Tips for Choosing a Therapist to Treat Harmful Sibling Dynamics

Finding a therapist who is knowledgeable of sibling dynamics can be a bit overwhelming. With all the different types of treatments and therapists out there, how do you know what you really need and where to start? How can you find someone who will take your experience with harmful sibling dynamics or sibling abuse seriously?

It is important to seek a therapist with a background and training, if not expertise, in sibling relationships, family systems, and/or child maltreatment. It is also essential that the therapist have a core understanding of trauma and attachment.

Negative sibling dynamics such as aggression and abuse are often, though not always, a result of faulty family functioning. If any of these dynamics are presently occurring, there may be a need for treatment to occur across various groupings of family members. For example, separate therapists may be needed for the parents/caregivers and individual children, with the goal of providing joint therapy later for the family unit.

Therapist's Training

When choosing a therapist, it is important to understand that therapists have a variety of degrees and educational/academic backgrounds that may impact the type of help you receive.

Social Workers (L.C.S.W.) have advanced training and an understanding of a person’s functioning in broader context: family, stressors, crises, strengths, limitations, history, and environment (culture, race, political climate, geographic location, social class).

Marriage and Family Therapists (M.S. or Ph.D.) diagnose and treat mental and emotional disorders specific to marriage, couples, and family systems. They are trained in family relationships and family functioning across the lifespan.

Psychiatrists (M.D. or D.O.) are medical doctors who specialize in mental health. They can prescribe medication to help address both mental and physical health symptoms. Psychiatrists conduct medical and psychological testing and engage in a variety of therapies.

Psychologists (Ph.D. or Psy.D.) seek to understand thoughts, emotions, feelings, and behavior and will explore family dynamics as part of that understanding. In addition, they are trained to conduct psychological testing.

Style of Therapy

There are many different types of therapy, but tools such as cognitive behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), or accelerated resolution therapy (ART) are helpful for treating trauma and improving general well-being and can be incorporated into any style of therapy.

A psychodynamic approach helps clients become more aware of the thoughts, feelings, behaviors, and actions that impact their sense of self, relationships, and functioning. Once awareness develops, shifts in perception and perspective can occur, leading to a greater sense of overall well-being. Psychodynamic therapy is based on understanding how the past impacts the present, how our past experiences are projected onto new people and new experiences, and how to develop greater self-reflection. Although it takes time, it has significant life-changing results.

Cognitive behavioral methods lend themselves to less time in therapy because they help to move the treatment along by providing concrete skills and techniques to alter intrusive thoughts and shift reactions and behavior. A cognitive behavioral approach addresses thought processes (often negative, distorting, or overwhelming) and offers adjustments or homework to address those faulty ways of thinking and develop coping skills. Integrating psychodynamic work with cognitive behavioral methods can be very helpful for survivors of sibling abuse.

Holistic therapy focuses on the whole person and integrates spiritual, physical, mental, and emotional forms of well-being. A holistic therapist may use other forms of healing to focus on symptom reduction, such as reflexology, breath work, and expressive arts. This can be very helpful when there are somatic effects of harmful sibling dynamics.

Finding the Right Fit for You

When looking for a therapist, practical considerations like location and insurance eligibility often take precedence. However, it is equally important to find a therapist who is a good fit for your experience and needs. Though it may feel intimidating, asking questions about a therapist’s training and experience is expected. This is your care and hearing the therapist’s answers will help you make the right therapeutic choice.

Consider having phone or in-person consultations with a couple of different therapists to determine which one is the best fit. If you aren’t ready for therapy, you may find several reasons why each person would not work for you, so consider your readiness.

No matter what type of education the therapist has or the method they use, it is essential that you feel validated, supported, and genuinely liked and cared for. It will take time for the therapist to learn you, but know that you are the expert of your own lived experiences and you will teach your therapist about who you are.

Depending on the role you played in sibling abuse, you may have different therapeutic needs. If you are a survivor, you may need help processing and managing your feelings (e.g., anxiety, depression, anger), addressing distorted beliefs about your responsibility for the abuse, and learning to trust others. If you are a parent of children who have experienced sibling abuse, you may want to find a therapist with a family systems approach who can help you intervene effectively. You may also need help with feelings of guilt and divided loyalties. If you are a sibling who caused harm, you may want a therapist who helps you behaviorally joined with psychodynamic exploration.