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Attachment and Adolescence

Dear Adoptive Families,

The new year 2013 is at the door. I take the chance to wish our adopted Chinese children and their families a happy and healthy new year. I also want to thank all adoptive families for your great parenting for so many years. Endless bottles. Endless diapers. Endless parent/teacher meetings. Endless trips to doctors’ offices. I could not thank you enough for what you have been doing. You are very special people and you are the best parents.

In recent years, we have received numerous emails and phone calls updating us on how the children are doing and inquiring about issues children may face as they enter their teenage years. Even adoptive families who adopted through other agencies have called with concerns about their teenagers. Thank you for your trust. We are inspired by your love and commitment to your children, our children. Although I understand the majority of our children are doing well and are continuing to thrive, I want to take the chance to share with you some of my thoughts on these issues. I hope to learn what kind of support we can draw from each other throughout our children’s adolescence. You and your children will go through this process no matter how hard it is. I just hope that together we can make the process easier and more meaningful.

Part one: How this subject came to our attention

The American government issued 12 entry visas for the adopted Chinese orphans in 1988 (China Center of Children's Welfare and Adoption, interview). According to the Adoption Institute, 115 visas were issued in 1991 (www.adoptioninstitute.org/factoverview/international). About 66,630 Chinese children were adopted into American homes between 1999 and 2011 based on the statistics provided by the Congressional Coalition on Adoption Institute website (www.ccainstitute.org/why-we-do-it-/facts-and-statistics). While it is hard to find the total number of Chinese adoptions that have taken place in the United Stated, it is estimated between 90,000 to 100,000.

Since 1996, our agency has placed more than two thousand children from the Chinese orphanages. As these children grow older, the agency has received more and more inquiries from adoptive parents. One father complained that his daughter was rude and not respectful. One parent brought her teenage daughter to visit our office hoping that I could convince her daughter that she was beautiful. One twelve- year-old girl wrote to us hoping to learn more about her birth parents. Several weeks ago we received an e-mail that started out like this: "I adopted my daughter back in 1998. At first it was an amazing experience. Once she became a middle school age child it was and continued to be a nightmare!"

As the agency became more aware of these growing concerns, it felt like overnight we received countless brochures about workshops and seminars on the correlations between adoptees’ developmental issues in late childhood and adolescence and their early institutional experience with malnutrition and deprivation before adoption. The fees for these workshops could be as high as $375 for just one full day's event. One family who had been searching for treatment for her child sent us a website from the Wolf Creek Academy. On their website it states that:

Anyone who has suffered early abuse, neglect, or frequent change of their primary caregivers may also suffer from attachment disorder. The caregiver’s lack of responsiveness to the child may serve to promote such insecurity and later leading to attachment disorders. As children get older and enter their teen years, you may begin to see the traits widen and manifest in various ways. Rebellion, disrespect, lying and stealing, lack of remorse for their actions, an inability to properly engage with the family, as well as anti-social behaviors seen outside the home, may become the ‘norm’ for the teen. The teen will have difficulty forming healthy, long term relationships with friends or family members and be content to move from one friend to the other once they have ‘burned the bridges'. (Nov. 10, 2012, pp. 1-2)

Suddenly, an uplifting image of parenting has turned grim. The concerns that have built over all these years suddenly seem very real and close. What sort of damage has been done to our children during their early stay at the orphanages? Many families choose to adopt from China because the birth family is not in the picture. How do the birth parents influence the parent-child attachment during adolescence? We have a parent who adopted thirteen years ago. Soon after getting home, she called us to say that her daughter had no signs of attachment problems which had been her greatest fear before the adoption. This year she called our office to tell us that: “I have read endless amounts of literature about Reactive Attachment Disorder and she meets all the criteria!”

