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 req uire 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 a dolescents received psychological counseling, after controlling for family demographic characteristics. Method: Two large data sets collected from 199 4 through 1996 by the National Longitudinal Study of Adolescent Health (Add Health) were used. In parallel analyses of the 2 data sets, hierarchical l ogistic regression models were implemented to assess the incremental effect s of problem behaviors, family characteristics, and adoption status on adol escents receiving counseling. Results: Selected adolescents' problems and f amily demographic characteristics were significant predictors for having re ceived counseling, but, after controlling for these variables, adoptees wer e still about twice as likely as nonadoptees to have received counseling. C onclusions: Prevalence of problems, adoptive family characteristics, and ad option status must all be taken into account to understand why adoptees are more likely to receive counseling. Clinicians should be sensitive to issue s that are especially salient in adoptive families.