When one family member suffers, everyone is affected. The effect of chronic illness on the psychology of a patient and their parents is well documented. However, less is known about its impact on siblings. Although researchers have investigated this topic, there is quite a bit of uncertainty. Some think that siblings of chronically disabled kids are an ‘at risk’ group, while others believe that they are actually ‘more resilient’. 

Although children with sick siblings are at a higher risk for anxiety and depression, the underlying cause is usually a changing family dynamic, not the existence or severity of their family member’s condition2. Generally, the more their sibling’s condition affects a child’s day-to-day functioning, the more likely they are to experience anxious and depressed feelings. One study found that a family’s resiliency consistently explains the difference in siblings’ emotional reactions. A family’s ability to adapt to changing demands, access resources, solve problems, and develop coping strategies affect the way that a child may respond to their changing situation3. When parents adjust well, both they and their children can combat negative psychological symptoms better. 

It is important to remember patience when caring for the sibling of a child with chronic pain. While it is common for siblings to take on a caretaking role, they should not be expected to always react calmly and compassionately to their situation2. When one child is sick, siblings may feel worried, stressed, jealous, or left out as parents must spend more time with their sick child. 

Pain disorders are often impossible to see, and some kids may have trouble believing that their siblings actually need all of the attention they’re receiving. To communicate and foster open relationships with both patients and their siblings, it is often helpful for parents to engage in ‘non-contingent’ child time*, positive interactions, and reflective listening*2


*Non-Contingent Child Time: providing regularly scheduled attention to a child. This attention should not depend on any other factors that might come up. Whether or not the child has been doing their chores, being nice to their siblings, etc. 

*Reflective Language: using words that mirror the child’s to describe your observations. ex. “I can see that you have not been very happy with your brother today.” 

 Donald Sharpe, Lucille Rossiter, Siblings of Children With a Chronic Illness: A Meta-Analysis, Journal of Pediatric Psychology, Volume 27, Issue 8, December 2002, https://doi.org/10.1093/jpepsy/27.8.699 

Coakley, Rachael. (2016). When Your Child Hurts: Effective Strategies to Increase Comfort, Reduce Stress, and Break the Cycle of Chronic Pain.

Riper, Marcia. (2000). Family Variables Associated With Well-Being in Siblings of Children With Down Syndrome. Journal of Family Nursing. 6. 267-286. 10.1177/107484070000600305. 

Bettoli-Vaughan, E., Brown, R. T., Brown, J. V., & Baldwin, K. (1998). Psychological adjustment and adaptation of siblings and mothers of children with HIV/AIDS. Families, Systems and Health, 16, 249-266.

 Palermo, T. M., & Law, E. F. (2015). Managing Your Child’s Chronic Pain. Oxford University Press.