Introduction

Child abuse (CA) studies have significantly advanced our knowledge with respect to the global epidemiology of the phenomenon, its consequences for survivors in both childhood and adulthood, and interventions for both children and parents (e.g., Melton, 2013). However, regardless of the profound consequences of CA for all systems in the lives of survivors, the sibling subsystem remains an understudied construct (Katz & Hamama, 2018; Katz & Tener, 2020). This is surprising given the empirical evidence that sibling relationships are central throughout the life span and can serve as a protective factor (e.g., Buist et al., 2013). Indeed, siblinghood is typically the longest-lasting family relationship (Dunifon et al., 2017); approximately 60% of children in the USA share a household with at least one biological or adopted sibling (Knop & Siebens, 2018), often spending most of their time outside of school together (Dunifon et al., 2017). The current study spotlights the sibling subsystem in the context of CA, as perceived by therapeutic professionals within the field of CA.

Child Abuse and the Sibling Subsystem

CA is a worldwide phenomenon and previous findings have indicated not only its high prevalence but also that children often experience more than one type of abuse (Briere & Jordan, 2009; Felitti et al., 2019), or “polyvictimization” (Finkelhor et al., 2011). Furthermore, it has been indicated that the perpetrators are usually the victim’s parents. The reported frequency of CA in the general population is 12.7% for sexual abuse and 22.6% for physical abuse (Moody et al., 2018; Stoltenborgh et al., 2015). Similar rates have also been reported in a large-scale Israeli study (18 and 18.7%, respectively; Lev-Wiesel & First, 2018).

CA often negatively affects children’s socio-emotional, cognitive, and physical development (e.g., Malloy et al., 2011; Steine et al., 2017). While previous studies have discussed siblings and CA in the context of scapegoating, whereby one child bears the brunt of the abuse (Halperin, 1983; Herrenkohl & Herrenkohl, 1979; Nakou et al., 1982), recent studies have presented ample evidence that any interfamilial child abuse places all siblings at risk (e.g., Assink et al., 2019; Corlis et al., 2020; Hamilton-Giachritsis & Browne, 2005; Kullberg et al., 2020; Witte et al., 2018). Moreover, children who had experienced abuse vicariously, by witnessing their siblings being maltreated, were found to develop complex PTSD (Teicher & Vitaliano, 2011; Williams et al., 2016).

Three studies have focused on the sibling dynamic in the context of CA through the analysis of children’s forensic interviews. These often-tender children conveyed horrendous experiences: some survived attempted filicide (Katz, 2013), others witnessed their mother's homicide by their father (Katz, 2014), and others were victims of parental sexual and/or physical abuse (Katz & Tener, 2020). What stood out in these testimonies was an outstanding sibling bond, with siblings often depicted as risking their own physical wellbeing to protect each other.

In a recent study, two types of sibling subsystem dynamics were identified (Katz & Tener, 2020). The most common was the protective sibling subsystem, described by the survivors as their most important coping resource. The second dynamic was of mixed feelings, including jealousy and fear of additional abuse at the hands of a sibling, alongside feelings of compassion, understanding, and forgiveness.

The latter finding has been supported by studies indicating that dysfunction in the parent–child relationship was associated with a harmful dynamic in the sibling subsystem (Crittenden, 1984; Mangold & King, 2020; Portner & Riggs, 2016; Tucker et al., 2019; Whiteman et al., 2011; Williams et al., 2016; Witte et al., 2020). The spillover into the sibling subsystem might manifest as a mirror image of the parental behavior. For example, there could be sibling aggression in an emotionally and physically abusive family (Dirks et al., 2015; Heinrich, 2017), a distant and hostile sibling relationship in the context of emotional neglect (Witte et al., 2020). In addition, sibling incest may occur in cases of parental neglect (Ballantine, 2012; Caffaro & Conn-Caffaro, 2005).

However, studies have also provided empirical and clinical evidence of a compensation effect, according to which siblings tend to comfort each other in times of distress and offer mutual support and affection as well as instrumental support (Dunn et al., 1994; East & Rook, 1992). Hence, siblings can compensate, at least partially, for parents’ unavailability or hostility (Bank & Kahn, 1982; Milevsky & Levitt, 2005; Tucker et al., 2013), try to meet the emotional and physical needs neglected by the parents (Williams et al., 2016), and be each other’s allies (Graham, 2018). A recent study offered partial support for the compensation effect, with findings that indicated that physical abuse and neglect and exposure to domestic violence may be related to more warmth and less conflict in the sibling subsystem, when parental emotional abuse or neglect was not present (Witte et al., 2020).

