Buzz is building for Deborah D. Gray’s
Nurturing Adoptions
Creating Resilience after Neglect and Trauma

For those of us who have read and referenced Deborah Gray’s first book, Attaching in Adoption, her second book, Nurturing Adoptions, is equally powerful and a must-read for adoptive parents and anyone who works with children. Attaching in Adoption is a hands-on resource for adoptive parents who are learning about and facilitating attachment. Written as a companion to her first book, Nurturing Adoptions will benefit parents while providing a tool box for social workers and therapists working with adoptive families. Nurturing Adoptions acts as a two-part guide in navigating the changes that have occurred in adoption, both domestically and internationally. An aspect of these changes involves a greater number of children being adopted later in infancy and/or childhood, many of them having experienced grief, trauma and/or neglect.

The first part of the book details the interrelationship of these problems, and the importance of helping children as quickly as possible after trauma. In the life of an infant, for instance, the defining trauma can be separation from the birth parent. Part two provides a hands-on practical approach for social workers to prepare families for adoption, and gives therapists case examples of children who have suffered early trauma and neglect. Treatment strategies and therapeutic techniques that can help create resiliency in the child and the family are also provided.

Through the use of solid research, vignettes and her experience as a therapist in adoption and foster care, Deborah Gray has once again provided the adoption community with help in addressing and meeting the needs of children who have suffered trauma and neglect. Adoptive parents will find this book to be a valuable resource for themselves and their family, one they will return to again and again. Nurturing Adoptions is simply that—a guide to nurture families created by adoption

Maxine Walton, MS, LICSW, Social Work Supervisor
Children’s Home Society and Family Services’ (MN) Adoption Services in Fall 2007 CHSFS Heart-to-Heart Newsletter
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I’ve been devouring books by Deborah D. Gray. I bought her Attaching in Adoption awhile back, based on the phenomenal reviews I got online and from people I knew. Because I had so many other books that were recommended to me, in addition to all the pre-adoption preparation I was going though at the time, I set the book aside.

This week, I came across Ms. Gray’s latest book, Nurturing Adoptions, and I snapped it up. Hubby and I feel at such a loss as to how to handle the profound issues our daughter has, and this book seemed to have answers. It does not duplicate her earlier work, but does reference it, thus I’ve got both books next to my bed and I toggle back and forth between them at night when I read.

Attaching in Adoption is a groundbreaking work, widely referenced in the adoption community. Its audience is primarily the layperson parent. Nurturing Adoptions is more a textbook for adoption professionals. Though my background is in Early Childhood Education, and I dabbled with the idea of going into clinical psychology, I’m reading the book as a parent looking for answers. That I “get” the scholarly research behind the book is a very nice bonus, but at the end of the day (literally), I’m a mama desperately searching out anything that might provide some immediate tools until the therapy our daughter is receiving “kicks in,” so to speak.

Both books provide practical tools for parents like me. Nurturing Adoptions is broken down into two parts – the “Why” and the “What to Do.” Attaching in Adoption provides answers to the “Whys” interspersed with vignettes that just about any adoptive parent could relate to, regardless of the issue(s) their children struggle with. These little scenarios made me see that there are other parents who are dealing with similar issues; that those issues can be dealt with successfully; and knowing these things, I can hang in there a little longer because I have a few tools to get me to the next therapy appointment.

The books are highly readable, and even though Nurturing Adoptions is geared toward the advance-degreed, I never felt that the author was speaking over my head. I think both books offer practical tips and solid research. Of all the adoption books I’ve read thus far, these two top my list.

 Posted by Marie Stroughter in Christian Adoption Blog

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April, 2008… In this new book author Deborah D. Gray leads on from her previous release Attaching in Adoption: Practical Strategies for Parents and Professionals. Offering specific guidance for the complex procedure of adoptions, aimed towards a variety of profession, you will gain new and additional tools for your professional toolbox. With so many challenges taking place along the path of adoption, this book will explore the multitude of changes that can take place when children are adopted from multiple foster care placements, institutional care, at older ages, and after experiences of neglect and trauma. 

