When a young one enters treatment, the entire family feels the impact. While much of the attention naturally focuses on the child receiving care, siblings are often left feeling confused, anxious, or even neglected. Let’s not forget about sibling support during treatment.
A sibling might experience a range of emotions such as fear, anger, guilt, loneliness and even relief, while struggling to understand the changes in the family dynamics. Parents play an important role in helping siblings feel supported and emotionally safe during this challenging time.
The Child Mind Institute provides some guidance on sibling support during treatment. When one child in a family consumes a lot of attention, restricts family activities, or upsets others in the home, siblings in the family usually react; and sometimes very differently. “Some kids will persuade themselves that they don’t need attention. Some start acting out and finding ways to get attention that might be negative. Some become big helpers and try to fix the problem for their parents. Some try to be extra good and avoid getting in the way. Some get angry.”, Says Dr. Emanuele.
Acknowledge their emotions.
Siblings may hold in their feelings when all the focus is on the child receiving treatment. Give them permission to express their feelings; even when those feelings are uncomfortable or difficult to hear. Kids might feel scared, angry, jealous or left out, and those emotions are completely valid. Let them know it’s okay to be upset. Create a safe space where they can talk out what they’re feeling. Focus on listening and acknowledging rather than fixing their emotions.
Encourage this sharing by asking open-ended questions, such as, “How are you feeling about everything?” Don’t assume they’re fine. When they do open up, give your full attention.
Communication is great, and so is having it age-appropriate.
Honesty is important, but you should tailor the information you share to your child’s age and developmental stage. For younger children, use simple language to explain what’s happening. Assure them they are safe and emphasize that the situation is not their fault, and not permanent.
For teens and young adults, they usually appreciate the respect of being included in conversations; they may want to know more or to help. Regardless of age, be mindful to give enough information so they feel included, and not too much to overwhelm them.
The hidden strain on siblings
When a child enters treatment for a serious illness, mental health condition or substance use disorder, the focus of the family shifts to the child whom is struggling. In the shadow of that intense attention lies a sibling that often goes unseen. Siblings often carry a silent burden. The sibling at home might avoid adding stress to an already fragile situation, thus becoming invisible. Parents, consumed with logistics, medical decisions, and emotional exhaustion, may overlook the quiet distress of the sibling who seems to be “doing fine.”
The emotional toll doesn’t always show up right away. In fact, it often appears in subtle behaviors such as trouble in school, sleep issues, anxiety, or strained peer relationships.
Awareness is the first step to change. Recognizing that a sibling is also on a difficult journey opens the door to more balanced care. Small actions can make a huge difference: Carving out one-on-one time, validating emotions, involving them in age-appropriate conversations, and seeking outside support when needed.
Participate in the family therapy provided by the treatment program.
Including siblings in the process isn’t just beneficial, it’s essential for maintaining family balance and emotional well-being. The feelings that the sibling at home is experiencing are normal. If not addressed, they can lead to long-term emotional struggles or strained sibling relationships. Parents can mitigate this by ensuring that siblings are part of the journey.
Inclusion doesn’t mean burdening siblings with adult responsibilities or frightening details. It means validating their emotions, answering their questions in age-appropriate ways, making sure all conversations aren’t “treatment talk”, and making them feel seen and heard. Bringing them to family therapy sessions, letting them write letters to their sibling and having regular check-ins to ask how they’re doing can mitigate the trauma on the child or children at home.
Help the sibling know their own boundaries.
The sibling at home might suppress their own feelings to avoid adding to their parents’ stress. Parents might not recognize the importance of helping siblings establish healthy boundaries with their recovering brother or sister. Research shows that many siblings deal with lifelong effects of having a sibling that has struggled with mental health or addiction.
Teach your children to set clear, respectful limits such as refusing to lend money, saying no to manipulation, or stepping away from toxic interactions. Let them know that it’s okay to protect their own mental and emotional health by creating distance if necessary. Reinforce the idea that love does not mean sacrificing their own needs. Maintaining boundaries can actually strengthen relationships by creating mutual respect.
Encourage peer support.
Sometimes siblings find it easier to connect with peers who understand what they’re going through. Support groups for siblings of children with mental health or addiction challenges can be incredibly helpful. The Sibling Support Project offers ideas for safe spaces to share and learn from others. You may want to involve trusted adults such as teachers, coaches or school counselors, who can provide siblings with another layer of support.
When a loved-one heals, the other loved-ones feels it.
Even though a child is in treatment, the family needs balance and stability. When one member is in crisis, the entire system feels the strain. When the needs of all children are acknowledged and supported, the family becomes more resilient. Healthy siblings who feel seen and valued are better able to cope, and can even grow into more empathetic, strong individuals because of what their family has been through. In the end, no child should feel like they have to compete for love or attention, especially during difficult times.
At Therapeutic Educational Consulting, we guide, support and recommend placement options for treatment centers, nature-based therapy, therapeutic boarding schools and alternative education for adolescents and young adults.
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