Abstract
Siblings of children with chronic disorders are at increased risk of experiencing family communication problems and poorer mental health. We assessed initial feasibility, acceptability, and outcomes of SIBS; a manual-based group intervention for siblings and parents of children with chronic disorders, aiming to improve parent-sibling communication and sibling mental health. Ninety-nine siblings aged 8–16 years (M = 11.5 years, SD = 2.0; 54.5% girls) and parents (63.6% mothers) of children with chronic disorders participated in three separate group sessions for siblings and parents and two joint sessions with integrated sibling-parent dialogues. We assessed participant satisfaction post-intervention and checked for group leader manual adherence. We measured the following outcomes at baseline, three, and six months post-intervention in an open trial: (1) parent-sibling communication quality; (2) sibling emotional and behavioral problems; (3) sibling adaptation to the disorder; and (4) sibling disorder knowledge. Using growth curve modeling, we found significant improvement in parent-sibling communication quality (p = 0.001), emotional and behavioral problems (p = 0.009), adaptation to the disorder (p = 0.003), and disorder knowledge (p = 0.000) from baseline to follow-up (effect sizes d = 0.22 to 0.64). Improvement in sibling-reported emotional and behavioral problems and adaptation to the disorder was partly explained by communication quality. User satisfaction was high and manual adherence was good. Our evaluation yields support for the SIBS intervention, with initial evidence of acceptability, feasibility, and beneficial outcomes. Our study suggests targeting parent-sibling communication may be a beneficial way of improving siblings’ mental health.
Highlights
IntroductionMany previous sibling interventions studies have included no parental involvement or have provided limited descriptions of the parental component (Tudor and Lerner 2015)
Siblings do not necessarily meet criteria for clinical diagnoses, a metaanalysis showed they are at increased risk of emotional and behavioral problems compared to controls (Vermaes et al 2012)
A recent metaanalysis identified that communication in families of children with chronic disorder (CD) is characterized by lower levels of warmth/ structure and higher levels of hostility/intrusiveness/withdrawal compared to families of typically developing children (Murphy et al 2017)
Summary
Many previous sibling interventions studies have included no parental involvement or have provided limited descriptions of the parental component (Tudor and Lerner 2015) These are important limitations, given that CDs affect the entire family system, and that parental behaviors and attitudes may be key to understand and relieve siblings’ emotional distress (Incledon et al 2015; Lobato and Kao 2002; Taylor et al 2001). We argue that targeting parent-sibling communication may help siblings share their emotional experiences and help parents provide emotional support, which in turn may improve siblings’ emotional and behavioral functioning and adaptation
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