The concerns and doubts seem to stem from the fact that the child was adopted, so the logical conclusion is that the attachment issues are adoption related problems. But, is it possible that it actually does not have much to do with inadequate orphanage care, the birth parents, or the adoptive parents? Could the challenges and difficulties that these adoptive families face actually be similar to the ones that birth families face with their teenage children?

The purpose of this writing is to explore the identity forming process in the adolescence period and to review the research on the application of the attachment theory and its implications on the parent-adolescent relationship for families with children from China. This is not an academic paper but I have quoted books and research papers in order to borrow credibility for my thoughts. The intended audience for this paper is our adoptive parents-- all of you are living these experiences, and many of you are professionals in the child development area. This writing is a stone to attract your jade. Let us help each other and let us support our children-- before when they were little, now when they are adolescents, and in the future when they become adults. We are here anytime they need us.

In order to clearly define the subject, there are several factors that need to be addressed. First of all, the orphanage care in the Chinese welfare system does not necessarily cause reactive attachment or disorganized attachment disorders. Our agency’s social workers have visited the Chinese orphanages and concluded that while the care in the orphanages was provided on adults’ terms, the children's basic needs were indeed met. For example, the children were fed every four hours, and given water every two hours, etc. The children were able to build trust with their care providers. A significant amount of research has proven this notion and it is commonly accepted that most internationally adopted children do not have attachment disorders once being adopted into middle class families (Zeanah and Gleason, p. 15). In 1975 Dong Soo Kim conducted adoption outcome studies on 451 families who adopted Korean children through the Holt International Children’s Services. He used the measures of self esteem, personality integration and adjustment and concluded that both the adoptive parents and the children were content with their lives (Silverman, A. p. 107-108). Secondly, the early childhood healthy attachment is very important and it is likely that it dictates the child's life-long trust and attachment style. With that said, parents grow older and children transition into different life stages. They face various challenges and have different emotional needs. People's understanding of what is a healthy attachment may change. Thirdly, the parent-child relationship is the most important one in human life. Parents have always been and will continue to be the giving and receiving party in this relationship. Regardless of the children’s temperament and personality and their particular experiences during adolescence, it is the responsibility of the parents to guide them through this difficult early adolescence period and reach the identity achievement stage. Lastly, the early adolescence period by nature is the exploration period in identity achievement. While the children’s vulnerability and rebellious behaviors reach its peak, it also presents a window of opportunity for the parents to work on the children’s emotional needs.

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Part Two: Attachment theory and its development

What is attachment? According to Berk, “Attachment is the strong affectionate tie we have with special people in our lives that leads us to feel pleasure when we interact with them and to be comforted by their nearness in times of stress” (p. 196). Ainsworth defines it as “A deep and enduring emotional bond that connects one person to another across time and space” (Lamp and Lewis, P. 473). Traditionally the attachment theory only applied to the infant-caregiver relationship. In 1969, the British psychiatrist John Bowlby provided a detailed explanation on the infant attachment development with parents, mostly mothers. This theory is based on the survival needs of infants and responsiveness and styles the care givers have to meet their needs. The infants develop Internal Working Models that are labeled as healthy or unhealthy attachments. The consistency and sensitivity of the care helps form healthy attachment. To test this model theory, Mary Ainsworth in 1978 developed a testing method and provided another important concept called “Security Base.” This notion described how the children use the attached adult as a safe base to explore other relationships (Lamb, pp. 473-474).

In the past thirty years, there have been some new developments in the research and application of the attachment theory. First, researchers have found that the attachment styles are influenced by important life events such as parental divorce, death of attached figure, etc. (www.attachmentexperts.com/adultcouple.html). A second aspect focuses on the relational nature of the attachment disorder. The research centers around how the caregiver’s unresolved attachment problems from previous relationships, as well as the social settings where the attachment occurs, can affect the development of an attachment disorder (Asten et al, pp. 3-4; Boris et al, p. 17). The third aspect is the new knowledge gained from the application of the attachment theory to other human relationships that arise throughout different stages in the life span such as adolescence, marriage, and mourning. For example, the concept of TRUST was introduced as part of the “Internal Working Model” (Barrocas, p. 11). As children grow older they are able to play a more active role in forming the attachment because they become more vocal and learn how to express their needs.

