Book Review: Seven Core Issues in Adoption and Permanency

Book Review:

Seven Core Issues in Adoption and Permanency: A Comprehensive Guide to Promoting Understanding and Healing in Adoption, Foster Care, Kinship Families and Third-Party Reproduction

by Sharon Roszia and Allison Davis Maxon

reviewed by Susan Dusza Guerra Leksander, LMFT


When the concept of Seven Core Issues in Adoption was first introduced in 1988 by Deborah Silverstein, MSW, and Sharon Kaplan Roszia, MS, it was nothing short of radical. The concept proposed a framework—still in use today—for broadening and understanding the emotions experienced by everyone touched by adoption.  Whether adoptee or foster alum, first or birth parent, adoptive or foster parent, Silverstein and Roszia said that the terrain of adoption-land was bound to include issues of:

  1. Loss
  2. Rejection
  3. Guilt and shame
  4. Grief
  5. Identity
  6. Intimacy
  7. Mastery/control

Of course, the exact reasons one might struggle with these issues would depend on their triad position(s), but these key experiences are critical to understanding the adoption and foster care constellation. Silverstein and Roszia’s theory opened the door to recognition that adoption is complex and more than a “win-win” experience for all.

More than 30 years later, Roszia and co-author Allison Davis Maxon, LMFT, have published a book based on Roszia and Silverstein’s original concept. Seven Core Issues in Adoption and Permanency: A Comprehensive Guide to Promoting Understanding and Healing in Adoption, Foster Care, Kinship Families and Third-Party Reproduction ((Jessica Kingsley Publishers, 2019) builds and expands on the original foundation to shed light on the emotional landscape of adoption. The authors have more than 80 years of combined experience in the fields of child welfare, adoption and permanency, and Roszia is also an adoptive and foster parent.

The first half of the book (the focus of this review) sets out to introduce the framework, explain each core issue, provide examples of how each issue affects triad members, and offer interventions and tools for growth and healing. Each core issue chapter ends with a special note to professionals who are working with triad members, highlighting clinical considerations in providing therapy.

The second half of the book discusses how the seven core issues play out in unique ways in different communities, for example in kinship adoption, tribal communities, and LGBTQ families. These chapters are written by adult adoptees within those communities as well as by adoption professionals and/or adoptive parents, including some who offer insider insight and analysis on adoption with which Pact does not always agree. (For example, “White parents lose their white privilege when they adopt a child of color, especially if they adopt a black child.”) This review focuses on the first section of the book.

Rather than pathologizing the experience of adoption or triad members themselves, Seven Core Issues does a nice job of presenting the core issues as the natural consequences that arise when moving a child from one family to another. The authors go to great lengths to remind us that sometimes it is society’s assumptions or biases about adoption that make it harder to live the adoption experience. They also point out that some adoption professionals have caused harm when they have recommended practices that do not truly serve the adoption/foster care constellations. They write:

“The professional and community response to the disassembling and re-assembling of families may create additional problems. The building of families related to people’s desire to parent because of infertility and/or some moral imperative, as well as a child’s need for a family, has led to a practice that focuses on solving an immediate problem and often ignores the long-term impact on the individuals involved.”

Roszia and Maxon state their values strongly, including some which are probably controversial and unpopular in certain adoption and foster care circles. These include the belief that separating a child from their family of origin should always be a last resort; that adoption is not about finding children for adults; and that first/birth fathers matter. They do all of this as a way to orient readers toward a more truly child-centered adoption system and repair the mistakes of the past. Pact appreciates this perspective and finds it refreshing and admirable to see such strong advocacy for the voice of the child.

Decades of experience clearly inform their work and set the table for this latest offering. The new book is easy to read and relatable, with helpful concrete examples that support their theory. The vignettes are on point in illustrating the many ways that the seven core issues weave through the lives of the triad members. In one example, an adoptee in a restaurant sees wallpaper identical to that in his grandmother’s house, and suddenly he’s bursting into tears and talking about how much he misses her. We can see the clear connection between this example and the issues of loss and grief.

However, sometimes information is given without clarity as to whether it is the authors’ opinion, or based on established research. The chapter on intimacy, for instance, lists “four defensive coping strategies when intimacy is challenging,” which are named as “peace at any price,” “critical fault-finder,” “detached thinker” and “evasive distracter.” While these intuitively make sense to me (and I can identify mine and probably those of most people I know), it was challenging to evaluate the credibility of this section and a few others like it. Are these grounded in some other theories or previous research? Or is this just what the authors think? Despite this weakness, the authors and their theories do appear credible and grounded in their decades of work.

