Give siBLinGs the oPPoRtunitY to exPRess theiR FeeLinGs outsiDe oF the FaMiLY in a saFe anD nuRtuRinG settinG. Individual and/or family therapy with a trained clinician can be extremely beneficial for siblings. Sibling support groups with adult facilitators can also provide a welcoming environment for siblings to talk with other sibs who appreciate what they’re going through. Just as parents benefit from talking with other parents of similar children, it can feel both comforting and liberating for siblings to meet others who share their experiences. Siblings shouldn’t have to harbor painful secrets about their home life. encouRaGe siBLinGs to have theiR own Lives. Encourage siblings to develop interests and hobbies of their own. When possible, separate siblings so they get a break from one another; spending time apart can be refreshing for siblings and can lead to more positive interactions when they come back together. Help siblings identify “safe buddies” -- friends or relatives they can turn to when home life becomes difficult. Try to spend one-on-one time with siblings, even if it’s a simple activity like watching television together or walking around the neighborhood. connect with otheR PaRents oF chiLDRen with MentaL heaLth neeDs. Parents who struggle with similar issues can provide valuable resources, in addition to advice and support. Meet other parents through organizations that serve families of children with mental health needs, such as Wayside Youth and Family Support Network, which offers parent support groups; Think:Kids, which offers support groups and an interactive message board for parents; or Child & Adolescent Bipolar Foundation, which provides online forums and a monthly newsletter. If a parent support group is offered in your community, join it. If one isn’t available, approach your local school or mental health center and suggest starting one. RecoMMenDeD ReaDinG The Explosive Child: A New Approach to Understanding and Parenting Easily Frustrated, Chronically Inflexible Children by Ross W. Greene (also visit www.livesinthebalance.org) Being the Other One: Growing Up with a Brother or Sister Who Has Special Needs by Kate Strohm Turbo Max: A Story for Siblings of Bipolar Children by Tracy Anglada The Sibling Slam Book: What It’s Really Like To Have a Brother or Sister With Special Needs by Don Meyer (Editor) This guide was written by Emily Rubin, 2009 Gopen Fellow (emily.rubin@masiblingsupport.org). The Gopen Fellowship is sponsored by the Massachusetts DD Network: institute for community inclusion at uMass boston • eunice kennedy shriver center Disability law center • Massachusetts Developmental Disabilities council E.K. Shriver Center ResouRces within Massachusetts Massachusetts sibling support network | www.masiblingsupport.org The MSSN provides education, community-building, and a listing of sibling support groups. Federation for children with special needs | www.fcsn.org The FCSN provides information and education, and guidance with the special education system. Massachusetts advocates for children | www.massadvocates.org MAC offers legal advocacy regarding a child’s disability, poverty, race, and/or limited English. children’s Behavioral health initiative www.mass.gov/eohhs/gov/commissions-and-initiatives/cbhi/ CBHI helps children with mental health needs obtain services to succeed in and out of home. the Parents’ how-to Guide to children’s Mental health services within Massachusetts www.bostonbar.org/docs/default-document-library/bbaguide_2011update_2.pdf This guide helps parents identify the mental health resources and services their children need. wayside Youth & Family support network | www.waysideyouth.org Wayside offers parent and sibling support groups, mental health education, and other services. Parent/Professional advocacy League | www.ppal.net P/PAL provides resources, advocacy and useful publications regarding children’s mental health. Massachusetts Department of Mental health | www.mass.gov/dmh DMH offers programs and mental health services for children, adolescents and adults. asperger’s association of new england | www.aane.org AANE offers support, information, resources, and services to families of individuals with Autism Spectrum Disorders, PDD-NOS, and Non-Verbal Learning Disability. nationaL ResouRces sibling support Project | www.siblingsupport.org The Sibling Support Project offers support and information to siblings across the lifespan. sibling Leadership network | www.siblingleadership.org SLN provides tools, information and support to help siblings advocate for their brothers/sisters. national alliance on Mental illness (naMi) | www.nami.org/youth NAMI offers information, support and local programs for families of people with mental illness. national Mental health services Knowledge exchange network www.mentalhealth.samhsa.gov/child/childhealth.asp This website provides fact sheets, resources and programs geared to mental health issues. child & adolescent Bipolar Foundation | www.bpkids.org CABF offers information, brochures for educators, assessment tools, online forums, and more. The printing of this brochure was partially funded by the Massachusetts Developmental Disabilities Council. Supporting SiblingS of Children with Mental health needS Massachusetts DevelopMental Disabilities network chiLDRen with MentaL heaLth neeDs anD theiR siBLinGs Growing up as the typically-developing sibling of a brother or sister with mental health challenges can be confusing, embarrassing and scary. Some brothers and sisters are explosive, and some are withdrawn; others alternative between periods of normal and inappropriate behavior. Life at home can be very difficult for siblings of these children. “Walking on eggshells” is not a healthy way for anyone to live. All too often, the child with mental health issues in a family receives the bulk of parental attention, leaving the needs of siblings largely unmet. Some siblings internalize their pain and identify as the “easy” child in contrast to their challenging brother or sister, while others act out, seeking attention and approval. These siblings need support so they can learn to express their complicated