The compensation and spillover effects are not necessarily mutually exclusive. Katz and Tener’s (2020) study provided support for the occurrence of both mechanisms, at times simultaneously, which should be further explored in future studies.

Professionals’ Perspectives

The vast majority of studies on professionals’ perspectives on the sibling subsystem in the context of CA addressed out-of-home placements following CA. The emphasis on maintaining sibling relationships is common in many Western countries’ legal systems (Meakings et al., 2017; Waid, 2014). In practice, however, child welfare systems frequently separate siblings and, all too often, contact between them is severed (for a review, see Golan-Shenhar & Doron, 2019). This may be the result of technical difficulties and lack of administrative support for interventions between siblings in foster care (McBeath et al., 2014). In other cases, separating siblings may be due to professional considerations such as harmful alliances, extreme rivalry and jealousy, sexualized behavior, and most importantly, sexual, physical, or emotional abuse between the siblings themselves (Wakelyn, 2007). In cases of protective sibling relationships where co-placement does not occur, preserving the sibling relationship requires greater effort (Shlonsky et al., 2005).

Previous studies have also explored professionals’ perceptions with respect to the sibling subsystem and how it relates to sibling sexual abuse (SSA). Professionals working with SSA are often required to cope with ambiguity and uncertainty regarding the course of events, as well as conflicts concerning the most beneficial interventions (Tener & Silberstein, 2019), and whether to follow the therapeutic or legal route (Tarshish & Tener, 2020). Furthermore, they face families who must make unbearable decisions regarding the protection of the abused sibling while also supporting the abusive sibling (Lafleur, 2009). Hence, SSA often requires multidisciplinary interventions (Bass et al., 2006; Caffaro & Conn-Caffaro, 2005; Kambouridis, 2010; Tapara, 2012). At the same time, inter-agency conflicts and lack of cooperation may jeopardize supporting the victim to heal (Welfare, 2010). Ambiguity and uncertainty may also be exacerbated by SSA survivors who do not experience themselves as victims or, alternatively, professionals who identify the SSA as mutual, in opposition to the external legal demand to label the siblings as either “offender” or “victim” (Tener & Silberstein, 2019).

The Current Study

Given the urgent need to advance the development of both theory and practice in the field, the current study examined how therapeutic professionals within the field of CA perceive the sibling subsystem in the CA context. The current study was guided by the following research questions: (1) How do the professionals perceive and experience the sibling subsystem in the context of CA in both childhood and adulthood? (2) How do the professionals perceive disclosure in the context of the sibling subsystem? (3) What can professionals tell us about their interventions in the context of the sibling subsystem?

Method

Participants

The participants were 30 therapeutic professionals with experience in the field of child abuse. All of the therapeutic professionals held a degree in social work as well as a degree in therapeutic approaches. The therapeutic professionals in the current study consisted of 25 women and five men, aged 30 to 50 (M = 36.45). All of the therapeutic professionals had worked in various systems for abused children in the welfare system.

Procedure

The participants were interviewed by two graduate social work students who received dedicated training and were provided with ongoing supervision. The semi-structured interviews lasted approximately 90 min and took place in the participants’ homes or another place of their choosing. The interview manual included the following content categories: sibling relationships in childhood or adulthood (e.g., “Do the children/adults in your care talk about their relationships with their siblings?”(; perceptions of the siblings’ roles in coping with the abuse (“From your experience with the personal stories of your clients, what role did the sibling system play at the time in dealing with the child abuse, or retrospectively, in adulthood?”); and intervention approaches (“What message would you like to convey to other professionals about how siblings should be treated in the context of abuse”).

Data Analysis

Data were analyzed thematically (Braun & Clarke, 2006). First, the authors read the interviews repeatedly to identify initial ideas, after which each transcript was entered as a case into the MAXQDA software. Next, we divided each transcript into manageable segments of meaning that were coded to represent core issues (Attride-Stirling, 2001). Third, codes or code groups were combined into themes and subthemes, subsequently refined into discrete themes broad enough to cover ideas arising from several segments (Attride-Stirling, 2001; Strauss & Corbin, 1998), and then developed further by referring back to the transcripts (Maykut & Morehouse, 1994). Throughout the process, we identified themes using data-driven inductive analysis rather than trying to fit them into preconceived notions (Braun & Clarke, 2006).

