Fostering Resilience in Siblings of Youths with a Chronic Health Condition: A Review of the Literature

Abstract

An accumulating body of literature points to the potential for successful outcomes among families who have a child with a chronic health condition. Resilience research has catalyzed a reconceptualization of the experience of such families from a deficit, pathological perspective to a growth-enhancing opportunity. However, scant data available about the specific risk and protective mechanisms influencing the psychosocial outcomes of well siblings in these families are lacking. This article draws on the literature addressing resilience in youths experiencing adversity to inform social workers about how to better promote positive outcomes among well siblings. Implications for future research and suggestions for social work practice to target the unique needs of well siblings are discussed.

The Perspective of Siblings of Children With Chronic Illness

“…Thus, siblings are affected by experiences of loss (Alderfer et al, 2010;Bellin & Kovacs, 2006;Murray, 1999;Van Riper, 2003;Wilkins & Woodgate, 2005) as perceived through the lack of parental availability (Alderfer et al, 2010;Bellin & Kovacs, 2006;Murray, 1999;Vermaes, van Susante, & van Bakel, 2012) and time (Alderfer et al, 2010, p. 797;Murray, 1999;Wilkins & Woodgate, 2005), as well as by separation anxiety (Murray, 1999) caused by frequent hospitalization and concern about the death of the ill sibling (Murray, 1999;Van Riper, 2003;Wilkins & Woodgate, 2005). As a consequence, they feel lonely (Alderfer et al, 2010;Murray, 1999;O'Brien, Duffy, & Nicholl, 2009;Wilkins & Woodgate, 2005;Williams, 1997), unimportant (Van Riper, 2003Wilkins & Woodgate, 2005), ignored (Alderfer et al, 2010), displaced (Bellin & Kovacs, 2006;Van Riper, 2003) neglected (Alderfer et al, 2010;Van Riper, 2003) and experience feelings of rejection (Murray, 1999;Wilkins & Woodgate, 2005;Williams, 1997). These attributes result in emotional deprivation (Bellin & Kovacs, 2006;Murray, 1999;Van Riper, 2003;Wilkins & Woodgate, 2005).…”

“…As a consequence, they feel lonely (Alderfer et al, 2010;Murray, 1999;O'Brien, Duffy, & Nicholl, 2009;Wilkins & Woodgate, 2005;Williams, 1997), unimportant (Van Riper, 2003Wilkins & Woodgate, 2005), ignored (Alderfer et al, 2010), displaced (Bellin & Kovacs, 2006;Van Riper, 2003) neglected (Alderfer et al, 2010;Van Riper, 2003) and experience feelings of rejection (Murray, 1999;Wilkins & Woodgate, 2005;Williams, 1997). These attributes result in emotional deprivation (Bellin & Kovacs, 2006;Murray, 1999;Van Riper, 2003;Wilkins & Woodgate, 2005). Wilkins and Woodgate (2005) reviewed one descriptive, exploratory study by Walker (1988), in which siblings applied internalization as a coping strategy in the sense of self-focusing.…”

“…Deliberately or subconsciously, they sought distraction, either alone or in a group, or withdrew themselves by taking a time out or even by escaping. Further intense feelings that siblings display range from sadness (Alderfer et al, 2010;Murray, 1999;Wilkins & Woodgate, 2005;Williams, 1997) and sorrow, for example about the affected family member, its death and the family's future perspectives (Murray, 1999;Van Riper, 2003;Wilkins & Woodgate, 2005), up to anxiety (Bellin & Kovacs, 2006;Murray, 1999;O'Brien et al, 2009;Sharpe & Rossiter, 2002;Wilkins & Woodgate, 2005). In contrast, Alderfer et al (2010) only emphasized tendencies, but at the same time no increased risks of anxiety in 78 % of studies (14 of 18).…”

“…In contrast, Alderfer et al (2010) only emphasized tendencies, but at the same time no increased risks of anxiety in 78 % of studies (14 of 18). Several authors surveyed a particular vulnerability of siblings (Alderfer et al, 2010;Bellin & Kovacs, 2006;Wilkins & Woodgate, 2005) and linked it to their sense of being at fault and responsible for their siblings' illness (Alderfer et al, 2010;Wilkins & Woodgate, 2005). If the illness is associated with a disfigurement of the affected child, siblings potentially depict feelings of shame (Bellin & Kovacs, 2006).…”

“…A number of studies implicated that siblings develop feelings of anger (Alderfer et al, 2010;Bellin & Kovacs, 2006;Murray, 1999;Vermaes et al, 2012;Wilkins & Woodgate, 2005;Williams, 1997). The following passage shows different ways of how they externalize their resentments.…”