Baumrind's Model of Parenting Styles received new interest when measuring adolescence attachment (Lamb and Lewis, p, 486). Baumrind labeled four parenting models: authoritarian, authoritative, permissive, and nonconformist. Authoritative parents encourage children's independence and attempt to shape their children's behavior by rational explanation.

Strength and weakness of the attachment theory is obvious. Its most striking strength from the adoption viewpoint is that it is a needs-satisfaction model, not a biological model. The theory has in itself the potential to develop into an intervention theory. The expansion of the attachment theory from a more emotional developmental perspective of parent-infant relationship to a more cognitional and social perspective of human development has provided the possibility for new understanding of human interactions. When both sides in an attachment process have the same capability level of cognition and communication, the knowledge and skills contributed to the attachment process become measurable for social work understanding and intervention.

The weakness of the traditional attachment theory is its methods: it was developed through observation. Its first weakness is hard to prove because the party who receives the diagnosis is children who have no socialized vocabulary to explain their experience. Therefore the theory is adult-centered. Secondly, this theory is not able to accurately assess care givers' parenting behavior for lack of measurable standards. Because of the inherent weakness, many researchers put their time and energy into validating the theory without satisfactory conclusions.

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Part Three: Early Adolescence

Adolescence is a well studied area in the western society because for a long time it was deemed as a unique phenomenon that only occurred within industrialized society. Adolescence is commonly accepted as the period of time between 12 and 18 years of age, although some theorists expand this age limit to the late twenties (Arnett, p. 27). The most drastic period for females is the onset of the menstrual cycle, between 12 to 14 years of age. There are four important changes that happen during this time:

Biologically, puberty changes the children’s body and sexual features become evident. Gender roles, beauty standards, and peer acceptance by same and different gender groups can cause a lot of pressure on appearance. Another important biological development happens in children’s brain. According to Berk:

"Sensitivity of neurons to certain chemical messages changes. In humans and other mammals, neurons become more responsive to excitatory neurotransmitters during puberty. As a result, adolescents react more strongly to stressful events and experience pleasurable stimuli more intensely – but have not yet acquired the capability to control these powerful impulses" (p. 367).

No wonder teenage children become more sensitive and self centered!

Emotionally and socially, children in early adolescence start the process of independence by gradually detaching from their parents. The transition from dependency to individualism is a strong value that parents encourage but also have a hard time to accept (Allen & Land, p. 320). Adolescents spend less time with family members and more time with their peers. Peer acceptance becomes more important when they seek support and understanding. At home, negotiating roles is an ongoing task that is constantly changing.

In summary: "The biological, social, and cognitive changes associated with puberty all make early adolescence a crucial transitional period during which youngsters are expected to consolidate their knowledge of the norms and roles of adult society and, at least in western industrialized societies, begin to become emotionally and economically independent of their parents” (Grotevant, 1998, as cited by Lamb and Lewis, p. 490).

Puberty happens rather fast therefore the teenager and their parents are often ill-prepared to deal with the sudden changes. Everyone, including theorists and well educated parents, birth and adoptive parents alike, all deemed the period of adolescence as a time of tension and conflict. The early researchers such as Anna Freud (1958) considered the conflict as a healthy transition from childhood to adulthood as she famously stated that "To be normal during the adolescence period is by itself abnormal" (Arnett, p. 23) and suspected that if the children did not have stress in this period, problems may develop later in life.

