with an “aha” reaction, and hope for a path forward.

One therapist noted, “[I use the Seven Core Issues in Adoption and Permanency book] with teens who have a desire to deepen their understanding about the impact and feelings on adoption and relationships. I have even used it with a teen in being curious about what her birth mother’s experiences with shame, loss, and rejection might be.” This is so important, as teens struggling with identity need all the puzzle pieces to make their identity journey successful.

Therapists agree that teaching the Seven Core Issues to adoptive, foster and kinship parents helps them understand the needs behind behaviors and reactions in themselves and their children and repair fractured relationships. It helps them with self-reflection, understanding that they also have loss and grief issues, and can unhook them from feelings of guilt and shame about their parenting skills. Parents often have feelings of failure when relationships falter, and this understanding helps to reframe those relationships, and work toward harmony.

One adoption-competent therapist has found that the Seven Core Issues is also applicable in her Reflective Practice work with other populations, such as immigrants separated from their children, who experience loss of power, culture, physical and emotional safety due to trauma, exposure to violence, and fear of rejection. A combination of these issues also applies to our children adopted from other countries and many of our children who have experienced the foster care system.

The Importance of Adoption-Competent Training for Mental Health Professionals

Therapists and other helpers often find that colleagues who do not have Seven Core Issues knowledge, and are not adoption-competent, will take a more traditional diagnostic approach which can create conflict in mapping treatment. For instance, psychiatrists do not have an appropriate diagnosis in the DSM to use in assessments.

Children can be labeled with an incorrect diagnosis based solely on presenting behaviors, complicating the treatment process and often doing great harm. Therapists and other helpers may find themselves teaching colleagues, including county social workers and behavioral health clinicians, the Core Issues if they are receptive, and recommend that they seek training in adoption and permanency issues. While my purpose here is not to recommend treatment strategies, I will offer a few ideas. In considering the many ways that this framework can be used therapeutically, I recall one therapist’s creative way to help parents understand their child’s losses by using a sand tray. The child told their story, prompted by the therapist, illustrating it by moving symbolic figures to one side of the tray. As the figures piled up, the parents saw a visual representation of the people and places their child had lost, and it impacted them in a way that verbal recounting did not accomplish, enhancing their understanding of their child’s pain and need to grieve each loss.

Therapists may use and books to prompt discussion about feelings in response to plots and character interactions. The language used to describe and communicate about adoption and permanency is especially important, and therapists and other helpers can teach proper language and change negative perception. Groups based on the Seven Core Issues help to normalize feelings and experiences and provide role models for all members of the constellation.

Clinicians can take advantage of several training series offered by C.A.S.E. to begin building adoption and permanency expertise, including the Training for Adoption Competency (TAC) and the National Adoption Competency Mental Health Training Initiative (NTI). The book Seven Core Issues in Adoption and Permanency and the two accompanying workbooks by Sharon Roszia and Allison Davis Maxon are the definitive texts on the subject.

The Seven Core Issues provide an invaluable framework to be revisited over time, for understanding and healing, dealing with loss and grief, fostering attachment, and support for the lifelong journey of adoption and permanency relationships, which are always changing. There is no one and done on this lifelong journey.