Sibling relationships are dynamic and come in many shapes and configurations. As a sibling, I shared laughter, silliness, family trips, meaningful glances, and inside jokes with my sister. I also remember deep regret after hitting her with the controller when I thought it was my turn and she would not share.
While growing alongside someone provides a wonderful source of connection and support, it often involves jealousy and conflict. Sibling play therapy offers a focused, emotionally safe space to help children navigate these relationships by using play to practice empathy, emotional regulation, and problem-solving. While traditional family therapy explores the broader system, this approach zooms in on sibling dynamics specifically.
Who is Sibling Play Therapy For?
The therapy space is most impactful for recognizing, processing, and managing different emotions. While Family Therapy takes a broader view of the family system, sibling play therapy focuses on specific sibling dynamics as an avenue for change. The most common reason for referrals is high levels of conflict (more on that in a moment). However, other areas well suited to this format include grief, divorce, relocation, or other significant changes in the family.
Check out this article to learn more about Play Therapy and how it works.
Even if a family has three or more children, therapists typically conduct sibling therapy in pairs. This is because the challenges may only exist between certain sibling combinations and it is easier to focus on strengthening one relationship at a time. Sibling therapy is best suited for children ages 3-11. Of course, different depending on the developmental stages of each of the children: An 11 and 3-year-old play very differently together than a 5 and 7-year-old.
Goals in Sibling Work
Siblings often present with several challenges, and the complexity can increase if one or both of the siblings has additional mental health concerns. In such cases, an important prerequisite to sibling work is for each child to have an understanding of their diagnoses, how it presents, and some strategies for managing emotions. In many cases, the clinician may have an existing working relationship with a child already.
The power in sibling work comes in re-creating adversity the child experiences in their day-to-day life, but now with the additional support of having their clinician present to help regulate emotions and provide guidance for managing the situation.
Beyond managing individual symptoms, there are several goals unique to having multiple people in the room. Some common areas of focus are:
Emotional Development:
- Promoting empathy and understanding between siblings
- Encouraging healthy expression of emotions, especially when frustrated or disappointed
- Building attachment through shared positive experiences
Behavioral and Social Skills:
- Teaching active listening and turn taking
- Expressing boundaries and need for personal space assertively (not aggressively)
- Supporting collaborative problem-solving to manage disagreements
Course of Treatment
The typical course of treatment begins with each sibling separately meeting with the therapist. The purpose of this is (1) to build an individual relationship with the therapist, (2) to assess readiness for change and willingness to engage, and (3) for both siblings to become familiar with the therapy space.
The goal is for siblings to enter therapy on equal footing, feeling comfortable with the clinician as a neutral guide. As a play therapist, I guide sessions by framing the work as “trying to be better siblings and get along together.” I emphasize that both children will need to make changes for their relationship to improve. The goal is for siblings to enter therapy on equal footing, feeling comfortable with me as a neutral guide.
Once siblings feel comfortable and engaged in the therapy space, we transition to joint sessions with both of them in the therapy room. Sessions begin by getting comfortable with naming feelings and identifying their causes. Then, we transition to playing together!
Typically, siblings will choose to take turns being the “leader,” with each of them having the opportunity to decide what we should all play together. This is where the session looks most similar to Child-Centered Play Therapy, especially if the “leader” chooses to engage in imagination play. Other types of activities look like board games, drawing/expressive arts, and role play.
As siblings play, their challenges become clearer. The clinician will have direct interventions for them to repair and deepen their relationship. These interventions vary, based on which challenges present most prominently, and which the kids are most motivated to work on. Regardless of where we focus a specific intervention, it will always be in service of the goals covered in the initial sessions.
Extending Beyond the Playroom: Supporting Sibling Therapy Goals at Home
Family involvement plays a crucial role in sustaining sibling therapy, and therapists provide caregivers with frequent updates. This will include hearing about the skills learned in and how they can reinforce these skills outside the playroom. For example, a therapy goal might be to co-create a conflict resolution wheel with the siblings.
Parents can support this by:
- Choosing where to display the wheel at home
- Guiding children to use the wheel independently, rather than doing it for them
- Modeling skills like turn-taking, boundary setting, and emotional regulation
Sibling therapy should focus on sibling goals, but these goals connect closely with family dynamics and parents’ objectives. Sometimes parents want more than brief updates. You may need extra time to unpack challenges and solve bigger-picture issues. In these cases, Family Therapy or Parent Coaching may be appropriate extensions to sibling therapy to explore broader family dynamics. These sessions can help parents align their approach, resolve conflicts, and improve family communication. Addressing these broader needs is essential for sustainable change.
Bringing it All Together
Play can be especially powerful in relationships. Recreating real-life situations in a supported setting gives children a safe space to practice new skills in the moment. This approach helps kids use skills immediately, instead of relying on memory to apply lessons later. For siblings repairing their relationship, play therapy can also create positive memories that support lifelong connection.
Repairing and deepening the sibling relationship is just one piece the larger puzzle. Additional support may come in the form of family therapy, parent coaching, individual therapy, or some combination of all of the above. Families play a key role in modeling behavior and reinforcing the new patterns of interacting.
Ready to Strengthen Sibling Connections?
If you’re interested in learning more about sibling play therapy, our team is here to help. Reach out today to explore whether this approach is the right fit for your children.
About the Author
Kerry Järvi, LCPC, is a licensed therapist at Montgomery County Counseling Center in Rockville, MD. Drawing from his background as an educator, he supports children, teens, and adults in building emotional regulation, communication, and problem-solving skills. Kerry specializes in play therapy, sibling dynamics, and helping neurodivergent youth and their families strengthen connections and reach their goals.
