International Social Work

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Family context for emotional recovery in internationally adopted

children
Jesús Palacios, Maite Román, Carmen Moreno and Esperanza León
International Social Work 2009; 52; 609
DOI: 10.1177/0020872809337679

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International Social Work 52(5): 609–620
i s w
Sage Publications: Los Angeles, London, New Delhi, Singapore and Washington DC
DOI: 10.1177/0020872809337679

Family context for emotional recovery

in internationally adopted children

Jesús Palacios, Maite Román, Carmen Moreno

and Esperanza León

Adopted children join their new families bearing a host of difficulties

derived from their previous adversity. Their problems have now been
widely documented, particularly in research on intercountry adoption
(ICA). Of particular importance to our purposes here are the difficult-
ies found in the area of attachment after experiences of institutional
deprivation. Research has shown that adopted children show fewer
secure and more disorganized attachments than non-adopted children,
but has also documented significant improvements in children’s devel-
opment after a period spent in their new family environment (Van den
Dries et al., 2009).
So far, adoption research has been more concerned with outcomes
than processes (Palacios and Brodzinsky, 2005). Much more is known
about the recovery that children undergo after adoption than about the
context in which it occurs. What type of family environment do adopted
children encounter that triggers their noteworthy improvements?
At the very beginning of adoption research, Kirk (1964) identified
a ‘role handicap’ in adoptive parents: they not only lack role models
of behaviour, but also encounter negative attitudes in others. More-
over, a high proportion of adoptive parents have experienced ‘the many
pains of infertility’ (Higgins, 2003), the impact of which may, for
many years, according to Raphael-Leff (2003), permeate every aspect
of their lives. Then, what comes to these couples deemed handicapped

Key words attachment disorders attachment security intercountry

adoption mind-mindedness

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610 International Social Work volume 52(5)

and troubled are children considered to be damaged by the wound of

separation and loss plus the adversity of their early experiences. Can
any good be anticipated from this combination of two supposedly
harmed trajectories?
Recent empirical research is producing a more positive portrait of
adoptive families. Compared with parents in general, adoptive parents
tend to have higher levels of education and income, and have lived
longer together before becoming parents (Hellerstedt et al., 2008;
Palacios et al., 2007). They have more resources from family and friends
(Cohen et al., 1993), express more marital satisfaction in the transi-
tion to parenthood (Levy-Shiff et al., 1991) and manifest more family
cohesion (Lansford et al., 2001). Also, adoptive parents make a greater
investment in their children’s health (Case and Paxson, 2001), spend
more time with (Lansford et al., 2001) and allocate more economic,
cultural, social and interactional resources to their children (Hamilton
et al., 2007). This advantageous context could be the environment in
which adopted children make their noticeable progress.
Our research question here focuses on the context of adopted chil-
dren’s improvement within the domain of attachment. Very little is
known about this. In the past, Hoopes (1982, quoted by Brodzinsky
and Huffman, 1988) found that adoptive parents (especially mothers)
reported being more protective of and careful with their children than
non-adoptive parents. They were also rated higher in areas such as
parent–child relatedness, acceptance of the child, praising of the child,
affection and warmth. Compared with them, non-adoptive mothers
acknowledged greater feelings of irritability with their children and a
greater sense of self-sacrifice.
More recently, those findings were confirmed by Priel et al.’s (2000)
study of maternal self-reflectiveness, in which adoptive mothers, com-
pared with their non-adoptive peers, showed a more complex descrip-
tion of the child, more positivity and uniqueness, and had more thoughts
about the child as a source of enjoyment. However, Priel et al. (2000)
found that adoptive mothers scored low, compared with non-adoptive
ones, in mothers thinking about themselves as mothering a specific
child and the meaning attributed to the parental role.
The data reported here stem from a project in which changes in attach-
ment and social competence following adoption are studied in a group
of children who were born in Russia and adopted into Spanish families.
Of interest are two aspects of the family context considered to be rele-
vant to the changes under scrutiny: the parents’ attachment security/
insecurity and the parental reflective functioning about the perceptions
of the child, the experience of parenting and parent–child relationships.