In the book, Ms. Gray covers issues such as identifying and treating problems in traumatized children, assessing and preparing families for adoption, matching children with families, making careful moves in transitioning children, helping children and parents to understand difficult pasts and prepare for a healthier future, understanding and
implementing the separate but equally important roles of the professionals involved in adoptive placements, and building professional practices networked for support and enhanced professional continuing education.

Using practical cases and examples to further illustrate her ideas, coupled with her extensive personal experience in working with foster and adoptive families, Ms. Gray has given us a resource book that is truly exceptional. The additional resources such as the glossary of terms listed in the back of the book and a comprehensive list of organizations to contact for further information, coupled with example checklists and exercises for parents and families only add to the importance of this book in the field. Therefore I would highly recommend it for everyone looking to learn more about this complex area and look forward to the next excellent resource Ms. Gray gives us.  

Vianna Renaud
TCM Reviews
Canada

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March, 2008… Since its publication in 2002, Attaching in Adoption has become a cornerstone of adoption literature. Now Deborah Gray follows up with Nurturing Adoptions: Creating Resilience After Neglect and Trauma. this new tool designed to help placement professionals and therapists whose practices are not focused specifically on adoption and attachment understand how new research on the impact of neglect, abuse, early trauma, and institutionalization on the developing brains of children can guide their practices in new directions. Nurturing Adoptions is a vital resource for clinicians, adoption and foster care professionals, and parents alike. Drawing on studies conducted by leading neuroscientists, as well as her own therapeutic cases, Gray deftly describes how untreated traumatic stress in infants and children can affect emotional regulation, social responses, memory, attention, and concentration. Gray beautifully explains the role of attachment in developing internal systems for coping with stress. Using vignettes from case studies, Gray illustrates the roles of parents and therapists in healing hurt children and guiding them into strong and healthy relationships and productive adulthood. Nurturing Adoptions is an important, sobering, and, ultimately, hopeful treatise on the impact of early trauma, and the transformative power of therapy and mindful parenting.

“Why do so many children show exteme feeling and behaviors, even after years of placement in a stable, loving family?”

 ”Why do some children with early maltreatment make poor progress in therapy?”

 ”What issues are agencies missing in their preparation of parents-to-be during the placement process?”

 These may be some of the questions you’ve asked yourself .  And Nurturing Adoptions: Creating Reslience after Neglect and Trauma by Deborah Gray may be exactly what you need to help find answers to these questions and many more. Deborah Gray has written a comprehensive, yet easy to read book for parents, teachers, caseworkers and therapists. It describes in great detail the effects trauma and neglect can have on children, but she also gives hope and practical advice on how to help our children.

 In the first half of the book, Gray gives a crash course on the inter-relationship between trauma, neglect, and post-traumatic stress disorder. The first step in helping families is to identify what trauma and neglect looks like in children coming from institutional settings. Research has shown that children who are neglected and traumatized suffer from high rates of traumatic stress symptoms: anxiety, social problems, aggression, and feelings of hopelessness. They need help. A detailed description of what physically happens to the (traumatized) brain is presented in the book. There are chapters on how neglect, traumatic stress, and attachment affect children at each stage of development.

The second half of the book is entitled “Putting the Pieces Together–Restoration after Traumatic Stress and Neglect.” The author provides practical information on how to move forward and how families can help their children. The information is concrete and covers a wide range of issues from how to restore hope, how to manage implicit and explicit memory, how to arrange physical surroundings, and more.

In addition to practical information, there is a detailed chapter that educates parents about the roles of the child welfare/social woker. Another chapter entitled “The Role of the Mental Health Worker” is very helpful as a family considers seeking professional help. This chapter explains in detail what happens when a child/family is involved in therapeutic treatment. The case studies are particularly helpful.

At the end of the book are tools such as the “Child Dissociating Checklist” and a series of exercises related to grief issues. An extensive resource list of books, organizations and websites is included.

