Grotevant, however, sounded a note of caution to those who portray it as a panacea. The children of open adoption do not have higher self-esteem than those in closed adoptions, he observed. For children in each group, self-esteem is about the same, his research found. He stressed that more research is needed to assess the impact of open adoption on adolescents. (The research he did with McRoy studies children up to age 12.)
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There are also private search companies and investigators who charge fees to do a search for or assist adoptees and birth mothers and fathers locate each other, as well as to help other types of people searching. These services typically cost much more, but like search organizations and search angels, have far greater flexibility in regards to releasing information, and typically provide their own intermediary services. However, they may not circumvent the law regarding the confidentiality process.
Closed adoption has been increasingly criticized in recent years as being unfair to both the adoptee and his or her birth parents. Some people believe that making the identities of a child's parents quite literally a state secret is a gross violation of human rights. On the other hand, the birth mother may have desired the secrecy because of the circumstances of the child's conception.

For those who do not want a completely open adoption, there is the option of semi-open adoption. Semi-open adoption is a great option to create an adoption relationship that meets the needs of a particular situation. Every adoption relationship is different, and semi-open adoptions can take many forms; a typical semi-open adoption involves communication without exchanging identifying information, along with sending pictures and letters on occasion.
Most open adoptions lie somewhere in the middle, according to Grotevant and McRoy, exchanging letters, pictures, and phone calls, and having face-to-face meetings once or twice a year. Whatever their situation, many families report that relatives and friends condemn openness, and voice fears that the arrangement will make the birth parent want the child back.
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