Adopted adolescents' overrepresentation in mental health counseling: Adoptees' problems or parents' lower threshold for referral?

A larger proportion of adopted adolescents receive mental health counseling than do their nonadopted peers. Adoptees might have more problems that require counseling, or their adoptive parents might have a lower threshold far referral (or bath). Objective: To test the hypothesis that both the extent of adolescents' problems and their adoption status would predict whether adolescents received psychological counseling, after controlling for family demographic characteristics. Method: Two large data sets collected from 1994 through 1996 by the National Longitudinal Study of Adolescent Health (Add Health) were used. In parallel analyses of the 2 data sets, hierarchical logistic regression models were implemented to assess the incremental effects of problem behaviors, family characteristics, and adoption status on adolescents receiving counseling. Results: Selected adolescents' problems and family demographic characteristics were significant predictors for having received counseling, but, after controlling for these variables, adoptees were still about twice as likely as nonadoptees to have received counseling. Conclusions: Prevalence of problems, adoptive family characteristics, and adoption status must all be taken into account to understand why adoptees are more likely to receive counseling. Clinicians should be sensitive to issues that are especially salient in adoptive families.