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Don't forget the siblings: School-aged siblings of children presenting to mental health services show at-risk patterns of attachment.

Authors
  • Kozlowska, Kasia1
  • Elliott, Bronwen2
  • 1 1 The Children's Hospital at Westmead, Westmead, Australia; Brain Dynamics Centre at Westmead Millennium Institute of Medical Research, Westmead, Australia; and Discipline of Psychiatry and Discipline of Child and Adolescent Health, University of Sydney Medical School, Australia. , (Australia)
  • 2 2 Private Practice - Good Praxis, Australia. , (Australia)
Type
Published Article
Journal
Clinical child psychology and psychiatry
Publication Date
April 2017
Volume
22
Issue
2
Pages
245–259
Identifiers
DOI: 10.1177/1359104516653993
PMID: 27324573
Source
Medline
Keywords
License
Unknown

Abstract

Family therapists understand that children presenting for treatment are often bearers of symptoms signalling relational problems within the family system. Rather than addressing the children's symptoms in isolation, family therapists typically take those relational problems as their starting point in therapy. This study used the School-aged Assessment of Attachment (SAA) to assess the self-protective (attachment) strategies of the siblings of children presenting for psychiatric evaluation and also of the siblings of control children drawn from the normative population. Siblings of children in the clinical group were much more likely than siblings of control children to use at-risk self-protective strategies and to have markers suggestive of unresolved loss or trauma. School-aged siblings were found to use a broad range of strategies, and the pattern of change from first born to later born involved either a reversal of strategy or a shift to a more complex strategy. The study highlights that siblings of children presenting to mental health services are significantly affected by family relational stress. A family systems approach to assessment, one that enquires about the wellbeing of all family members, will ensure that the emotional needs of siblings are also addressed during the therapy process.

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