The Double Bind of Siblings in Adolescent Substance Abuse Treatment
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Siblings have been found to be perhaps the greatest source of social risk for adolescent substance abuse, particularly when the relationship is close. But, close sibling relationships are also linked to an array of important developmental and lifelong protective benefits. Sibling closeness simultaneously poses considerable risks and benefits. These conflicting findings suggest opposite treatment directions, or a “double bind” for practice. That sibling closeness risks contagion suggests treatment that aims to decrease sibling closeness. On the other hand, the many lifelong and protective benefits of close sibling relationships suggests increasing sibling closeness when possible. Family-based treatment is recommended for adolescent substance abuse, but offers little explicit direction for involving siblings in general, and none for this double bind. This paper untangles and translates the extant literature into preliminary practice guidelines; the Sibling Substance Abuse Treatment Matrix. Important variations related to gender, and age-spacing are considered. Implications for future research and practice are discussed.
KeywordsFamily treatment Sibling influence Brothers and sisters Substance use Adolescence
The author would like to thank Dr. Daniel Caspi for assisting in the conceptualization of The Matrix.
J.C.: conceptualized, designed and wrote the manuscript and treatment matrix. D.T.L.: collaborated with the design, format, and writing of the manuscript. V.R.B.: collaborated with the design and writing of the manuscript.
This study received no federal, state, private or other funding.
Compliance with Ethical Sandards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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