Engaging Siblings in Family Work
Leah Madamba, MS, NCC, LCMHC, Family Services Director at Trails Carolina
Brenda Zane is a Sky’s the Limit Fund board member, Founder of Hopestream Community, and podcast host of Hopestream
About the episode:
Siblings are our longest standing relationships; in 1998, 83% of the adult population in the U.S. had at least one sibling in their family. Leah Madamba sheds some light on the importance of this relationship and engaging them in family work.
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Hi, and welcome, we are back for another guest speaker series with Sky’s the Limit Fund. I’m Brenda Zane, I am the lucky board member of Sky’s the Limit Fund who gets to have these amazing conversations with some of our partner, program staff. And today we are going to have a great conversation all around siblings, which is a topic that tends to get forgotten about. So I’m very excited for it. First, let me give you just a brief update on what sky’s the limit does and why we exist. It is a amazing organization, nonprofit where we help families who have a young person in crisis, either an adolescent or young adult in crisis, who is really in need of getting into a therapeutic environment. And so we support families in getting their kids into wilderness therapy, and then also supporting them with wraparound services after that wilderness therapy with coaching both for the family and for the young person. So that’s what we do we survive on the and thrive on the donations from organizations, families, and foundations. And so we thank you very much if you are supporting us. And today, like I said, we are going to be talking with Lea Madamba from Trails Carolina, she’s the Family Services Director there. And she’s going to be talking with us about the sibling relationships and how that is such an important element of the whole therapeutic process and how there’s some research out that we can learn about that’s been really helpful to really understand why that relationship is important and how we can incorporate it. So let me just go ahead and welcome Leah.
Hello. Hi, Brenda, nice to see you.
Nice to see you too. I’m so glad that you could be here with us today to have a conversation that tends to not get talked about a lot. And I know it’s something that you are really focused on that there actually is research about that a lot of us don’t know about. So I’m excited to have the conversation. Why don’t you just give us a little bit of background on where you been over your career and how you ended up at trails and what you’re focused on now. Yeah,
I have been in this industry for over 20 years, I’m a licensed clinical mental health counselor and a parent coach as well. And most of that time has been in wilderness, although I did have some time supporting some residential treatment programs and running a nationally based transition program. And that gave me a perspective of seeing families throughout the continuum. And all of that is what brought me back to wilderness and trails specifically, because I just think, you know, being in the wilderness is where the magic happens. And it Trails Carolina, we have a really great team, we’ve integrated family from the beginning of our program. And it’s it’s a real honor to lead that team in the services we offer.
Amazing. Yeah, I would imagine that that’s very interesting for you to see the whole process with not only the young adult, or the adolescent who’s there for treatment, kind of as the identified patient, and then seeing the whole family and all the dynamics that come into play when one is really struggling. But as we know, the whole family has really been impacted. So I’m excited to to learn a little bit more. Why don’t you just tell us what, what kind of the thinking is in the industry right now around siblings? Because I’m curious to see how that’s developed over the years.
Yeah, you know, the wilderness therapy field has developed so much, even going from that mentality of an identified patients, including family and that has been happening for the past couple of years. But I think that the sibling frontier in particular is still not always included or addressed by everybody. And there’s some reasons for that we’ll talk about today I think that sometimes tricky to address the sibling dynamic because they’re not the identified patients are not the one that is in program so it can be harder to or you know, to figure out when do you bring them in and how do you do that, but it’s something that we’ve been really focused on lately and we’ve seen some really great benefits come from it.
Yeah, and why siblings because it seems like you know, clearly one one child in the family is really struggling with something maybe mental health concern maybe substance use. And if that other child isn’t the one struggling why is it important to include them?
You know, the the research which there’s not a lot them on siblings, but the research that they have done shows that siblings can ask actually have a really strong effect. I think that the 9098 they said that 83% of the US population has at least one sibling. So there’s a lot of them out there. And this is the longest standing relationship that we have. And so it’s, you know, the mentality is like, Well, gosh, if there’s something we could do to, to use that as an influence, and and help the person that’s in the program that can help shift the whole system, why wouldn’t we do that?