The authors are earnest and thoughtful in their desire to offer strategies for healing, so the book is not just a litany of the issues but a manual for addressing them. Roszia and Maxon offer some very targeted interventions for triad members to heal different core issues or to help children in addressing the core issues.

“Going back as far as you can remember,” the authors write about grief, “make a detailed list of everything you’ve lost in your life and in your journey to adoption and permanency…It is easier to grieve when you name the losses.” Or for intimacy: “Explore how adoption and permanency has affected your intimate relationships. What do you expect from relationships? What do you expect from yourself in relations to others? What fears do you have about getting close to others?”

At times, the authors could have benefitted from a less-is-more approach in making sure their suggestions are tailored and relevant. Some of their tools could be applied to anything. For example, “Be generous” as a tool for healing loss, or “happiness is living in the present and celebrating your blessings each day” as a way to heal shame and guilt both come off as somewhat generic advice and have the effect of undercutting the more powerful interventions suggested.

Overall, the first half of this book accomplishes its goal of offering “a unifying lens that is inclusive of all individuals touched by the adoption experience.” It even envisions a new illustration of the adoption triad. Instead of a triangle comprised of adoptees, birth/first parents and adoptive parents, all constellation members are gathered together in the middle, and the sides of the triangle are now the Seven Core Issues, Attachment, and Trauma, respectively.

That said, I would argue that there are some significant problems when approaching adoption with this unifying imagery/theory. While this new illustration touches on some of the potential benefits—such as greater empathy and less of an us-versus-them mentality between triad members—the authors fail to provide an analysis of the challenges and limitations of essentially saying that all people touched by adoption have the same feelings.

There is a fundamental difference of experience for adoptees and former foster youth who grapple with these issues from birth and/or childhood because of choices adults made for them, and that of first/birth parents and adoptive/foster parents who encounter these issues later in life (unless also adoptees themselves). For an adoptee, there is no “life before” the seven core issues; they are woven into the entirety of a person’s body and psyche from the outset. This is not captured in the author’s idealized depiction of the constellation, and failing to emphasize the importance of this experiential difference could lead to greater misunderstanding about the adoptee/foster youth experience.

Well-meaning birth/first or adoptive parents, for example, may feel like they “get” the adoptees in their lives because they’ve experienced the “same” things. This completely erases the reality that, for the one-third of the triad that experienced these issues from birth or childhood, it was because those very adults claiming to “get” them made choices that sent them to adoption-land. This, in contrast to the two-thirds of the triad that were typically adults, choosing to walk into adoption-land—even if the choice was very uninformed, misinformed or without any real alternatives.

Adoptive parents, for their part, enjoy the greatest amount of choice. Unless they were part of a sudden kinship placement, most people parenting foster or adopted children took many intentional, deliberate steps into adoption-land over the course of months and years, effectively saying again and again “I choose this.” When this pursuit of adoption is minimized or ignored—or given the same weight as the adoptee’s experience—statements by the authors such as “Everyone touched by adoption must lose something significant before gaining anything” ring hollow. Yes, many adoptive parents lost something before adopting – the ability to conceive, a pregnancy, other possible placements – but they had the power. “Seven Core Issues” shies away from addressing the inherent power differentials between adoptees and their parents, as well as between first/birth and adoptive parents.

There is certainly much to be said for greater empathy between all triad members. But an adoption theory that longs to say “we are all the same” creates barriers to accurate empathy. Because in order to have a neat and tidy unifying theory, the authors had to gloss over some important, albeit messy and complicated, differences. And, as a first mother and especially as an adoptee, I’m here to tell you that if you don’t see those differences, you don’t see me.

Despite this criticism, I would recommend this book to all those touched by adoption and permanency issues. For any triad member, it does offer a greater understanding of the ways the core experiences show up in their lives and relationships, as well as how other triad members are impacted. It is also helpful for professionals who work with these populations.

Susan Dusza Guerra Leksander, LMFT, is a Latina first mother, transracial domestic adoptee, and licensed psychotherapist who specializes in the adoption and foster care triads, providing treatment and consultations since 2009. When Pact became a licensed full-service adoption agency in 2017, Susan was appointed its founding Agency & Clinical Director, launching Pact’s Center for Race and Adoption Focused Therapy in 2021. She is on the ongoing complex journey of reunion with her first families and the daughter she placed for adoption.

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