Trustworthiness was achieved by audit trails and peer debriefing once a week throughout the analysis (Morse, 2015). The audit trail consisted of documenting how raw data were collected and analyzed. Direct quotes were attached to all interpretations and the peer debriefing process was documented in writing (Bowen, 2009). The authors also wrote journals to maintain awareness of various influences on their interpretations (Jootun et al., 2009).

Ethical Considerations

The study was approved by the Ethics Committee of Tel Aviv University. We obtained the participants’ informed consent and devoted particular attention to their dignity and confidentiality, using pseudonyms and removing all identifying details from the dataset.

Findings

Three major themes emerged from the analysis: (1) dynamics in childhood and adulthood; (2) disclosure dynamics; and (3) interventions.

Dynamics in Childhood and Adulthood

The participants described a continuum of sibling dynamics. At one end, the siblings perceived each other as a source of support and identification. These siblings cared for each other and, at times, served as primary caregivers for one another in place of the abusive or unavailable parents. Practitioners used terms such as “fateful partnership” to describe these dynamics. This was further described by Ora, who works in an out-of-home placement:

A brother and sister. She was three and he was one year old, and she would really take care of him in everything. You see a girl aged three putting a boy to sleep […] and only when he falls asleep does she go to sleep. Or first she makes sure he eats and then she eats.

At the other end of the continuum were detachment, competition, jealousy, hostility, and physical violence. This was further emphasized in Ora’s description of two adolescent sisters: “It heated up so badly, and it got to the point of mutual violence, until the police were summoned to the house, in front of the little siblings.”

Professionals explained these negative feelings in terms of siblings’ emulation of abusive parental patterns, competition for parental attention, and a sense of inferiority, described primarily with regard to children in out-of-home placement being envious of those who remained at home. This was further emphasized by Liat, a clinical psychologist:

[…] having siblings at home, it's like proving to them this feeling that they're kind of abandoned. We also see, for example, children whose mothers get pregnant while they are here [in out-of-home care] and this is something that raises a lot of difficulties. Because how come, if you’re unable to raise me, you can raise another child […]?

Some participants worked with young adults’ siblings. They described sibling subsystems that continued to maintain strong supportive relationships, even at the cost of losing one’s independence, as well as conflicting adult sibling systems and systems characterized by physical and emotional detachment. When describing supportive relationships in adulthood, some used the term “blood pact,” described by clinical psychologist Michal as “some very deep, inextricable emotional bond between the siblings who support each other emotionally and financially even years after the abuse.”

Professionals further emphasized the shared abusive life story as generating a shared language between the siblings that only they can understand: “[…] we both came from this nothingness and this shit […] and we somehow managed to get out of it and survive it and it's a very powerful emotion that unites them” (Shira, employed in an out-of-home setting).

Yet, even when the relationships in adulthood were described by professionals as strong and protective, they were aware of the prices the siblings paid, including the difficulty of disconnecting from the sibling subsystem and leading an independent life:

My client, after many, many years of abuse […] takes some steps towards […] cohabitating with her partner and she plans to take her sister to live with her as well, her younger, adolescent sister. […] and all the years she actually continues to fund her. And this teenager's entry into their life, into their home, sometimes creates friction with her partner as well (Michal).

In other cases, participants described detachment and even hostility and rivalry between siblings in adulthood, for which they gave several reasons. First, in some families, the abuse was not disclosed and adult survivors feared that having relationships with their siblings might jeopardize the secrecy. Other adult siblings, who suffered harsh emotional consequences, were afraid to burden their siblings with their emotional distress. At other times, siblings felt that the sibling subsystem had not been a source of support for them in childhood and, thus, could not be relied on in adulthood: “It actually […] continues to accompany them in adulthood and even when they turn to us in circumstances of distress, their siblings will not necessarily be those they can really rely on. […] Because there are […] unresolved issues from the past […]” (Daria, social service worker). Sharon, also a social service worker, further emphasized:

There is a need to go through significant work in order for [siblings] to become a potential support system. And they may also never get there [...]. We tend to think siblings are benevolent. But now if I come to a woman and I tell her, “you didn’t talk to your siblings for 15 years now because they hurt you and betrayed you but maybe you can renew the relationship because there may be something good there.”