While the book is long at over 500 pages, it is easy to read, comprehensive, and an excellent resource for families who have adopted children with trauma and neglect in their histories

Mary Ellyn Lambert
FRUA’s The Family Focus, Winter, 2008

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November, 2007… Here is another exceptional resource from Deborah Gray. Nurturing Adoptions is the professional companion and extension to her first book, Attaching in Adoption. It is difficult to find a therapist who has understanding of trauma, trauma, abuse or adoption issues, and understands ways to provide helpful therapy. This is a goldmine of information for the adoption world, for parents and professionals.

Nurturing Adoptions is a guide for social workers and psychologists who provide therapy for adopted children and teens suffering from neglect or abuse. This book is a wonderful resource for parents adopting children through the US social services system, from Eastern Europe and older children from other countries. The trauma caused by long years in orphanages, neglect by parents, frequent transitions, and even abuse are well documented in this book. Dr. Gray delves into the myriad ways that children can be affected by adverse circumstances - biological, psychological, behavioral, and even moral. She teaches ways to find the child’s point of view, and key points of stress, and to help reframe their awareness and behavior into a more positive and adaptive structure, ultimately leading to more balanced and fruitful lives. Dr. Gray’s advice is always practical and well researched, but also sympathetic. This is an excellent resource for anyone interested in attachment and older child adoption.

Allison Martin
Comeunity.com

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 November, 2007… For those of us who have read and referenced Deborah Gray’s first book, Attaching in Adoption, her second book, Nurturing Adoptions, is equally powerful and a must-read for adoptive parents and anyone who works with children. Attaching in Adoption is a hands-on resource for adoptive parents who are learning about and facilitating attachment. Written as a companion to her first book, Nurturing Adoptions will benefit parents while providing a tool box for social workers and therapists working with adoptive families. Nurturing Adoptions acts as a two-part guide in navigating the changes that haveoccurred in adoption, both domestically and internationally. An aspect of thesechanges involves a greater number of children being adopted later in infancy and/or childhood, many of them having experienced grief, trauma and/or neglect. The first part of the book details the interrelationship of these problems, and the importance of helping children as quickly as possible after trauma. In the life of an infant, for instance, the defining trauma can be separation from the birth parent. Part two provides a hands-on practical approach for social workers to prepare families for adoption, and gives therapists case examples of children who have suffered early trauma and neglect. Treatment strategies and therapeutic techniques that can help create resiliency in the child and the family are also provided.  Through the use of solid research, vignettes and her experience as a therapist inadoption and foster care, Deborah Gray has once again provided the adoptioncommunity with help in addressing and meeting the needs of children who havesuffered trauma and neglect. Adoptive parents will find this book to be a valuableresource for themselves and their family, one they will return to again and again.Nurturing Adoptions is simply that—a guide to nurture families created by adoption. Maxine Walton, MS, LICSW, Social WorkSupervisor, CHSFS Adoption Services

Fall, 2007 Heart to Home Newsletter

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September, 2007…  Clinical social worker Deborah D. Gray applies her extensive experience counseling adopted children to Nurturing Adoptions: Creating Resilience After Neglect and Trauma, an in-depth examination of both domestic and international adoptions. Written especially to aid professionals working with adoptive families in the twenty-first century, Nurturing Adoptions covers the especial difficulties involved in helping children, from infants to early teens. Chapters discuss the effects of early life neglect and trauma on brain development, how to build attachment, the role of the child welfare or social worker, how to structure careers and practices, and much more. Numerous case studies illuminate this straightforward and accessible resource. “When parents lose sight of normal childhood development, expecting much more than developmental progress allows, there is trouble ahead. The set-up for the child is that the parents will always be disappointed and displeased. The child can never feel like a wanted and accepted child.” A “must-have” for social workers, counselors, psychotherapists, and other professionals involved in helping adoptive families adjust.

 as reviewed in Midwest Book Review

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Summer, 2007…  Someone is finally speaking up about the potential damage of moving a child—including an infant—too abruptly. In her new book, Nurturing Adoptions: Creating Resilience after Neglect and Trauma, Deborah Gray writes, “There is evidence that moving infants abruptly causes a massive disequilibrium in neuroendocrine regulation, with potential for long-term effects. (Dozier, 2006.)” For some infants, the effects are immediately apparent, with obvious expressions of grief. Other children seem to transition smoothly by outward appearance. Having witnessed an almost flawless adjustment in my own child, looking back I now believe what I saw was shock. Not surprisingly, “it is not possible for children who are in shock and denial to form a smooth attachment to a new psychological parent, or attachment figure.”