In the past thirty years, the research has indicated a more peaceful and harmonic picture. Lamb and Lewis listed reports done by Maccoby &Martin in 1983, and introduced some positive concepts of “interdependence” and "mutuality." The majority of the young adolescents have a positive relationship with their parents. The parent-adolescent relationship is a crucial indicator of the children’s emotional wellbeing and academic achievements as well as peer relations. The adolescents who have higher school performance, higher self esteem, and stronger peer relations all reported to having fairly good relationships with their parents while recognizing that their parents were not perfect (Lamp & Lewis, p. 492). How does one measure "smooth adolescence transition?" By various researches conducted between 1983 and 1997, "the families with adolescent children on average argue approximately twice a week" over small issues. It seldom escalates into conflicts and does not interfere with healthy parent-child relationship. (Lamb & Lewis, p. 493).

Andrea Barrocas used the Inventory of Parents and Peer Attachment (IPPA) questionnaire to follow up on 24 racially diverse middle class adolescents from grades eight to ten. The purpose of her research was to examine how the parental attachment influences the peer relations. Her paper "Adolescence Attachment to Parents and Peers" provides some important information and concepts. She states that parents can greatly influence adolescents' self-esteem, and that parents are the security base from which the adolescents explore their peer relationship and other relationships (p. 11). Detachment from parents is actually the re-attachment process through the new self finding and identity building.

Lamb and Lewis used the Coleman and Hendry 1990's concept to describe this period: "Adolescence is a phase of development in which, as with every other stage, individuals come to terms with successive shifts - in parental, peer, and heterosexual relationships" (Lamb and Lewis, p. 493).

While there is plenty of research done to prove that the early adolescence is a challenging period for the children and parents in general, I hope to go back to the purpose of this paper: the challenges specific to internationally and interracially adopted children and their parents. In order to help these adolescents, it is imperative that the parents are able to identify their needs. Only then can the parent and adolescent truly continue bonding and forming a stronger attachment through this difficult period of time.

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Part Four: Unique challenges the adopted Chinese children face in adolescence

I was amazed when I searched online for the challenges for adolescent interracial adoptees. While there is not a lot for Chinese adoptees, the research done on Korean adoptees provided some insights into the process. From what I read, the race/ethnicity identity is the most important challenge that interracially adopted adolescents have in identity forming. I read extensive material about the racial identity process for birth children who are white, black, and biracial. While the stages may be different, they all have to go through the phase of understanding racism in their lives. This is also proven by the 112 pages of study done by McGinnis et al, released by Evan B. Donaldson Adoption Institute in 2009. Here is one of the findings:

Coping with discrimination is an important aspect of coming to terms with racial/ethnic identity for adoptees of color. The Korean respondents in our research were less likely than White (adoptees) to face discriminations on adoption status, but more commonly confronted racial discriminations. Eighty percent reported such discrimination from strangers and 75 percent from classmates. Nearly half (48%) reported negative experience due to their race in interaction with childhood friends. A noticeable finding was that 39 percent of Korean respondents reported race-based discrimination from teachers. It is clear that the adoption professionals, parents and others including schools, need more effective ways of addressing these realities” (p. 2).

It was quite shocking to realize that racism is still this prevalent in the American society. Are the adoptive parents aware of this? Do parents talk to their children about racism? I talked to our social work team about the racism in daily life. According to them, the American society has evolved from a white centered government and social structure. However, the racism looks quite different from half century ago. Nowadays it is more subtle and people express it without even knowing that it is not appropriate, or could even express it out of good intention. Yes, we believe the adoptive families are educated on racism before adoption but they may not be sensitive enough to prepare their children for the reality in life.

Apart from the daily racism, the racial and ethnic identity can also mean different things at different stages for the female Chinese adoptees. For example, when children’s sexual features develop fully during the early adolescence, they receive more attention and they may feel inadequate and unattractive, because the mainstream standard for beauty is white-centered.