Sibling Dynamics During Disclosure

Two main disclosure dynamics were found. The first was strong resistance of the siblings to the disclosure attempts by the abused sibling. The participants explained it in terms of the fear that disclosure would break up the family. The second dynamic was less common and referred to an attempt by one of the siblings who had witnessed another’s abuse to disclose it to other siblings. Rona, a social worker who works with children, addressed the more common secrecy dynamics:

And there’s one kid who says, “my dad beats the hardest” […]. And the big sister […] tries to keep it in the family. She is in a parental role. So, she says, “enough David, you're talking nonsense” […] that's how they all are, you know, a sense of concealment and also of fear.

When describing how siblings maintain the secret, one participant used the term “conspiracy of silence.” Even in cases of abuse and chaos, the fear of losing the family serves as a powerful mechanism. This was further described by Merav, who works with sexual abuse victims:

They want to keep the family cell […] and want to basically ensure that there would be peace and quiet and serenity again […], even if it was not peaceful and if it was also full of abuse, but that was the situation that they knew and it's actually scary for them to […] disclose […].

In fewer cases, professionals described how the siblings themselves initiated the disclosure to protect their other siblings, in some cases after being abused themselves. Although they thought of themselves as able to bear the abuse, they feared their siblings would not be able to endure it as they did.

The other side of this is a “fateful partnership.” I think two things are happening there. The first is that it's a sister who's really older and she understands that her sisters are hurt too many times, so they pick up the phone and call us [and say] “It already happened to me, I'm done for or I'm the victim, but I have little sisters and I take care of them […].” We see it many times in cases of fathers remarrying […] and now there are little children in the second round […]. (Anat)

Interventions

Most participants discussed the importance of recognizing and focusing on the sibling subsystem during CA interventions, especially in the context of out-of-home placements. They spoke about the siblings as being key in recovering from abuse and used terms such as “hope” and “support.” In the following quote, Adi, who works in social services, described the significance of the sibling relationship in gaining visibility and validity:

[…] a sibling system is sometimes […] the only support system that really understands this thing. […] there is something in the shared experience and in the common position in front of the abusive parents, unitedly or separately, which can greatly affect the resilience later on. […] I identify a lot of potential […] in being able to recover from this thing, to do the narrative together. […] where this is impossible […] you are actually left with some kind of loneliness or invalidity.

Accordingly, professionals described that their “default” in cases of out-of-home placements was to keep siblings together, and when this was impossible, to encourage the continuation of the relationships, saying things like “the bond between the siblings must exist”:

Even when they wanted to separate some siblings for me, I didn’t agree. And I said that […] they should go to one good institution that we would check for them and not have them split between two families, but that was really up to the case. (Ora)

Theory aside, professionals also discussed how the sibling subsystem was a neglected issue in practice: “I did a little quick search before the interview, to look for some literature about it and there’s not much. And that already says a lot about the importance professionals attach to it” (Mira). The practitioners mentioned several reasons for the lack of interventions focused on siblings, including logistic issues, lack of motivation by the siblings, and the need to make difficult decisions concerning the parental abuse, which marginalizes the sibling relationships. Yet for some professionals, the interview itself was an opportunity to reflect on this issue: “It occurred to me during [the interview that] I suddenly understand that it is a big issue […] Why is it unspoken or why don’t I ask? […] It makes me wonder […]. I’ve never thought about it until now” (Meital, works in a welfare department).

Discussion

The current study examined the way professionals experience and perceive the sibling subsystem in the context of child abuse (CA). Three main domains arose from the interviews: dynamics in childhood and adulthood, disclosure dynamics, and interventions. With regard to the first domain, in childhood, the professionals shared two distinct profiles, the first of which was a powerful protective bond, a “blood pact.” Their narratives included descriptions of very young siblings nurturing their younger siblings and taking over the parental caring role they never experienced.

This protective profile has been described in several studies on forensic interviews with CA survivors as ensuring the abused child’s physical and emotional survival (Katz, 2013, 2014; Katz & Tener, 2020). It echoes two theoretical frameworks. The first is family system theory (Minuchin, 1985), which examines the ways in which variables in the child’s environment act as key factors in shaping the sibling dynamic. One of this theory’s main principles is that elements in the family unit, such as the sibling subsystem, can only be understood in the wider context of family behavioral and emotional patterns. The family is viewed as a complex and organized whole made up of various subsystems, such as the marital, sibling, and parent–child subsystems, as well as individual family members. The subsystems are separated by boundaries and governed by unique rules and patterns. The different elements are necessarily mutually dependent and interact in a way that maintains homeostasis. However, a natural part of the family lifecycle is change—adaptation to the developing needs and wants of family members. When CA occurs, it dramatically affects the family system. This might generate a compensation process in which the sibling subsystem acts to reduce the negative impact of the parental abuse as well as find ways to provide for needs that are not addressed by the abusive and non-abusive parents.