Gray reports on a 2006 study out of Harvard University showing that “over half of the children in foster care leave with an anxiety disorder. They have twice the rate of traumatic stress as compared to Vietnam veterans.” Since “in therapy, children reference sudden moves as among their most difficult problems when working through grief and shock,” one naturally comes to the conclusion that in order to reduce the impact of adoption trauma, one must find a way to transition children less abruptly. Gray explains, “Moves that are done abruptly, and especially those that include trauma, lead to pathological or complicated grief,” a grief in which there “is no completion and children continually mourn, [remaining] highly reactive to reminders of their loss.”

Nurturing Adoptions includes an entire section dedicated to best practices in “moving children with as little damage as possible.” Because “there are specific damages to the emerging personality when children lose their homes and attachment figures,” we recommend that every adoptive parent and professional—especially the social workers who are actually involved in decision making—read Gray’s book, taking particular note of the recommended moving schedule for children. For infants 1-4 months, Gray suggests a transition time of six days, outlining what the role of the adoption parent and the foster parent should be on each day. Infants 5-10 months should be transitioned over ten days.

Infants 11-24 months need ten to fourteen days to create a safe transition. Notably, children “moved too abruptly at this stage can get locked into [the] protest “No” stage; or they may feel reluctant to attach again.” Gray only briefly touches on something of immense consequence to many families adopting internationally, where children are leaving their foster families between the ages of nine and fifteen months. “Typically, the social worker should try not to move children who are in a six-month window of attachment, which is an exclusive stage between about nine and fifteen months of age,” …assuming that “the baby is in a safe, nurturing, and securely attached relationship with the caregiver.” (Our bold.) She goes on to explain that in order “to determine whether the baby is in that exclusive window, social workers can note whether the baby usually cries or fusses when the caregiver walks out of the room or has progressed to the stage in which he knows that the caregiver will come back.” The potential damage from moving a child between the ages of nine and fifteen months is something that every adoptive professional and parent needs to be aware of.

Preschoolers, age 24 months to 5 years, should optimally experience fourteen to twenty-one days in transition. Gray goes on to talk about older children, details of which can be found in the book. For each age level, birth & up, she outlines precisely what parents and foster families need to do on each day of the transitional period. She points out that a less abrupt transition also serves to honor the work of foster families. Under many current practices, foster parents are impacted by the abrupt removal of children—often well-loved children—from their families. A better transition gives them time to feel comfortable with the adoptive family. Currently, the child’s transition from foster family to adoptive family often just becomes a front row seat to watch adults mourn–or stoically attempt to hide all emotions from the child—neither of which is the optimal situation. Imagine instead a transition where the foster parents have learned to know the adoptive parents enough to trust them and to send the child off with confidence that the child has already begun to establish a bond.

So where does this leave us? I believe this leaves us with immense hope; hope that changes to the way we transition children can lead to more secure little individuals. It won’t be easy to change the system. But our little ones are currently suffering the effects of a system that is not designed in the best interest of children. And the potential damage can be life long.

Cynthia Hockman-Chupp, M.Ed.
article on www.a4everfamily.org
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Summer, 2007… Since its publication in 2002, Attaching in Adoption has become a cornerstone of adoption literature. Now Deborah Gray follows up with Nurturing Adoptions: Creating Resilience After Neglect and Trauma. A theoretical, yet practical, guide, Nurturing Adoptions is a vital resource for clinicians, adoption professionals, and parents alike.

