Post adoption support needs and implications for future practice – a systematic review

Adoption is increasingly seen as a lifelong experience, with cascading effects from early life experiences into adulthood. Consequently, support needs can often persist long after adoption. Current post-adoption support has largely been informed by infant studies and developmental theories such as attachment theory, emphasising the importance of early bond forming with adoptive caregivers. Recent evidence and cohort studies as adoptees have grown older suggest that support needs, especially beyond early childhood, are both broad and complex. This systematic review aimed to consolidate research about adoptee support needs as reported by adoptees and/or their families. The review included international, English-language primary studies published between 2002 and 2025 that reported on the lived post-adoption experiences of adoptees and their families, with particular attention to areas of unmet support. Following a review of 120 full texts, 76 were included. Support needs were identified for areas of attachment, identity, neurodevelopmental conditions, mental health and trauma, education, grief/loss, and contact with birth families. Participants reported that neurodevelopmental problems and the role of early adversity and trauma on later mental health outcomes were not well understood among service providers, which created a barrier to diagnoses and interventions received. Practice implications and recommendations for service providers are discussed.