The protective profile among siblings in childhood also echoes the attachment theory. The concept of sibling attachment has been a recurrent theme in children’s testimonies of their abuse, whereby they elaborated on their mutual emotional commitment (Katz & Tener, 2020). It might be that, in certain contexts, intense attachments form between siblings (Seibert & Kerns, 2009). In such cases, behaviors we may expect to see in a parent–child relationship are found between siblings, such as caring and comforting in cases of distress (Stewart, 1983). Therefore, in the context of parental CA, a kind of secure attachment can develop between siblings.

As opposed to the protective profile among siblings in childhood, the participants also discussed another profile involving distance, detachment, hostility, and even physical violence between siblings. This destructive profile can be seen as a spillover effect occurring within the family system, whereby emotional and behavioral patterns in one subsystem “infect” other family subsystems. For example, negative emotions in the marital subsystem might cause negative parental behavior and, in the specific context of the current study, parental abuse can infect the sibling subsystem. This spillover of the abuse from the parental to the sibling unit might be extremely damaging for the children involved, an issue that requires further attention in future studies.

It is important to note that the spillover effect can sometimes occur in the form of sexual abuse between siblings. Some of the participants addressed this in their narratives and emphasized that it should not be seen as abuse per se but rather as an attempt by the sibling subsystem to provide warmth and closeness to compensate for the parental abuse (Tener & Silberstein, 2019). In studies that analyzed children and adults who had experienced sibling sexual abuse in childhood, some of the siblings perceived these relationships as neither abusive nor mutual, but rather as routine sexual relationships, deeply integrated into their daily lives, at times involving almost all of the siblings in the family (Tener, 2020; Tener et al., 2017). The routine is experienced as natural, at least in childhood, and as part of a unique sibling culture hidden from external society (Corsaro, 2005).

This spillover effect also echoes the phenomenon of transgenerational transmission of trauma. This phenomenon has never been explored among siblings, either generally or in the context of CA. These initial findings suggest the possible transmission of maltreatment or abusive behaviors from parents to children (Fuchs, 2017), who then incorporate them into the sibling system. This transmission of the abusive relationship can also be discussed within the framework of Ferenczi’s groundbreaking contribution (1932/1988, 1933/1994). Ferenczi’s concept of identification with the aggressor described a process in which the child loses their own agency and replaces it with that of the perpetrator, becoming hypersensitive to the perpetrator, adopting the perpetrator’s experience concerning the abuse, and identifying with the perpetrator’s aggression. It should be noted, however, that this was not the common pattern described by professionals in this study and, therefore, it needs to be further examined in future studies.

An additional aspect touched upon in the current study related to situations in which children were removed from their homes following CA, while some of the siblings remained in the homes with their parents. Based on the participants’ narratives, the children removed from the home experienced this as abandonment and rejection, thereby exacerbating their negative self-attribution and self-blame for the abuse and its consequences. The exploration of what happens to children and the sibling dynamics following out-of-home placement is rare in the literature and requires further exploration. However, the current findings echoed previous studies that have indicated that even in extreme cases of CA, children did not stop loving their parents and longed for any kind of connection with them (Katz & Barnetz, 2014; Katz et al., 2020).

When discussing the sibling dynamics in the context of CA in adulthood, the professionals continued to address these two distinct profiles, first, a profile in which the blood pact remained into adulthood and in which the sibling subsystem continued to provide support and validation of the trauma, potentially replacing the parental subsystem throughout the siblings’ lives. However, the professionals also discussed the potential cost of this dynamic, describing how this pact often hampers individuation and particularly the ability to form intimate relationships with others outside the sibling subsystem in adulthood.

The second profile in adulthood was described as more common: disconnection between the siblings. The professionals described years-long detachment between siblings and attributed it to possible difficulties due to the abuse still not having been disclosed, out of fear of being the emotional burden of the living proof of the abuse, and the realization, in some cases, that a system that was not supportive in childhood could not remain important in adulthood.

