High rates of abuse, neglect, and maltreatment are occurring in young children under the age of five, requiring placement into foster care that leads to over 50,000 adoptions annually (Follan & McNamara, 2013; US Department of Health and Human Services, 2012). Children adopted after age three from the foster care system often struggle with emotional, behavioral, and social disturbances, creating difficulties throughout the lifespan (Clarkson Freeman, 2014; Edelstein, Burge, & Waterman, 2002). Clinical treatment of late-adopted children and their families is complex because of prolonged trauma experienced in the formative years of development (Baker, Mehta, & Chong, 2013; Romanowski, McKean, & Voort, 2017). Training exists for foster/adoptive parents, but lacks a comprehensive approach to helping them understand the behavioral and social-emotional dynamics that a fost-adopt child may be struggling with (Baker, Mehta, & Chong, 2013). There continues to be a need to expand the research of clinical treatment approaches that these children and families can best benefit from (Lindsey, 2001).

Contextual therapy theory is underused in the clinical setting and family therapy research, despite the fact it can provide a framework for clinicians to understand the complex dynamics at play and use a variety of interventions from systemic, art, and play therapies. This phenomenological case study analysis used a contextual therapy theory framework as a lens for identifying key components to successful adoption treatment and emphasized how relational ethics can be used to better understand the difficulties encountered with this unique population. Qualitative data analysis of interviews with the adoptive mother and case file revealed that relational ethics constructs such as loyalty, fairness, and accountability were major factors in treatment that should be emphasized when treating adoptive families. The significance of self of the therapist work was another major finding that should be addressed in training and supervision when working with foster and adopted youth. The study was limited by only using adoptive mom as an informant, length of time since ending treatment, and myself being both the therapist and the researcher. Further research to establish assessment, treatment, and supervision protocol would be beneficial for current and future clinicians.