Yeah, that does make sense it is, it is a long standing relationship, I guess outside of your parents. So that person knows you better than most. Maybe for for good or worse. You know, you better than most, what kinds of relationships are happening among siblings? I guess, you know, we all think about our, if we have siblings, we kind of think about our own and some are good, and some are challenging for sure. What do you see with the relationships between these between kids and families,
you know, some, some of the siblings come in with a lot of resentment. Because there have been so many resources being poured into that identified patient, the person, that’s the kiddo that’s in the wilderness program, and that’s where all the family resources, time, emotion, sometimes even money to is going. And so sometimes those those other siblings are getting the short end of the stick, and they feel really irritated about that, or they feel concerned and, you know, depression and anxiety can come up because they are watching this sibling who’s maybe dealing with depression, and, you know, suicide ideation. And those can be really scary things, too. So, you know, it’s important, we want to make sure that we’re giving space to the siblings to share their part of the story and, and help give them a way to feel like they can be involved in it.
Yeah, I know, just from my own experience, with my son, when he went to wilderness, you know, there were years of drama, and chaos, and, and all of that, and what you just said, really resonated as far as the resources all going to the one who was really struggling. And it took a little while to kind of figure out what that was gonna look like going forward. So do you actually have siblings participate in, in therapy? Or how do you actually like, what’s the mechanism to get the siblings involved?
Yeah, you know, the, one of the big pieces, we did a psycho education. And that was what some of the research found to, you know, when they did research on siblings, they found that when there’s a long standing chronic mental health issue, that that’s where you know, you get some of these effects on, on the siblings. But these, they really lump everybody together from cancer patients to kids on the spectrum to depression. And but with that big broad group, they talked about the importance of psychoeducation, which really reaffirms what we were already. Research shows that psychoeducation is a really big, important factor for kids and understanding what’s happening for their siblings and reading that was really reassuring to some of the work that we’re doing. It Trails Carolina, because we’re trying to educate the siblings about what the work is at trails, what are what’s my son? Where’s my sibling eating? You know, where are they sleeping? How do I write them letters? And what are the skills that they’re learning? So that’s one part of the psychoeducation. And then we also talk with families about, you know, as, especially as we learn more about the kids while they’re with us, are there other things that we could be educating them about, about what is depression? And what does it look like to have a sibling on the spectrum? And how does that influence their lives?
Oh, yeah. I was gonna ask for those of us who aren’t familiar with the term psychoeducation. What’s kind of the layman’s term of that? We could think about,
yeah, just really teaching teaching what what happens in the program, and also teaching about what does it mean to have a mental health issue? And, and I think sometimes even naming those things can be helpful for siblings to reassure, like, oh, let’s, it wasn’t all my fault. And I’m just caught up and part of the family system that I live in.
Yeah, it would be important, I would think, too, because I think sometimes as parents, we assume that our kids know more than they know. And also, I think on the flip side, sometimes we think, Oh, well, they don’t know everything, when the kids might actually know even more than we do as parents because those relationships can be close. Do you find things like that?
Absolutely. We see very frequently, the siblings, some of them are even helping to enable the situation, you know, they get caught up in it too. And maybe they’re helping to cover things up, or helping to facilitate, help, you know, choices that aren’t always healthy for their sibling. So they will often know more than maybe even the parents know about what’s happening.
Right. And I would think that there could even be some guilt or potential Willie, if they have been, you know, just probably doing what they thought was the right thing to do, or the helpful thing to do. Or potentially sometimes I think siblings could even feel a little bit threatened. Well, I have to do this. Because, you know, I see my siblings going through this. And then when they when they have to go into treatment, that other sibling that still home, I would think could feel some guilt or some like remorse, did I do the wrong thing? Did I make this happen? Or those kinds of things that that you guys help work through with them?
Absolutely. We I worked with a family once where the daughter that was with us was tech, she had a really strained relationship with her parents, but she felt very close to her big brother. And he was off at college. So he was a great candidate to be involved. We had some zoom sessions together. So we were able to, you know, in in those, I’m not functioning as a therapist with him. It’s more of that coach role and a liaison between the program and his experience, and helping, you know, for him to get some perspective on what’s happening, and how to support her too, because she was almost overly relying on that relationship. And as a way to avoid conversations with her parents. And so just giving some suggestions about how to how do we handle that and letter writing? And what are some ways that you know that he could manage that in the moment?
Right? Do you find that sometimes the sibling might be resistant to getting involved in treatment? Are they like, no, no, no, I’m, I’m the good one. I don’t need to be part of this. Do you see that as well?