To better understand this disconnection, we need to attend to the role of dissociation within the process of living with trauma. Dissociation, which is reflected in various forms of the loss of integration of thoughts, feelings, and experiences (Bernstein & Putnam, 1986), might partially explain the detachment between siblings in adulthood. A sibling might serve as a living reminder that triggers trauma in adulthood; therefore, distancing oneself from this reminder might be protective. For example, in a study of adult survivors of sibling abuse, most of the participants chose to sever the relationship with the perpetrator siblings in adulthood, even when their relationships were perceived as mutual or routine during childhood. Yet, some of the participants in the study described being emotionally affected by the perpetrator figure, even if they were no longer physically present in the participants’ adult lives (Tener, 2019).

The second theme that arose from the interviews was the dynamics during disclosure. Here, the participants provided preliminary indications of how the parental perpetrator could manipulate the sibling subsystem to conceal the abuse and ensure that it would not be disclosed. Early disclosure of CA can end the abuse, prevent repeated victimization, protect other siblings, enable psychological intervention for direct and vicarious victims, and hold the abuser accountable for their criminal behavior (e.g., Leclerc & Wortley, 2015; Leclerc et al., 2011; Lev-Wiesel & First, 2018; McElvaney & Culhane, 2017). This concealment dynamic is revealing. “Appointing” the siblings as responsible for this family secret not only places a heavy burden on their shoulders but can also escalate the stress within the sibling subsystem, providing another potential explanation for the aforementioned dynamics of spillover and hostility. In any case, it is of crucial importance to highlight that disclosure itself might have adverse consequences for children (e.g., Ahrens, 2006; Ullman, 2011) and that siblings may have some inkling of these consequences. Hence, they try to protect their siblings and the sibling subsystem as a whole by preventing disclosure. This behavior has been referred to by the terms, role reversal, or parentification of children, which has also been reported in different forms of abuse.

The professionals described how, upon reaching adulthood, some survivors disclosed the abuse, having realized its impact and their responsibility to save younger siblings. Adults’ disclosures of CA may touch on a late recognition of the impact of the abuse as well as a sense of responsibility in preventing others from experiencing abuse. This dynamic has been further discussed in the literature on barriers and facilitators of child sexual abuse disclosure (for a review, see Morrison et al., 2018). This process of moving outside the abusive dynamic into the realization of what was happening and turning this acknowledgement into action deserves further exploration in future studies.

When reflecting on the third theme of interventions, the professionals shared that during the interviews, they had a rare opportunity to grasp the huge importance of the sibling subsystem. They discussed how interventions within the sibling subsystem in the context of CA might enable survivors to experience togetherness instead of the tremendous loneliness they so often describe. The participants also perceived such interventions as a rare opportunity to provide survivors with a space in which their stories could be shared and validated instead of their ongoing experience of the invalidation of their traumatic experiences. Despite these powerful intuitions, the professionals shared that they did not have sufficient knowledge, training, or skills with respect to the theory or practice of treating the sibling subsystem in the context of CA.

Indeed, studies on therapeutic interventions that have focused on the sibling subsystem are scarce, with most based on clinical experiences (e.g., Caffaro, 2013). These studies commonly discussed an individual in therapy with abused or offending siblings or parents, instead of sibling dyads or groups with emphasis on improving the sibling relationship (e.g., Dirks et al., 2015; Shadik et al., 2013; Tener & Silberstein, 2019). Caffaro’s (2013) groundbreaking book based on clinical experience offers therapists dealing with cases of CA specific guidelines for the assessment of the sibling subsystem’s strengths, conflict resolution skills, communication skills, empathy, awareness and acknowledgment of the abuse. Yet, in practice, the sibling subsystem is often not included in treatment programs for children abused by a parental figure) Baker et al., 2002).

Limitations

The contribution of the current study should be discussed in light of its limitations. The first limitation is the sample’s relatively small size, social homogeneity, and the fact that it is almost exclusively made up of women. It is important to further advance theory with respect to the sibling subsystem in the context of CA by drawing on the knowledge and experience of professionals from various disciplines and social groups.

The second limitation is related to the nature of the interviews. Many of the participants shared their surprise at the focus of the study. Therefore, it might be that, given the understudied nature of the sibling subsystem, its examination in focus groups might have provided the professionals with a more enriching and inspiring environment to discuss it, hence contributing to the depth of the findings.