Drawing on studies conducted by leading neuroscientists, as well as her own therapeutic cases, Gray deftly describes how untreated traumatic stress in infants and children can affect emotional regulation, social responses, memory, attention, and concentration. Gray also hopes that Nurturing Adoptions will serve as a call to action. A generation ago, the majority of adoptions were of newborns. But increasingly, older infants and children are adopted from domestic foster and international placements, and few parents are given much information about neglect or infant trauma, or about the risks of not addressing them, leading to, in Gray’s opinion, a growing public health disaster.

But one that’s not without a solution. Gray beautifully explains the role of attachment in developing internal systems for coping with stress. Using vignettes from case studies, Gray illustrates the roles of parents and therapists in healing hurt children. Destined to become another classic in adoption literature, Nurturing Adoptions is an important, sobering, and, ultimately, hopeful treatise on the impact of early trauma, and the transformative power of therapy and mindful parenting.

Reviewed in the August 2007 issue of Adoptive Families magazine by Heidi Holman, an adoptive mom who’s researched and written about the effects of trauma and sensory deprivation.

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2/25/2007… Deborah Gray, once again, addresses the primary issues that parents and professionals confront when they become involved with hurt children. She has something for just about everyone in the adoption world! Her detailed examination of many cogent issues will help anyone whose life is touched by children and adolescents who have lost so much prior to their adoptions and yet have so much to gain in their new families. Reading Gray’s work will leave no stone unturned.

Gregory C. Keck ,Ph.D.
Founder/Director of The Attachment and Bonding Center of Ohio
Co-author of Adopting the Hurt Child and Parenting the Hurt Child

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2/27/2007… Deborah Gray thinks like a child, both imaginatively and yet very concretely. That’s why Nurturing Adoptions is filled with creative ideas and practical suggestions that bring a fresh approach for traumatized children learning to love and trust in an adoptive family. I started to mark the pages of Nurturing Adoptions that contained especially useful ideas and soon found myself in a blizzard of bookmarks. Too much good stuff!

Mary Ann Curran, M.A.
Director of Social Services
World Association for Children and Parents (WACAP), Washington state

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2/27/2007…People sometimes do not understand that attachment work has many facets. Deborah Gray’s Nurturing Adoptions helps parents, therapists, and social workers integrate trauma, loss and grief into attachment work. As always she uses clear language, case vignettes, and is able to take complex issues and break them down for easy understanding. This should help all concerned view attachment as a process not an event which ,depending on the family, has many issues that need to be addressed. Thank you Deborah for this contribution.

Regina M. Kupecky LSW
co-author with Gregory C. Keck PhD Adopting the Hurt Child and Parenting the Hurt Child; author of curriculum My Brother, My Sister: Sibling Relations in Adoption and Foster Care; co-oauthor with Arleta James and Gregory C. Keck of curriculum Abroad and Back: Parenting and International Adoption.

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3/7/2007… In Nurturing Adoptions, Deborah Gray delivers an exceptional depiction of the emotional, developmental and neurological impacts of early childhood trauma and neglect. Additionally, she highlights critical areas of assessment that social workers must consider when home studying families prior to placing children who have experienced abuse or neglect. In a field laden with a variety of controversial and coercive methods of working with children demonstrating symptoms of reactive attachment disorder, it is refreshing to see that Deborah not only discourages the early and over diagnosis of RAD, but provides lots of strategies for assessing and working with children and families that are evidence based and sensitive to the developmental needs of children. My hope is that this book will be read by all social workers and therapists working with foster and adoptive families. We will be making it required reading for our social work staff.  Thank you, Deborah, for such a valuable contribution to this field.

