Effectiveness of a group intervention to improve mental health in siblings of children with chronic disorders: a cluster randomized controlled trial.

Abstract

Abstract Objective: We evaluated the effectiveness of SIBS, a preventive intervention for siblings and parents of children with chronic disorders (CDs). Methods: This two-arm, unmasked cluster randomized controlled trial registered on ClinicalTrials.gov (NCT04056884), included 288 siblings (M age ¼ 10.4 years, SD ¼ 1.9) and parents of children with CDs (mainly neurodevelopmental disorders) randomly assigned to intervention (k ¼ 34, n ¼ 137) or waitlist control (k ¼ 35, n ¼ 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-totreat (ITT) and complier average causal effects (CACE). Results: Although not statistically significant, at 3-month follow-up, the intervention group showed fewer mental health problems (ITT: siblingrated d ¼ −0.16, 95% CI [−0.49, 0.17]; parent-rated d ¼ −0.10, 95% CI [−0.48, 0.12]; teacher-rated d ¼ −0.18, 95% CI [−0.50, 0.29]) and higherquality parent–child communication (ITT: sibling-rated d ¼ 0.21, 95% CI [−0.10, 0.52]; parent-rated d ¼ 0.24, 95% CI [−0.07, 0.55]) compared to waitlist. Conclusions: 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. Keywords: siblings, parents, intervention, prevention, randomized controlled trial.