I'm assuming that the pediatrician has ruled out any actual medical causes for the peeing, and that the therapist has done what she can to determine what might be causing it psychologically (although I'll admit, it sure sounds like she could take her pick, poor kid). I will say that if you don't like what the first pediatrician has said, it's well within her birthmother's right to request a second opinion, either from another ped in that office or a different office altogether, just to rule out any medical cause. Are you absolutely sure the girl is doing this on purpose, and it's really not accidental? But what about the girl herself? Is SHE embarrassed by the accidents? What's her reaction to them? If she's doing them on purpose, you're going to have to determine why she's doing it before you can figure out how to convince her to stop - whether it's reassurance that you and her birthmom still love her and want her, that she's not going to lose contact with her brother and/or you, or that she's still a valued member of the family whose opinions matter, and not something that's been shuttled from one household to the next. (I'm not saying you haven't told her any of these things, but perhaps she hasn't been able to believe it yet.) Good luck.