We do. You know, the ones that are most eager are often the younger ones. Because they’ll get out, you know, you kind of forced them onto the Zoom call, they’ll learn the communication skills. But if there’s a similarity in age, and especially if, as the parents journey through wilderness, they start to realize, oh, gosh, maybe I should be tightening up some boundaries at home. It’s that kid at home that starts to experience that themselves. And they really are like, Well, wait a minute, what is this that we’re doing? Wait, why don’t I have new phone limits happening? And, and so the ones that are not bought into the idea of treatment, or especially wilderness therapy, they are the ones that are a little bit more skeptical and harder to get engaged in the process?
Right? There might be a little bit of a protective feeling like, you know, well, you did this to my sibling, and I’m on their side, I see that a lot with the families that I work with those siblings will kind of take sides, depending on how many there are in the family. And somebody’s partnered over here with Mom, mom, or somebody’s over here with dad, and there’s little camps that gets set up. So this having one of them leave to a treatment setting would completely disrupt those little those little units.
Yeah, the alliances that they have going in?
Yeah, definitely. You said, the younger ones. And that just triggered a thought in me is, how does a parent know? What is age appropriate to share? If they’re, if you have one child who’s gone into treatment? Maybe, you know, the siblings are younger, in their, you know, preteen? How do you know what is okay to share? And to what degree so that it doesn’t, you know, scare them more or or just so that it’s appropriately, you know, communicated?
Yeah, I think for families, it’s about, again, explaining that there were some choices that the older sibling was making that weren’t safe, I think when we frame things and have an idea of what’s safe, and what’s unsafe, healthy, unhealthy, that that can help kind of bring some clarity for the younger ones, without going into a lot of details, because there might be some stories that families have some experiences that really aren’t appropriate for the younger one to have. But if you start with that idea of they were making some unsafe choices, then it lets you figure out, you know, you can kind of test the waters and see how much they do know. And then, you know, going backwards is part of it. But we really want families to also go forward. And in going forward, it’s about, you know, how do we create the family atmosphere that we want to create? And what are the things you know, even going back to let’s start with our values. Let’s clarify what those are and use that to build the home environment we want to build. So there’s a lot of looking forward with the siblings as well.
Yeah. What about for parents who they’re thinking about treatment for one of their kids, and they’re so so there’s still potentially some chaos going on in the house, things are a little unstable. How do you determine or do you have thoughts on how you can determine what is okay to share because of those relationships sometimes, you know, I was from my own personal experience, I was not sure that I should share with my son who ended up going to treatment. I didn’t know if I should share that with his younger brother because I wasn’t sure what their alliances were. And if all of a sudden we were going to be outed, that we’re gonna know he was going to tell his brother, dude, you’re going into treatment? Do you have thoughts on how parents can kind of walk that fine line of we are doing? We’re doing something there’s there’s work in progress without potentially like spilling the beans?
I think that’s such a good question. Because especially if families are in the middle of it, like you said, there’s you want to be really intentional about the plans that you’re making, and, and sharing the time that’s appropriate with both the student you’re placing, and then any other kiddos that are left at home. So I would err on the side of caution. And, and maybe put those plans in place. If you feel like you’ve got to say something to a younger sibling, because maybe it’s a scary situation, or they’re looking to you for help. And something. I think you could say that, yes, we’re working on this, we see things and we’re going to take some action. But you know, I think once the kid that has joined us at the wilderness program, then there’s so much more you can have an open conversation about,
yeah, are there times when it’s just not the right time to pull a sibling in maybe the maybe you have one child who is in treatment? I think that’s a really rocky time for parents when they you know, initially their their adolescent or young adult goes into treatment. And things feel really unstable at first, maybe the first few weeks, is there a timing consideration of when you start bringing siblings in?
Yeah, it’s a great question. I like to give families time to settle in general, because it’s so it can be really chaotic. And sometimes when we families, first place their child and wilderness that first week or two, it can be very overwhelming, there’s a lot of information that we as a program have, and and then there’s just that emotion, kind of that and it feeling like my kid is finally safe, being able to take a deep breath. And so that first part can honestly just be about, let’s do some self care, some deep breathing. And then when we’re ready, you know, get the parents going, we actually like to give it a week or two, before we start pulling in the siblings, we have a sibling handbook that we send out, we kind of right at that sixth grade level. So it can go either way for the different age groups. But we won’t start doing a call with a sibling until maybe three or four weeks in just to give the family the time they need to get a little bit more settled.