Karen Alvord, LCSW
Executive Director of Lilliput Children’s Services
Sacramento, California
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3/12/2007… At last there is a “how to” book for professionals working with children with the scars of abuse and neglect. Deborah Gray lays out the foundations of research in this field, explaining how and why children respond to stresses of their early lives. From these foundations she helps professionals and families to create a milieu that will build self-esteem, address trauma and grief, and work towards resiliency. Therapists with little experience in this field may not recognize the many issues that are impacting the child’s behavior. Often I find that these mental health professionals are at a loss, incompletely understanding the impact of a child’s early trauma on their emotional development. Here, as well, is a toolbox to help both adoption professionals who are new to adoption and those with years of experience. This book will be quoted over and over again to my patients, therapists in my community, and even in my home. I plan to have two copies - one to share with families at work, the other to refer to as a parent as I nurture my own children towards coping with their pasts.

Deborah Borchers, MD
Pediatrician specializing in adoption and foster care medicine
Adoptive Mom
Cincinnati, Ohio

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3/12/2007… Deborah’s work in Nurturing Adoptions identifies the importance of considering the biological impact of trauma and neglect in children. She bridges the physiological and psychological effects of traumatic stress that can develop into lifelong emotional or attachment issues. Deborah has the unique ability to give practical context to the challenging outcomes that are reflective of stress, trauma and neglect in children. Her sensitive, insightful writing style draws the reader into her work with ease. Whether you are a parent by birth, adoption or foster care or a professional working with children you will benefit from Deborah’s expertise and dedication to families!

Cindy Haftner, Executive Director
Leah Deans, Resource Director
Adoption Support Centre of Saskatchewan Inc.

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3/12/2007… The “required reading in adoption” list just got longer, and shorter. Nurturing Adoptions is several long-awaited books in one: a deft overview of neglect and trauma’s effects on children and families, a collection of practical pearls for adoptive parents, a best practices primer for child welfare professionals, and a lovely illustration for child therapists of Deborah Gray’s state-of-the-art therapeutic approach.

While I do enjoy traipsing around the Pacific Northwest to her fantastic trainings, it�s so nice to finally have this material collected in book form, especially one so infused with hope, wry wit, empathy for all involved, and hard-earned practical wisdom. Her previous book, Attaching in Adoption, which has been our must-read attachment book for parents and professionals, now has a wonderful new sibling.

Julian Davies, MD
Co-Director of The Center for Adoption Medicine, University of Washington

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3/12/2007… This is an essential book for professionals and parents! Deborah Gray reviews and explains valuable, current and applicable research. She then goes much further and clarifies the “whys” and “how’s.” Why are we seeing children and families in such distress and how do we assist them? Nurturing Adoptions offers skill building in assessment, treating, placing, parenting, teaching and loving traumatized and neglected children.

Parents and professionals will find important information about building the resiliency of children, of families and of professionals. The vignettes used to describe research, techniques and strategies are so thorough and encouraging they can be visualized.

Deborah, what a gift you�ve given to those of us that are committed to and have claimed hurt children. Thank you for sharing your passion with this optimistic resource. As soon as it available, Nurturing Adoptions will be on my list of �must haves.�

Yolanda Comparan, MSW
Owner/Operator
Adoption Referral & Information Service
Mom by Adoption
Washington State

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3/13/2007… Deborah’s book made me sigh with relief. Finally there is a resource that let’s us see the big picture. There is risk to focus only on what is diagnosed “on the surface”. For example, a child adopted internationally may have RAD or sensory integration disorder. Deborah enlightens us that children are not that simple. She fosters one to stop and think about the child as a whole, how the child was wired in the womb and how the child’s world to date has left an enduring impression. She blends the scientific biomedical research with hands-on easy to understand therapeutic approaches to children who have experienced trauma. Both parents and professionals will find this book a blessing.

Julie K. Keck, MD
Neurodevelopmental Pediatrician
Director of the International Adoption Clinic at Riley Hospital for Children
Indianapolis, Indiana

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3/13/2007…  Nurturing Adoptions is a “must read” for anyone providing therapeutic services to adoptive families. Deborah Gray provides a wealth of information based on current research that enables therapists to help children and their families heal and develop positive relationships.

Patty Jewell, LCSW
Therapeutic Foster Care and Home Run Program Supervisor
Bethany Christian Services, Indianapolis Branch

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