Caring for siblings of a person with psychosis

How to ensure their emotional well-being and not leave them out of the process

Dr. Regina Vila Badia

Postdoctoral psychologist at the MERITT group. Research and Development Unit.

Parc Sanitari Sant Joan de Déu

Marta Coromina Sadurní

Psychiatrist. Assistant to the Mental Health Department

Parc Sanitari Sant Joan de Déu

When a child or adolescent has a psychotic disorder, the impact is significant for the entire family , not only emotionally, but also in organizational, work, economic, recreational aspects... And among all family members, the brothers and sisters of the affected person are especially vulnerable , due to the bond they usually have and because, often, they are still in a process of personal maturation. For this reason, it is essential to take care of them and give them the appropriate support so that they can face the disorder more effectively.

The lack of knowledge about psychosis, and how it will affect family dynamics, and the stigma associated with this disorder mean that siblings are often excluded from the process and there is a lack of awareness of how to include them. This leads to avoiding talking about the situation with them , with the intention of protecting them, and can make them feel displaced or forgotten in the midst of this challenging situation, creating a communication gap that can be detrimental for everyone.

Siblings are often excluded from the entire process, due to a lack of knowledge about the disorder, and people avoid talking about the situation with them, thinking that this will protect them. But that's not the case.

Furthermore, on certain occasions, this situation can generate an attitude of resentment towards the person with psychosis, since much of the attention and resources are probably directed towards them. Therefore, although attempts are made to keep siblings on the sidelines, often thinking that they will not notice what is happening, it is completely the opposite, and not including them can be very counterproductive .

How to manage psychosis at home

Recommendations for accompanying the siblings of a child or adolescent with psychosis

We leave you with some recommendations that can help you include siblings in the family process of adapting and supporting your son or daughter with psychosis, taking care of their well-being and strengthening family relationships.

Give them all the information so they can understand psychosis. Do it gradually, according to their needs, and encourage them to ask lots of questions, to find out to what extent they understand or not what is happening. The more they know, the easier it will be to manage the situation. Remember to answer their questions with truthful information and adapting them to their understanding capacities, adapting your language to their level of development. If you have difficulties or doubts about the extent to which they can understand what is happening, ask for help from health professionals or look for specific material for their age.
Listen and validate their feelings. They may feel a wide range of emotions, such as confusion, fear, sadness or frustration, and even a sense of responsibility. Encourage them to talk about their feelings and experiences and validate their emotions. Listening with empathy is essential.
Encourage open communication. Promote an environment where they feel comfortable sharing their concerns and thoughts. Open communication can help strengthen family bonds.
Establish routines and normality. They may feel disoriented at times. Establish clear routines and make sure to maintain a sense of normality as much as possible. This can help them feel more emotionally stable.
Encourage self-care. Remind them of the importance of taking care of themselves. Self-care, such as rest, proper nutrition, and exercise, is crucial to maintaining emotional strength.
Offer them emotional support. Be available when they need it and listen to their concerns. Sometimes, they just need someone to listen to them.
Encourage them to seek outside support. Sometimes talking to someone outside the family can be beneficial. Encourage them to also seek support outside the home (friends, support groups, or therapists), if they feel they need it.
Promote patience and understanding. Recovery for the person with psychosis can be a long and challenging process. Encourage them to be patient and understanding along the way.
Involve them in the treatment process . When appropriate, explain to them what is happening, what treatment is being carried out, and how they can be part of the ongoing support.
Find spaces to enjoy with family. Look for spaces for the whole family to enjoy, but also, if necessary, find moments alone with siblings not affected by psychosis. Maintaining a strong bond with parents is essential, and finding time alone with them will make them feel that their concerns and problems are also important. They need to be able to enjoy life like any other child in a different environment, participating in activities as they did before (trips, excursions, school camps, outings), as this can contribute to their well-being and normalize their experience.

The role of siblings is crucial in the recovery process of a child or adolescent with psychosis. Caring for them, educating them, and providing them with resources can provide a beneficial environment for resilience and recovery. Together, as a family, you can face this challenge and grow stronger.