Yeah, I can see that that that would be really helpful because it feels, it just feels like a lot. And so I think if somebody is watching this, and you’re thinking about this whole process, just to know and rely on the team, at your program, to know when the right time is and they’re, you know, depending on the situation, maybe maybe it isn’t for a while, while that the one who’s in treatment gets a little bit more stable. And I also just wondering about kind of on the other end of the spectrum, when students coming home from wilderness, and now they have new tools, parents might have new tools they may have the sibling may have a few new tools, and there’s probably going to be new rules in the house. That seems like it could also be a bumpy time because that sibling now maybe for a few months has has not had that other sibling around. And all of a sudden now you’re we’re all meshed back up in the same home. What what happens during that transition?
Yeah, it you know, this is why we want to start working with this siblings and to teach them the same communication skills because everybody’s got this new language. And we want the siblings to be part of that too, or otherwise, it’s just gonna be so already it’s hard to shift the way this family operates. And so that’s a way to give more skills for success. You know, the other thing we see for parents, if if they’re really having their child come home after wilderness, they’re often putting together some kind of a home agreement or transition plan. So they’re addressing lots of things in that next step and and if they’re able to start thinking about some of those things in advance so that again, if there’s other siblings at home and we decide we’re changing the bedtime we decide we’re changing how we manage electronics in the house. You can start doing some of that even before the child gets home from wilderness and, and making it so that it fits for each of the siblings because that can help avoid resentment to it’s, you know, some of those because we’re like, wait a minute, why do I have to have a special curfew if I’m doing okay? And so there’s ways to create that agreement to say you’re right, if if things aren’t going, okay, then you can have a little bit more freedom. That would make sense,
right? So much to think about. So, you know, and, and having been there and I feel for anybody who’s watching in if you’re in the situation, or if you’re thinking about wilderness, you’re so overwhelmed to begin with. And I think, in the, in the parents that I work with, there’s a lot of guilt about that the other kids at home, and there’s a little bit of an elephant in the room situation to have, oh, like, I’m so exhausted from working with the one who’s struggling. But I know I need to have this conversation over here. And I know I need to do some work over here, because you want to get ahead of the resentment and you want to get ahead of the whatever could fall apart. And I know a lot of parents do are worried about is my younger sibling going to follow in the same footsteps? Because they’re so stressed out from what’s been going on in the home? So any thoughts for a parent? Who is they don’t yet have a kiddo in treatment? But they’re feeling all of those feelings of the guilt? And they’re like, Oh, what if this? What if this happens to my other child? What if they’re so mad about what’s going on? That they decide to go out and start smoking weed too, right? And there’s just this kind of cloud of fear and dread? Any, any words of wisdom for them?
Well, first of all, you’re not alone. That’s actually one of the pieces that the research points to is that when there is chronic illness, mental health issues in siblings, that’s one of those are, that’s just some of the factors that you can see in the house, you can see like, that parents are feeling that stress and from from having to give all that energy to that. So knowing that you’re not alone. And I think having doing some of that self care and getting some of your own support. So that, because that’s one of the big things we talk about, especially in our family coaching calls is giving the parents that support so that they have the energy and the confidence to re engage in those situations. And to move forward with whatever it is they need to do at home with the other kids.
Yeah, maybe maybe some of that self care, too, could translate to the other child just to say, hey, maybe it’s been a long time since we have fun in our family, because it’s gotten really serious, you know, and it does. So that’s, that’s a really good, really good idea. Well, this has been so helpful, I think it’s going to be really enlightening for a lot of people who are in the situation and really worried about those other kids. Because you do you do wonder what that impact is going to be. And I know from personal experience, it can be really positive to, I don’t think we always have to look at this as Oh, I’ve screwed up my other kids now, because of you know what was going on over here, it can really be a time. And I think what you’re talking about the psychoeducation is to, I feel like the more educated we are, the more empathetic we can be. And that goes for our kids as well. And so I see in my own other, my own other kids and in other families that if you can be open, then those kids can be incredibly empathic towards people who are struggling, not just with substance use or mental health, but in any way. Gives them a different perspective. Do you see that as well?
Absolutely, that the empathy allows us to connect. And when we’re connected, then it’s like, alright, well, we’re able to do anything together for feeling that connection. So I agree with that completely.
Yeah. Thank you, Lee. This is so great. We’re thrilled to have Trails as a partner of Sky’s the Limit Fund. And we know when we send a kiddo your way that they’re being so well cared for loved up and that you’re really thinking about the whole family, which I love. It’s just so important. So thank you so much for joining us and taking the time today.
Thanks for having me, Brenda. We’re, we’re glad to be partners as well. Yeah.
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