The third limitation of the current study was the different life stages from childhood to adulthood and the various contexts of the children’s lives as addressed by the participants. Some survivors were still in the abusive homes, while others had been moved to out-of-home placements. Both groups deserve specific attention in future studies.

Fourth, the study did not examine sociocultural factors which could strongly affect the professionals’ work with sibling subsystems (e.g., working with religious or BIPOC sibling subsystems). Additionally, the current study’s results provided only a preliminary glance into the dynamics and development of the sibling subsystem over time.

Finally, it is of crucial importance to emphasize that the current study provided us with the perspective of professionals. Future studies must interview the children themselves to advance the development of theory regarding siblings in the context of CA. Although previous studies have analyzed narratives provided by children during forensic interviews (e.g., Katz & Tener, 2020), they are limited in their scope of exploration. Future efforts should be dedicated to examining the experiences and perceptions of children.

Implications for Research, Policy, and Practice

Developing a conceptual and theoretical framework regarding the sibling subsystem in the context of CA should shape future studies in the field of CA and trauma. More specifically, the current study pointed to several future directions that merit investigation. The first is with respect to the nature of the spillover dynamics between siblings in childhood, which could lead to identification with the perpetrator and transmission of the trauma. The current study provided an initial glance into the world of children removed from their abusive homes while their siblings remained with their parents. This seems to have had a tremendous impact on the children’s lives and needs to be further explored.

In addition, the current study addressed the disconnection between siblings in adulthood. This dynamic should be further explored with a specific focus on the memory of the trauma, the mechanism of dissociation that might be involved, as well as potential triggers of the trauma that the relationship with the siblings might hold for the survivors. In addition, it seems that the transition from childhood to adulthood might facilitate disclosure for some survivors. Further exploration of the sibling subsystem in the context of CA disclosure is therefore necessary.

More broadly, the advancement of theory as it relates to the sibling subsystem in the context of CA can enable and encourage professionals to view the subsystem as a potential source of resilience and agency to counter abuse and trauma. As acknowledged by the professionals who participated in the current study, the sibling subsystem can be a rare platform of togetherness and validation for survivors.

To further support and refine such theory, cross-cultural research and theory development are needed. Thus, although large families are usually considered a risk factor for child maltreatment (Zhou et al., 2006), a study of Jewish ultra-Orthodox families with between 5 and 9 children in Israel (Bartl et al., 2020) showed that parents perceived the family’s size as directly related to its health. Similarly, the siblings who participated in the study perceived the large sibling subsystem to which they belonged as a source of happiness, love, belongingness, and support. The authors stated that most studies in this area had been conducted from a Western, educated, middle-class childcare philosophy, relating to the nuclear family model as the norm and neglecting other types of relations, including the meaning of the sibling subsystem in the extended family.

Cultural contextualization is also important in relation to our suggestion that the sibling subsystem be further examined in under the lens of attachment theory. Attachment within the sibling subsystem should be explored via cultural contexts, as contextual variability is crucial to meet the purpose of adaptation (Keller, 2013) and sibling attachment may carry different patterns in different cultures.

In addition, our findings have important policy implications. Policies must be based on updated theory and offer clear guidelines to professionals in decision-making processes regarding the joint or separate out-of-home placement of sibling groups. Recent studies (e.g., Katz & Tener, 2020) have illustrated how survival often depends on the siblings staying together and that their separation might severely damage their mental health and wellbeing. On the other hand, as previously mentioned, the sibling subsystem can also be harmful and abusive, mandating the careful examination of each case.

Furthermore, policymakers have a responsibility to optimize child protection and address all of the siblings throughout the decision-making process in suspected CA cases. The initial stages of engagement with families, for example, can benefit from examining the target child’s siblings (their testimonies and individual statements). In addition, policies must include detailed guidelines as to how the sibling relationship should be approached following out-of-home placements. These guidelines should help practitioners with ethical and professional dilemmas, such as if and how efforts should be dedicated to maintaining contact between siblings.

Finally, with regard to practical implications, the strengths of the sibling relationship need to be given further consideration and visibility in both research and practice. Efforts should be put into generating the development of intervention efforts that incorporate the sibling relationship as a central tenet while recognizing cultural norms and expectations. CA interventions involving siblings should be implemented throughout the lifespan and not only limited to childhood, as sibling relationships are long-lasting and appear to play an important emotional role throughout CA survivors’ lives.