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 Palacios et al.: Family context for emotional recovery 611

The choice of children adopted from Russia seems appropriate as,

according to Van den Dries et al. (2009), Eastern European adoptees have
more difficulty in forming secure attachments than children from other
regions. The choice of parents’ attachment security/insecurity is justi-
fied by the well-known existence of an intergenerational transmission of
attachment patterns (Van IJzendoorn, 1995). Finally, the parental reflective
functioning about the child, parenting and relationships has been suggested
to be one of the mechanisms through which the parents’ attachment style
influences their children’s attachment style (Bernier and Dozier, 2003) and
has been found to be related both to parents’ attachment style and parents’
behaviour towards their young children (Slade, 1999).
In our study we expected that: first, after experiencing nurturing,
loving relationships with their parents, adopted children would, at least
in great part, recover from their initial attachment difficulties; second,
there would be no significant differences between adoptive and non-
adoptive mothers in terms of attachment security, as this trait is the
result of significant emotional relationships that probably are more simi-
lar than different in the two groups; and third, because adoptive parents
are prepared to interact with children with more complex emotional
needs, we expected them to exhibit more complex reflective function-
ing about their children, themselves as parents and their relationships.

Method
Participants
The participants in the study were 30 adoptive parents and 30 biologi-
cal mothers who served as a comparison group. The adoptive families
were contacted through two agencies that specialize in adoptions from
Russia and the comparison group was contacted through schools in the
same region. The children were between 4 and 8 years of age at the time
of the study and had been at least nine months in their adoptive homes.
Their average age was 38 months on arrival and 74 months at the time
of the study (the non-adopted children’s average age was 72 months).
The parents identified the adult who spent more time with the child. This
was the mother in all cases in the non-adoptive group and in all but four
cases in the adoptive group, in which the father was interviewed. The
groups were matched for educational level (76% of the adoptive parents
and 67% of the non-adoptive mothers held university qualifications).

Procedure
The families were interviewed and observed in their homes. Infor-
mation was also collected from the children’s teachers, who were visited

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612 International Social Work volume 52(5)

at their schools. The data reported in this paper refer only to part of the
work done with the parents.

Measures
Children’s attachment disorders The study of the children’s serious
difficulties with attachment was carried out using the Minnis’ Relation-
ships Problems Questionnaire (RPQ),1 a 10-item checklist of attach-
ment disorder behaviours of both the inhibited and disinhibited types
described in DSM-IV (Minnis et al., 2007). Sample items are ‘Gets
too physically close to strangers’ (disinhibited behaviour) and ‘Some-
times looks frozen with fear, without an obvious reason’ (inhibited
behaviour). For each one, there are four possible responses (‘exactly
like my child’, ‘like my child’, ‘a bit like my child’ and ‘not at all like
my child’), scored 3, 2, 1 and 0 respectively. The adoptive parents
answered two versions of the RPQ, one phrased in the past tense refer-
ring to their child on arrival (Cronbach’s alpha = .82), and the other
phrased in the present tense, referring to their child at the time of the
study (Cronbach’s alpha = .64). The non-adoptive mothers responded
only to this latter version (Cronbach’s alpha = .67).

Parent’s attachment security/insecurity This construct was explored

using the secure base script concept proposed by Waters and Rodrigues-
Doolabh (2001) and Waters and Waters (2006). The concept of the script
has been proposed as a means of analyzing the structure and functionality
of the internal working models of attachment. Individuals with a personal
history of secure base support represent in their memory a secure script that
will then be readily accessible in relevant situations. Attachment-related
scripts have been found to be stable over time (Vaughn et al., 2006) and
to influence both mother–child interactions (Bost et al., 2006) and the
child’s attachment (Verissimo and Salvaterra, 2006).
Once established, the secure base script will underpin generalized
expectations about close relationships and will be used to organize
attachment-related narratives. In order to elicit those narratives, Waters
and Rodrigues-Doolabh (2001) constructed six prompt word sets, four
to elicit the secure base script and two neutral ones. Of the first four,
two refer to mother–child interaction and two to adult–adult interaction.
Parents are requested to make up a story using the prompt words
(Waters and Waters, 2006). The narratives are scored on a 7-point
scale indicating the extent to which the passage is organized around the
secure base script. Scores of 3 or lower indicate the absence of a secure
base script and are considered as insecure.
Two trained coders,2 blind to the group each subject belonged to,
coded all four of the non-neutral narratives produced by each subject,
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 Palacios et al.: Family context for emotional recovery 613

with a reliability of Cohen’s k = .75. The summary scores allotted by

each coder to each individual were then averaged to give the parent’s
final security/insecurity score.

