Abstract
Background: Sibling sexual abuse (SSA) creates particular challenges for practitioners working with affected families, as it damages multiple family relationships, generates loyalty conflicts among parents and children, and produces ambiguity around responsibility. These challenges may necessitate a specific treatment for the impact of SSA. However, information on how to approach the challenges during treatment is scarce.Objective: This study qualitatively investigated, from a practitioner's perspective, helpful elements for tailoring the treatment of families that had been exposed to SSA.Participants and setting: Twelve practitioners from different treatment centres in the Netherlands with experience in the treatment of families exposed to SSA.Methods: Online one-on-one interviews were conducted and thematic analysis was used to identify central themes.Results: Four themes were generated: (1) family crisis; (2) guilt, shame, and secrecy; (3) balancing act; and (4) restoration of family relationships. Practitioners highlighted the importance of tailoring treatment to the specific dynamics related to the SSA. Families starting treatment after the disclosure of SSA are often in 'shambles', as the situation affects the relationships between all family members. Restoration of family relationships was described as both the most challenging and the most essential aspect of treatment, with parents having a central role in this recovery process. Professionals needed to assist them with offering appropriate support for all their children and re-establishing trust and safety within the family.Conclusions: The findings offer initial practical considerations and recommendations for the treatment of families that have experienced SSA, thereby providing a first step towards developing a practical framework for applying systemic therapy to families that have experienced SSA.