emotions in appropriate ways and develop into well-adjusted adults. PaRentiFication Due to dysfunctions in the home environment, some siblings assume adult responsibilities before they are developmentally ready to do so. Taking on the role of the “little mother” or “little father” in the family can be the siblings’ way of managing stress, as well as an indicator that siblings are missing out on their childhood. inDePenDence Accustomed to less parental attention, many siblings of children with mental heath needs are more independent than their peers. Young siblings are often capable of tasks that typically exceed their age range, such as putting themselves to bed, completing homework without help, and preparing their own meals. oveRPRotectiveness Many siblings sense the vulnerability of their brother and sister, and come to their defense when criticized. They may try to protect them on the playground, in family arguments, and try to cover up for poor choices the brother/sister has made. The flip side of overprotectiveness is avoidance, when siblings become distant and withdraw from their brother or sister. coMPetinG FoR attention Children with mental health issues require unusual amounts of attention, and some siblings resort to negative behaviors of their own in order to attract parental attention. Other siblings see how emotionally taxed their parents or guardians are, don’t want to add to the perceived burden, and end up keeping too many personal problems to themselves. Love/hate ReLationshiP Since mental health issues often manifest sporadically, some siblings have periods where they get along well together, followed by bouts of intense dislike. It’s confusing for siblings when their best friend transforms into their worst enemy. The love/hate relationship can lead to feelings of guilt, worry and sadness. anGeR anD ResentMent It can feel unfair when the brother or sister is held to a different set of standards, or when siblings’ opportunities are curtailed due to the needs or demands of the brother or sister. Many siblings perceive that their brother/sister is rewarded for negative behavior, while the siblings’ efforts to comply with rules aren’t appreciated. Siblings can harbor great resentment over seemingly preferential treatment for their brother/sister; they don’t understand the difficult choices parents/guardians make when they “pick and choose” their battles, trying to keep peace in the house. whY suPPoRt siBLinGs? Siblings need to know that it is not acceptable to be treated poorly by someone they love or who loves them. When siblings accommodate themselves to their brother or sister’s dysfunctional behaviors, they learn an unhealthy model for building relationships in the future. To minimize the risk of entering abusive relationships as adults, siblings need the opportunity to address their conflicting feelings about their complicated families. It’s also important for siblings to understand their brother or sister’s condition, and why it leads them to act the way they do. Research shows that many children with behavioral challenges carry a diagnosis of developmental disability, mood disorder, or other psychiatric impairment. As they age, siblings tend to become primary advocates for their brothers and sisters with disabilities; this is especially true of female siblings. The more information and education siblings receive growing up, the more likely they are to advocate for their brothers and sisters later on, with awareness and compassion. In cases of extreme physical and verbal aggression, some siblings develop symptoms of post traumatic stress disorder. Ongoing support interventions for these siblings can help mitigate the onset of PTSD symptoms. Siblings need to understand that they are not responsible for their brother or sister’s mental health problems; it’s not their fault nor can they fix it. Knowledge is power. By examining and recognizing the complexities of their families, siblings can develop a strong sense of self and self-worth. how to suPPoRt siBLinGs taLK oPenLY with siBLinGs. The most effective intervention is for parents or guardians to talk openly with siblings, acknowledging the challenging family life in age-appropriate language. Listen actively to the sibling, and validate his/her complaints (“I know it makes you really angry when your brother/sister does such-and-such”). This will let the sibling know that their concerns are important, and that you understand how difficult it is for them. Try not to blame the child with mental health needs, and remind siblings that everyone has something they struggle with. Help siblings figure out what to say to friends and relatives about the brother or sister’s mental health issues. the siBLinG exPeRience The lives of most siblings are filled with fun, friendship, fights and rivalries, but siblings of children with mental health needs tend to experience a wider range of highs and lows. The following dynamics are common among these siblings: conFusion The unpredictable behavior and sometimes rapidly shifting moods of children with mental health needs can be very confusing to their siblings. Often the brother or sister is held to a different set of expectations and rules of discipline which may feel like a double standard. Another confusing dynamic is when relatives and family friends interact with the brother or sister in a different manner than they do with the siblings. saFetY Siblings of children with mental health needs are often subjected to physical and verbal aggression. Sometimes the brother or sister has alarming conflicts with caregivers, and sometimes the brother or sister threatens to harm him or herself. A sibling’s concern for his/her own safety or the safety of family members can lead to generalized anxiety, sleep problems, impaired concentration in school, and many other issues. shaMe Brothers or sisters with mental health needs often have difficulty controlling their behavior at home, at school, and in the community. Siblings might feel embarrassed by this behavior, which can translate into reluctance to invite friends over, to be seen in public together, and to participate in extracurricular activities.