Kate Snow, NBC News

International adoption is by its nature an emotional journey, one that traverses the highs of creating a family and the inevitable lows born of jarring change.

The road can be rough, both for the parents who often must deal with children with post-traumatic behavioral issues, and for kids who suddenly find themselves immersed in a new family and a strange culture.

"It's the wildest ride you will ever take," says Shelli Giess, who with her husband, John, adopted two boys – one from Russia and the other from Guatemala. "And it's also the most satisfying and loving ride you will ever take."

While adoption can itself be daunting, adoption of a child from another country carries its own special set of challenges, experts say. Often the children have endured poverty, neglect or abuse and become anxious or act out in their new surroundings. And, however difficult the circumstances, they also have been separated from their birth parents and been uprooted from their homelands.

With minimal professional support often available, many newly forged families struggle behind closed doors. There, feelings of anxiety, anger and inadequacy can feed a destructive cycle that leads parents to consider desperate measures such as private "re-homing" – a practice in which they transfer guardianship of the children to strangers, without any consultation or oversight from child welfare agencies, counselors, courts or lawyers.

An innovative program in Cincinnati is working to change that dynamic for the Giesses and other families, providing a network that can help them weather the storms – or ensure that the kids land in a safe harbor if a living situation is untenable.

"I don't want them to be feeling alone, that there's no one out there that can help them," said Dr. Mary Staat, who founded the International Adoption Center (IAC) at Cincinnati Children's Hospital in 1999, based on her experiences as a doctor and an adoptive parent of three foreign-born kids. "… I think that's where we have the problems with re-homing. … People feel that, ‘No one understands what I'm going through. … I'm ashamed of what I'm feeling and I'm ashamed that I can't care for the child anymore and I'm at the end of the road."

With international adoption by U.S. parents declining in recent years – down from a high of 22,991 in 2008 to 8,668 in 2012, according to the State Department – some adoption advocates are concerned that funding for programs like the IAC will be scaled back.

But Staat says that would be short-sighted, given that hundreds of thousands of internationally adopted children are living in the U.S. and will continue to need support, even as they become adults.

"It's not just when they come home, but it's throughout their lives," she said.

The IAC provides a broad range of services -- everything from counseling for couples or individuals contemplating adoption to education, nutritional guidance and mental- and behavioral-health therapy for families having difficulty adjusting to their new reality.

NBC News got an inside look at the program in early March, observing as therapist Tisha Way, seated behind a two-way mirror, coached Shelli Giess as she played in an adjacent room with her adopted son Braeden, 8, who was born in Guatemala.

Known as "parent-child interaction therapy" the session unfolded with Way sometimes letting mother and son play on their own and at other times offering tips on behavior modification techniques via a hand-held radio and an earpiece worn by Shelli.

"A lot of times, the behaviors can be so difficult to manage for families that … even just having that one-on-one time with their child is something that is a struggle to do," Way said. "So what we're really doing is kind of taking a step back. Even though we may not be specific talking about the behaviors that we're targeting, we're helping them re-engage with the child.

"… Our goal is to kind of start really small, helping put some really good parenting practice(s) in place, and then see kind of where we can go from there in handling some of the other pieces."