Siblings have different service needs over the course of their brother or sister's cancer journey. The below Timeline provides suggestions for the kinds of psychosocial risk screening, assessment, and support services that siblings might receive.
Some steps may be important at the time of the cancer diagnosis, while others may be most helpful a few months later, after the family has had a chance to adjust to cancer treatment. Certain steps (represented below with dashed lines) may only be necessary if the sibling shows signs of elevated psychosocial risk.
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Hover over each of the boxes below for more information.
Italicized steps represent comprehensive suggestions.
At cancer diagnosis: family-level screening using a validated measure (e.g, the Psychosocial Assessment Tool (PAT))
Family-level screening using validated measure (e.g., PAT)
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3 months after diagnosis OR with any medical event or treatment transition: Brief sibling-specific psychosocial screening (e.g, PAT Sibling Module - follow up version)
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6+ months after diagnosis: repeat brief sibling screening every 3 months and/or with any medical event or treatment transition until end of treatment
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Off-treatment (i.e., survivorship, bereavement): continue brief sibling screening as regular intervals (e.g., every 6 months)
Brief sibling-specific screening, involving multiple informants, every 3 months or with any medical event or treatment transition
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This is triggered by targeted/clinical screening outcome at diagnosis (family risk) or thereafter (sibling risk)
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Repeat sibling screening more frequently
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Comprehensive suggestion: Clinical interview with multiple informants, including parent, sibling, (and potentially school), in person or via telehealth
In-depth assessment in hospital or community focused on sibling risk, involving multiple informants
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Parents may also be better able to attend to siblings' needs after treatment is underway
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Possible "point-people" might include hospital psychologists, social workers, school counselors, etc.
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Revisit all universal-based support recommendations as families adapt to new cancer-related stressors
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Identify a "point-person" within hospital or community to ensure follow-through
Also includes all items under "Universal" support
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Refer for short-term hospital- or community-based coping skills training
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Raise sibling concerns to oncology team
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Provide consultation to community providers
Also includes all items under "Universal" and "Targeted" support
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Refer for individualized hospital- or community-based psychotherapy to address symptoms of psychopathology
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Provide medication evaluation as needed
Timeline made using Biorender.com
Sibling Blueprint
Our goal is to help psychosocial providers and their centers overcome common barriers and better support siblings when a brother or sister has cancer.
Funding
We are grateful to the Mattie Miracle Cancer Foundation for funding this research.
Email: childfam@bu.edu
Phone: 617-358-1633
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