It seems that adoption is another aspect of identity forming. As the 2009 Adoption Institute Study showed:

"Adoption is an increasingly significant aspect of identity for adopted people as they age and remains so even when they are adults. A primary contribution of this study is the understanding that adoption is an important factor in most adopted person’s lives, not just as children and adolescence, but through adulthood. …… For example, 81 percent of Koreans and 70 percent of Whites rated their identity as an adopted person as important or very important during young adulthood” (p. 2-3)

Adoption means a different thing to the adopted children at different life stages. Before adolescence, it can mean that being adopted is special, unique, beautiful, or even romantic. When children enter into adolescence and develop abstract thinking capability, adoption becomes an identity forming issue. They all have to process the concepts of abandonment and birth parents, loss and grievance. In this sense, it is also a painful healing process involving digging and looking deeply into the primal wound. According to what I read, throughout life, the issues that concern adoption itself – poverty, gender, social classes, single motherhood and unwed pregnancy, etc., can pose a lot of soul searching and emotional ups and downs when children face similar challenges in life. So it is a lifetime identity forming process for the adopted children.

At the same time, it is also difficult for our adoptive parents. They are often concerned about their adopted children's birth parent anxiety. In fact, the birth-parent anxiety is a big part of the identity forming process. The adopted children have to work though these concerns in order to better understand where they come from biologically and generationally. It is difficult for adoptive parents to watch their children struggle with this, and understand that it is a normal process. The parents may feel hurt or under-appreciated. The children's questions about their birth parents may trigger unresolved issues of loss the parents faced before adoption.

How can the children and parents understand each other’s challenges in this difficult parenting stage? Communication is still the key! A counselor who is specialized in adoptee issues told me that families come to her only when they have problems. Many issues are similar to problems birth families face, however these challenges can become more complicated with families who have adopted. For example, when parents go through a divorce or separation, the adopted children may think it is their fault. They believe that if they were birth children, the parents would stay together. Parents can think in a similar way: if their adoptive children were birth children, the children may feel more secure therefore not act so strongly. Both sides begin to internalize these thoughts and feelings when blaming their issues on adoption, whether consciously or subconsciously. If their relationship lacks strong communication and openness about these issues, then it becomes easy to start questioning each other's love and commitment.

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Part Five: Thoughts and Suggestions - What We Could Try as Parents

For all the adoptive parents, no matter what adolescent challenges you have, I have to congratulate you on your good parenting: You have laid a good safety base for your children to reach out to explore new areas of other relationships. Their boldness and assertiveness is the proof of your good parenting. On the way toward their individualism and independence, you have provided your children a new example of identity achievement: unconditional love, trust and support. Forever our parents are the ones our children can lean on when they are sad, tired, or lost. The good personal quality in you is so precious and so important for our children to learn from.

According to Berk, Erikson provided two important concepts for identity theory: exploration and commitment. Based on the theory, there are four identity statutes: identity achievement; identity moratorium, identity foreclosure and identity diffusion. The identity exploration and identity achievement are the positive ones and the later are the negative ones. Early adolescence is the time for exploration in identity moratorium (Berk, p. 403).

Professor Tatum discussed her identity achievement process as a middle class black person in her famous book “Why are all the black kids sitting together in the cafeteria.” In this book professor Tatum identifies the four identity stages that she went through: experience with white mainstream culture, understanding racism, immersion with the culture the general public thinks one belongs, and finally identity achievement. I highly recommend this book to all our families.

Let us look at the first step: White Mainstream Culture. Some children want nothing to do with their Chinese heritage. Some children desperately want to appear to be White any way possible. This is actually all normal. Before their body changes and their physical features become more evident as Chinese, they do not realize that the general public will see them differently. Even though they want to be seen as a part of the main stream, they actually have no choice but to be different.