Parental reflective functioning Reflective functioning is a narrative

manifestation of the person’s mentalization capacity (Fonagy et al.,
1991) to understand one’s own and others’ behaviour in terms of under-
lying mental states (intentions, feelings, thoughts, desires, beliefs).
Parental reflective functioning or ‘mind-mindedness’ refers to the par-
ents’ capacity to reflect upon their own experience as parents and upon
their child’s experience. According to Slade (2005), presumably, it is
the parents’ internal working model of their child and of their child’s
mental experience that will help them to ‘mentalize’ and thus regulate
their relationships and the child’s internal world (Fonagy and Target,
2005). Maternal mind-mindedness has been found to remain stable over
time (Theran et al., 2005), and to be related to both the mothers’ attach-
ment styles and their mothering behaviour (Bernier and Dozier, 2003).
Parental reflective functioning is typically explored using the Parent
Development Interview (PDI), a semi-structured clinical interview.
For this study, a modified version developed by M. Steele and her col-
leagues in the Attachment in Adoption Research Project (Steele, Hodges
and Kaniuk, principal investigators) was used, with all the adoption-
specific items omitted for the interviews with the non-adoptive mothers.
The parents’ narratives were coded using the Experience of Parenting
Coding System developed by Henderson et al. (2007), which yields
three main groups of codes: parent affective experience codes (anger,
need of support, guilt, joy/pleasure, competence, confidence, level of
child focus, disappointment/despair, warmth, attachment awareness-
promotion, hostility), child affective experience codes (child aggression/
anger, child happiness, child controlling/manipulating, child affection,
child rejection) and global codes (parental reflection on relationships,
overall coherence, richness of perceptions, description of relationships,
parent discipline styles). For each of the specific contents there is a
quantitative score, and only parent discipline style is categorical. Two
trained coders3 scored 10 percent of the narratives, with total agreement
(Cohen’s k of 1) for the parent discipline styles and k = .88 for all other
codes. Each coder then scored half of the remaining protocols.

Results
For the attachment disorders on arrival, the average score of the
adopted children was 9.1 (SD = 5.8). Taking into account that what the
RPQ uncovers is a clinical condition, this score suggests a relatively
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614 International Social Work volume 52(5)

meaningful presence of serious attachment difficulties on the children’s

arrival. Around half (47%) of the adopted children scored higher than
10 on arrival (20% scored 15 or higher). No significant differences
were found relating to age on arrival or gender.
For the same adopted children, the average score about three years
later was 4.0 (SD = 3.6), which marks a statistically significant differ-
ence from scores on arrival, t = 5.98, p < .001. Only two adoptees had a
score higher than 10 (in both cases, 11). The correlation between scores
on arrival and at the time of the study was also significant, r = .59,
p < .01, the implication being that those who arrived with more symp-
toms of attachment disorder tended to be ranked higher around three
years later, but with significantly reduced scores. In fact, the RPQ scores
at the time of the study did not differ for the adopted and non-adopted
children in the sample (for the latter, mean score of 3.7, SD = 3.3).
Regarding the parents’ attachment security scores, out of a maxi-
mum score of 7, the average was 3.75 (SD = 0.88) for the adoptive
parents and 4.29 (SD = 0.66) for the non-adoptive mothers, with
significant differences between the groups, t = –2,715, p < .01. No sig-
nificant differences were found in the two narratives elicited by the
adult–child word-prompts and in one of the two adult–adult word-
prompts (camping trip), but the difference was significant in the other
one (car accident) (4.48 for non-adoptive mothers compared with 3.56
for adoptive parents). Compared with 90 percent of non-adoptive
mothers, only 60 percent of adoptive parents scored 3.5 or higher, c 2(1) =
7.20, p < .01. Whereas the non-adoptive mothers’ security scores were
independent of their children’s age (r = .16), in the case of the adop-
tive parents the security scores were lower for those whose children
were adopted at an older age (r = –.44, p < .05) and also for those
whose children were older at the time of the study (r = –.47, p < .01).
With respect to parental reflective functioning, the adoptive parents
scored higher than the non-adoptive mothers in a number of positive
specific dimensions within each of the first two groups of contents
(parental affective experience and parental perception of the child’s
affective experience), whereas the non-adoptive mothers scored higher
only in less positive (the need for support/self-nurture) or clearly nega-
tive contents (the degree and expression of anger). As for the global
codes, the adoptive parents obtained higher scores in all contents, with
the exception of parent discipline styles, with no differences.
In adoptive parents, the higher current scores in their children’s attach-
ment disorder indicators correlated only with perception of a greater need
for support (r = .39, p < .05) and more acknowledgement of guilt feelings
(r = .48, p < .01). In non-adoptive mothers, there were significant positive

