For the past 50 years, adults who were adopted during infancy have been research participants for empirical studies with goals ranging from twin studies for heritability, to adjustment following adoption, to attachment. While the research body is broad, it has given little attention to counseling practices with adopted adults. Because empirical research and clinical practice can inform each other, this article integrates literatures in both areas so that counseling practice with adopted adults can guide research, just as research guides practice. The authors grouped the clinically relevant literature into three main areas: identity (including genealogical and transracial adoption issues), search and reunion, and long-term outcomes. Within each section, the authors critiqued the literature as it informs counseling practice, used case studies to depict clinical implications, and suggested treatment strategies for use with adult adoptees. Epidemiological research found adequate adjustment for adopted adults. However, clinicians and researchers must address the consistent finding that a subset of adoptees struggles and copes with issues different than their nonadopted counterparts. The authors identify best clinical practices and a future research agenda related to adult adoptees and propose an adoption-sensitive paradigm for research and practice.