The second stage is going through racism. Let us discuss this issue openly and honestly. The reason is simple: If we do not talk to our children about this as parents, other people can, and will talk about this issue in the way that might hurt the parent/child relationship. Our children should know that they can rely on their parents and teachers when they encounter any form of racism. They should be able to come to us and understand that they can do something to improve it- whether they introduce Chinese culture into their classroom or through other means. Let us talk to our children about dating, about peer acceptance, and about school performance. Let us discuss what being a Chinese adoptee means in daily life and in all these matters. The color blind approach is admirable but is unrealistic. I am thinking about one subject for my next writing: Are We Beautiful? I want to invite all Chinese adopted adolescents to write this paper with me. When do we start spending more time in front of a mirror? Why doesn't the boy I am attracted to pay any attention to me? What does my mother mean when she tells me it is more important to be beautiful inside?

For birth parents, yes, let us discuss this concern openly and honestly. We have to allow these unseen birth parent figures to live with our children and also live with ourselves in our imagination. With that said, we have to follow our children’s lead. There is no reason to let our own birth parents fantasy, anxiety, or our own need to prove that we are open-minded good parents, take the lead if our children are not ready. Let us talk about it when our children are eager to! Tell our children that their birth parents are safe, have food and clothes, and work hard, like the ones they saw in the movie ‘Somewhere between.” If they want to search for their birth parents, let us talk about it!

To reach identity achievement for the Chinese adoptees, the third important step is to become immersed in the Chinese culture. It is great to celebrate the Chinese New Year! It is great to practice Chinese cooking and learn Chinese words! But suddenly I feel like our children need even more when they become teenagers. I believe returning to China and visiting the orphanages is important for our children. This can play a huge role in our children's identity formation. According to the report by McGinnis et al, released by Evan B. Donaldson Adoption Institute in 2009, 62% of the Korean respondents to the questionnaires or interview made the trip to South Korea and listed it as the most important step for identity achievement (p. 4). In the documentary “Somewhere between,” all four girls traveled to China. It pains me to realize that this identity achievement is such an expensive undertaking! Can we make this a more affordable process? I want to know if the adoptive parents would allow me to bring their children in groups, with three or four of them to share one hotel room, to go back to China! I also hope to develop some charity projects in China for our children here to participate in, so that they could look beyond their personal wounds and concentrate on the positive result of their abandonment, which is their adoption.

Let us talk about peer groups. In the early teens, peer acceptance is very important. Who are the peers in our children’s lives? Can we as parents help them to form some Chinese adoptee peer groups? I travel to some adoption group reunions every year. Our agency’s first adoption group has met every single year. Thank you, Susan, Beth, Chris, Carol and Don, Holly and Paul! The children are like sisters even though they only see each other once or twice a year! Susan, Rhode Island’s first female Superior Court justice, hosts a Thanksgiving party every single year for her second adoption group and other adoptive families in Rhode island. Thank you, Susan! Yes, many adoption groups still have reunions every year. Let us get together again! Let the children see each other more often and form their own unique peer groups outside of schools. It is important for the children to know that there are other children like them. For the adoptive families who are not able to travel with a group when they adopt, it is important to form groups based on the year they traveled to China, or the age of their adopted child. We have families who have already proposed to organize groups like this! Of course, we should open our heart to the children and families who adopted through other adoption agencies if they want to join us.

I would like to go back to my thoughts on you, our adoptive parents, as the most important part of the identity achievement process. It is a privilege to parent-- the parents are in a position to shape their children’s way of thinking. The children have no chance to learn from their birth parents but they have you for all these beautiful years. They can only say that "I learned to work hard from my parents” or “I learn to be persistent from my mother!” Someday when they parent their own adolescent children, they will remember what you showed them: “I was so stubborn but my parents were so patient!”

There are two things in my mind. One is that early adolescence is the stage of role shifting in parent-child relations: dependence to inter-dependence. In order to reach inter-dependence, it is time to share some of our own struggles in different life stages. This is really quite tricky: When, what, how and how much is safe parental self disclosure?