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 Palacios et al.: Family context for emotional recovery 615

correlations between the children’s serious attachment difficulties and

the anger with the child and the relationship felt (r = .42, p < .05) and
shown (r = .44, p < .05). Also, in these mothers, children’s indicators
of attachment perturbations correlated negatively with feelings of joy,
contentment and happiness in the relationship (r = –.45, p < .05); per-
ceived competence in coping with their children’s difficult behaviour
(r = –.45, p < .05); understanding of attachment-related issues and ability
to behave in ways that promote attachment in the child (r = –.51, p < .01),
and the perception of their children as happy (r = –.37, p < .05). It then
seems as if adoptive parents were more able to reflect on their children’s
attachment-related difficulties in a way that did not interfere with their
positive thoughts and feelings towards their children.
In the case of adoptive parents, it was the age of the child, more than
the symptoms of attachment difficulties, that correlated with the parental
reflective functioning. The adoptive parents of children who were older
on arrival perceived them to be less affectionate (r = –.45, p < .05), and
adopted children who were older at the time of the study were seen by
their parents as being less happy (r = –.47, p < .01), less affectionate
(r = –.38, p < .05), experiencing more disappointment/despair (r = .38,
p < .05) and hostility (r = .48, p < .01). Also, the longer the child had
lived with the adoptive family correlated significantly with a parental
perception of a greater need for support (r = .46, p < .05) and less satis-
faction with the received support (r = –.55, p < .01).

Discussion
The results of this study add to the extant literature showing that chil-
dren adopted internationally arrive with the sequelae of their previous
adversities, and then undergo a noteworthy recovery after experiencing
a nurturing, loving and stimulating family environment. In the present
study, a significant reduction in attachment disorder symptomatology
was documented, thus confirming our first hypothesis and the findings
of many others, as summarized in the meta-analysis by Van den Dries
et al. (2009). Within this context of clear amelioration, there continues
to be a significant correlation between scores on arrival and some three
years later, showing that the improvements in the new family circum-
stances do not set the children’s counter to zero so that their life starts
again from scratch, a fantasy often found among adoptive parents.
Our second hypothesis predicted no differences in attachment security
between adoptive and non-adoptive parents. There are no norms for the
attachment script scores, but the mean in other studies for non-adoptive
parents was 3.8 (Vaughn et al., 2006), similar to the average score of

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616 International Social Work volume 52(5)

the adoptive parents in our sample (3.75). Contrary to our expectations,

however, the non-adoptive mothers scored higher in attachment secur-
ity than the adoptive parents. Although small, the difference was
statistically significant.
Two speculations are offered to explain the unexpected lower aver-
age score for the attachment script of the adoptive parents. One would
be that the average scores were already lower at the time of adoption.
Perhaps the struggle with infertility or the uncertainties which are
inherent to the adoption process had an adverse impact on the way that
these parents perceived themselves. One source of feelings of secur-
ity is being competent or having mastery over one’s environment
(Pietromonaco and Feldman Barrett, 2000). It is this aspect that could
be affected by the circumstances leading to adoption. For instance, in
the very successful preparation courses that prospective adopters in
southern Spain must attend, they are routinely exposed to the difficul-
ties and challenges that adopted children may pose as a consequence of
their previous adversity. While this is something they need to know, it
could at the same time raise concerns regarding personal competence to
meet their future child’s needs.
A second possibility would be that the differences were not there
initially, arising only later as a result of parenting children with attach-
ment disorders. This seems more plausible to us. The parents who
adopted older children and those who were parenting older children
showed lower scores in terms of their attachment security, whereas no
connection was found between the attachment scripts scores and the
age of the children in the case of non-adoptive mothers. The litera-
ture on the intergenerational transmission of attachment has typically
focused on the top-down processes by which the relationships with the
parents shape the children’s attachment experiences and internal work-
ing models. But perhaps bottom-up processes could also be at stake:
parenting an emotionally challenging child and not seeing the chal-
lenges completely met after long efforts, could have an undermining
effect on one’s perception of personal parenting efficacy, thus affecting
internal working models of attachment. Although this speculation needs
further empirical evidence, the type of bi-directionality we are suggest-
ing has been demonstrated in domains such as temperament (Wachs
and Kohnstamm, 2001).
Our third expectation was that parenting a child with more complex
needs would give rise to a more complex parenting reflective function-
ing. Indeed, this hypothesis was fully confirmed, as the adoptive par-
ents had higher scores than the non-adoptive mothers of comparison in
most of the domains explored. The adoptive parents’ mind-mindedness

