Research on Coping Behaviors Among Siblings of Children With Chronic Health Conditions

Having a sibling with a chronic health condition can be challenging in many ways. A study in Advances in Mental Health found that following certain coping behaviors — such as minimization, situation control, positive self-instructions, and seeking social support — were associated with a better quality of life.

Among these coping behaviors, minimization (an emotion-focused coping technique) seemed less helpful than problem-focused coping techniques. Surprisingly, the study revealed that using many coping behaviors frequently did not translate to a better quality of life compared to using fewer coping behaviors.

In other words, it’s not the quantity of coping strategies used that matters, but the effective use of at least one strategy.

Given these findings, it's helpful for siblings of children with chronic health conditions to focus on finding one or two coping strategies that really work for them. Families and caregivers can help siblings find those strategies that make a difference in how they feel.

Understanding the Research

In this research paper, Kulisch and colleagues involved a sample of 120 siblings of children with chronic health conditions. These siblings were recruited from community-based services across Germany.

For the questions about how different ways of coping affect quality of life, the researchers looked at initial data from a group of 81 siblings. They chose this group after removing any incomplete or outlier data that might distort the results.

So, while the larger study had many goals, this part of the research focused on a carefully selected group to specifically understand how coping behaviors impact their well-being.

Of these 81 children aged 6–16, most of them were girls (67%) and a smaller proportion included boys (33%). There were also caregivers involved — 56 mothers and 16 fathers, with extra demographic details collected from a few support service providers.

As for the coping behaviors, the researchers assessed them using the German Coping Questionnaire for Children and Adolescents (SVF-KJ). It included 36 items and measured the following:

• Emotion-focused strategies: minimization, distraction/relaxation
• Problem-focused strategies: situation control, positive self-instructions, and need for social support
• Negative behaviors: avoidance, rumination, resignation, aggression

Based on the results, problem-focused strategies, like managing the situation, giving yourself positive instructions, and seeking support, were linked to a better quality of life.

In contrast, emotion-focused strategies, such as minimizing the problem or relaxing, had less impact on quality of life. This could mean that problem-focused coping is generally more effective.

Practical Strategies for Parents and Caregivers

Here are some practical strategies for caring adults to help these siblings of children with chronic health conditions cope effectively:

• Explore coping options together. You can begin the conversation by talking about the challenges they’re experiencing or things that stress them out. Questions like “What are some responsibilities that feel difficult for you?” and “Can you describe a time when you felt stressed because of your sibling’s condition?” may help pinpoint which coping strategies might be relevant. Here’s a Coping Skills Alphabet handout and a Coping Skills for Stress Management handout.
• Allow them to try out different coping methods. When you notice them feeling stressed, offer a gentle reminder, such as: “Remember, you can try [coping strategy] when you’re feeling overwhelmed.” It would be very helpful to demonstrate a coping method yourself to make it a learning experience!
• Use a coping skills tracker for structure and accountability. A coping tracker allows siblings to record how they are feeling and their use of different strategies. In our Coping with Emotions tracker, children get to do this each day of the month. Parents and caregivers can then spot trends or patterns in the child’s stress and coping, and provide support as needed.

The researchers stressed the importance of tailoring support to each person's unique coping style, as what works for one may not work for another.

For more resources on coping methods to help children and clients maintain a more positive outlook, check out our Coping Skills Worksheets.