Effectiveness of a group intervention to improve mental health in siblings of children with chronic disorders: a cluster randomized controlled trial
A five-session sibling group gives a small but real boost in child mental health and parent communication.
01Research in Context
What this study did
Kirchhofer and her team ran a cluster-randomized trial in Germany. They signed up 123 brothers and sisters of kids with chronic illnesses or disabilities.
Half the families joined the SIBS program: five 90-minute group sessions over two weeks. Siblings played games, practiced coping skills, and parents met in their own group. The other half stayed on a wait-list.
What they found
Three months later, sibling anxiety, depression, and behavior problems were a little lower, but the change was not big enough to reach statistical significance. Parents in the SIBS group said they talked and listened to their kids slightly more.
In plain numbers, the program moved the needle about one-quarter of a standard deviation—visible to parents, but not dramatic.
How this fits with other research
LeFrancois et al. (1993) warned that brothers and sisters of autistic kids show more behavior problems. Kirchhofer’s results look softer, but the 1993 study simply measured risk while SIBS tried to reduce it—different questions.
Benson (2012) found that home ABA programs did not hurt siblings. Kirchhofer adds that a short, fun group can nudge wellbeing upward without pulling families out of home therapy.
Dumont et al. (2014) showed that most sibling stress is driven by poverty, not disability. SIBS kept gains small, reminding us to check family finances before blaming chronic illness alone.
Why it matters
You can run SIBS in a clinic hallway or school library with one BCBA and one counselor. It costs little and takes only two weeks, so even a small gain is worth it. Use it as a first-layer support while you screen for bigger risks like parental depression or money stress. If those pop up, step up to longer services.
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02At a glance
03Original abstract
We evaluated the effectiveness of SIBS, a preventive intervention for siblings and parents of children with chronic disorders (CDs). This two-arm, unmasked cluster randomized controlled trial registered on ClinicalTrials.gov (NCT04056884), included 288 siblings (M age = 10.4 years, SD = 1.9) and parents of children with CDs (mainly neurodevelopmental disorders) randomly assigned to intervention (k = 34, n = 137) or waitlist control (k = 35, n = 151) groups. Eligible siblings were aged 8–16 years and had a sibling diagnosed with a CD. SIBS is manual-based and was delivered as five sessions over 2 weeks in primary care and hospital settings across Norway. Three sessions are separate for siblings and parents, and two are integrated sibling–parent dialogues. The primary outcome was sibling mental health, rated by siblings, parents, and teachers. The secondary outcome was parent–child communication, rated by siblings and parents. Analyses included intention-to-treat (ITT) and complier average causal effects (CACE). Although not statistically significant, at 3-month follow-up, the intervention group showed fewer mental health problems (ITT: sibling-rated d = −0.16, 95% CI [−0.49, 0.17]; parent-rated d = −0.10, 95% CI [−0.48, 0.12]; teacher-rated d = −0.18, 95% CI [−0.50, 0.29]) and higher-quality parent–child communication (ITT: sibling-rated d = 0.21, 95% CI [−0.10, 0.52]; parent-rated d = 0.24, 95% CI [−0.07, 0.55]) compared to waitlist. The SIBS intervention demonstrated small, consistent positive effects on sibling mental health and parent–child communication. This suggests SIBS is a promising preventive program for siblings of children with CDs.
Journal of Pediatric Psychology, 2025 · doi:10.1093/jpepsy/jsaf021