New pathways to parenthood are being traveled by growing numbers of couples and single adults, including many who face medical and social barriers to having children. From a psychological standpoint, families formed by complex adoption and assisted reproductive technology (ART) are first and foremost just that/m-/families. Yet they also face a unique array of issues and challenges that may be clarified and resolved in the therapeutic setting. This much-needed book provides a deeper understanding of the ways that complex adoption and ART shape the life experience of children and parents, identifying important areas and methods for assessment and treatment. Combining developmental and ecological research with in-depth case material, the book establishes an integrative framework for clinical practice. The authors draw upon knowledge and skills gained from working in a variety of new family contexts. In the area of adoption, many new options have evolved that differ from traditional practices of adoption at birth. Thousands of older children in foster and institutional care in the United States and abroad are awaiting permanent placements. Open adoption, kinship adoption, and transracial adoption are also transforming family life, as is the use of ART, which raises significant issues of family identity and family process. The book explores such key themes as the significance of early experience, the capacity to recover from exposure to trauma, the impact of heredity and the difference that environment can make, and the centrality of primary attachment relationships. Also discussed are the impact of bias and other issues affecting families of difference, including lesbian and gay families. Concluding chapters consider promising future directions for training and research. This is an important resource for social workers, family therapists, clinical psychologists, psychiatrists, and other professionals working with children and families, as well as researchers and students in these fields. It will serve as a text in advanced undergraduate and graduate-level courses.