Another role shift is called Therapeutic parenting. This concept means that given the healing feature of the identity forming process for the adoptees, the parental emotional support for teens should be similar to the support given to infants. Parents should incorporate acceptance, empathy, love, curiosity, and playfulness in daily guidance to their teenage children (Hughes, p. 95).

I have been thinking about the role our agency can play. Yes, our main work is adoption and we are indeed very busy in our daily operation. Yes, we have no legal responsibility to the adoptive relationship after your adoption is finalized in China. However, as a proud player in the adoption community, we are here to provide emotional support for our children and families after adoption. For the families who need counseling service, we have a referral system for you. For general support, yes, we hope to help with events, workshops, etc., that are organized by the adoptive parents and adopted children.

I understand if you have some concerns. Many years ago, my daughter had serious adolescent issues and I was in tears all the time since she entered middle school. My English was embarrassing. My clothes did not match in color. My cooking was terrible. My curfew was not fair. I felt guilt for not paying enough attention to my daughter, and feared I neglected her somehow. I felt shame as a Chinese mother who was inadequate in the main stream culture. I was also angry at this little monster: so spoiled and Americanized! It was hard for me to share my struggle with people – it would sound as if I were blaming the child!

While I feel it is important that our families support each other, we will not impose our thoughts on you. Instead, we will follow your lead. Please consider the following questions:

  • What role should the agency play?
  • Do you think it is a good idea that the agency sponsor some bi-monthlyl support meetings in our office? Should we organize some workshop or some concerns and skills?
  • Do you feel like it is sufficient if the agency recommends activities or groups in the are run by some universities such as big sib/little sib programs? What other support groups are out there that may be better than the agency's support?
  • Would you rather have support groups for just parents? Just children? Both?

Please feel free to email us your comments at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it . Your insight is greatly appreciated!

Many thanks,

Lillian Zhang

Executive Director

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References

Allen, J. & Land, D. Attachment in Adolescence, Cassidy, J., & Shaver, P. R. (1999). Handbook of attachment, theory, research, and clinical applications. New York: The Guilford Press.

Arnett, J. J. (2007). Suffering, selfish, slackers? Myths and reality about emerging   
adults. Journal of Youth and Adolescence, 36, 23–29.

Asten, P., St-Laurent, D., Ethier, L., and Provost, M. (2004). Aims, measures, study sites and participant samples of the transcultural study of postnatal depression. The British Journal of Psychiatry, 2004(184), s3-s9. Retrieved from This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Berk, L. E. (2010). Development through the lifespan (5thed.). Boston: Pearson.

Barrocas, A. L. (n.d.). adolescence attachment to parents and peers. (Master's thesis), The Emory  Center for Myth and Ritual in American Life, working paper No. 50

Boris, N. (2003). Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder of infancy and early childhood. American Academy of Child and Adolescence Psychiatry, Retrieved from www.aacap.org

Hughes, D.A. (2006) Building the Bonds of Attachment, (2nd edition), New York: Jason Aronson

Lamb, Michael H. and Lewis, Charlie, The Role of Parent-Child Relationships in Child Development,  (2011). Developmental Science (6th ed.). New York, NY: Psychology Press.

McGinnis et al, Beyond Cultural Camp: Promoting Healthy Identity formation in adoption, Evan B. Donaldson Adoption Institute www.adoptioninstitute.org/research/2009_11_culture_camp.php,

Silverman, A. (April 1993), Outcomes of Transracial Adoptions, The Future of Children, Adoption Vol. 3, No 1

Tatum, B. D. (1997). Why are all the black kids sitting together in the cafeteria? (1 ed.). New York, NY:  Basic Books.

Wolf Creel Academy web site: (http://www.worfcreekacadmy.org/reactive-attachment-disorder/

Zeanah, C. (2010). Reactive attachment disorder: A review for DSM-V. AMERICAN PSYCHIATRIC ASSOCIATION, p. 15.

Adult/Couple Attachment Therapy, www.attachmentexperts.com/adultcouple.html