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 Palacios et al.: Family context for emotional recovery 617

regarding their children, their relationship and the parenting experience

seems more articulate and is more positive than that of the non-adoptive
mothers. In the case of the non-adoptive mothers, indicators of attach-
ment difficulties have been found here to be related to a number of
negative processes (more anger, less joy/pleasure, etc). Perhaps the
adoptive parents were better prepared to face attachment-related diffi-
culties, or maybe the challenges posed by their adopted children trigger
a reflective functioning that is more sophisticated and more positive.
However, for them, when adopted children are older at arrival, when
they get older after adoption and when they have been living together
for longer, more problems seem to emerge. Our expectation that the
security scores of adoptive and non-adoptive parents would be similar
had been very coherent with this picture. However, albeit with a small
difference, the adoptive parents’ attachment security scores were, on
average, lower than the non-adoptive mothers’ scores. This difference
seems intriguing and needs further clarification. The fact that adopting
older children or currently parenting older children is related to lower
security scores suggests that, rather than being a pre-existent difference,
it develops as a consequence of the parenting experience in which the
age of the child is involved. This reduction in security, perhaps through
being so small, does not prevent adoptive parents from developing
reflective thinking about their children and about themselves as parents
that is likely to help them in their efforts to stimulate their children’s
development.
An implication of our findings is connected to professional inter-
vention with adoptive parents. The data presented in this article suggest
that adoptive parents manage to help their children to overcome their
more complex emotional needs. We have speculated that adopting older
children and parenting adopted children who are older can reduce one’s
personal feelings of competence, with an impact on the adoptive par-
ents’ security scores. Perhaps adoption preparation and post-adoption
support should take this possibility into account, helping adoptive par-
ents not only to facilitate their children’s recovery and development,
but also to protect themselves from feelings of incompetence. Also, it is
possible that adoption preparation and post-adoption support are more
focused on how to help children during the first phases of their integra-
tion into the new family, and are less concerned with the later stages of
adoptive family life. Expanding the focus of both adoption preparation
and post-adoption support could make an important difference in these
parents’ and their adopted children’s lives.
There are a number of limitations to our study. Our sample size is
small, is restricted to children adopted from Russia and refers to a

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618 International Social Work volume 52(5)

limited age group (children aged 4–8). But the data reported here
represent only a small portion of a project with many more measures
for both children and parents, plus data collected also at the children’s
schools. We argue that the relatively small sample size can be compen-
sated for by the rich information obtained.
We do not have information about the children’s attachment styles,
but only about their symptoms of attachment disorder as reported by
parents. And while the recorded parent–child interactions are analyzed,
we can only report data reflecting parents’ inner characteristics (attach-
ment security, mind-mindedness), but not their behaviour towards their
children.
These limitations notwithstanding, we hope that the data presented
here may help to improve our understanding of adoptive families and,
in particular, to inform the professional interventions aimed at helping
adopted children and adoptive parents.

Acknowledgements
The study reported in this article has been funded by the Spanish Ministry
of Education (project SEJ2006–12216/PSIC) and by the Swedish National
Board of Health and Welfare. This article was written while the first author
was a Visiting Scholar at the Department of Social and Developmental
Psychology, Faculty of Social and Political Sciences, University of Cam-
bridge, UK, funded by the Spanish Ministry of Science and Innovation
(grant PR2008–0291).

Notes
1. The authors are grateful to H. Minnis for providing the latest version of the RPQ and
helping with translation and scoring issues.
2. The coders were trained by M. Verissimo and B. Vaughn, to whom the authors remain
very grateful.
3. The coders were trained by Miriam Steele, to whom the authors remain very grateful.

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Jesús Palacios, to whom correspondence should be addressed, is Professor in

the Department of Developmental Psychology, University of Seville, Calle Camilo
J. Cela s.n., 41018 Sevilla (Spain). [email: jp@us.es]
Maite Román is Assistant Professor in the Department of Development
Psychology, University of Seville, at the same address.
Carmen Moreno is Associate Professor in the Department of Development
Psychology, University of Seville, at the same address.
Esperanza León is Assistant Professor in the Department of Development
Psychology, University of Seville, at the same address.

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