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Item The development of a psychosocial intervention that supports siblings of children and adolescents with serious chronic health conditions in Aotearoa New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University(Massey University, 2024-11-12) Armstrong, KathleenDue to recent advances in medical care, many childhood chronic health conditions (CHCs) are less likely to be fatal and more able to be successfully managed. This has led to an increase in the prevalence of children living with CHCs, which presents the affected child, their parents, and their siblings with significant long-term consequences and challenges. Extant literature points to siblings of children with CHCs being a vulnerable population who are at increased risk of developing depression, anxiety, post-traumatic stress symptoms, lower quality of life, and disruption to academic and social functioning. Consequently, there have been calls for the development of sibling support services both in Aotearoa New Zealand (New Zealand) and internationally. Recent needs-based research on siblings of children with cancer and other serious CHCs in New Zealand reported critical unmet needs across the following domains: Information about the illness; Dealing with feelings; Time out and recreation; Support from friends and other young people; Understanding from their family; and Relationship with their affected sibling. These findings emphasise the necessity of a nationwide intervention that provides siblings with support close to the time of their brother’s or sister’s diagnosis. The aim of the present study was to develop a needs-based psychosocial intervention for siblings of children with serious CHCs, which protects and promotes the health and wellbeing of this vulnerable population and recognises their existing individual and familial strengths. A literature review was conducted to investigate the impact serious childhood CHCs have on siblings, and to establish whether the commonalities in sibling experiences justify taking a transdiagnostic approach in the development of a sibling intervention. This was followed by a systematised review of existing sibling interventions and an evaluation of their efficacy. Informed by the two major reviews and existing needs-based sibling research, a manualised intervention was developed to meet the self-reported unmet needs of siblings, using a combination of evidence-based therapeutic modalities.Item The unmet needs of siblings of children with cancer and serious chronic health conditions in Aōtearoa/New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, Aōtearoa/New Zealand(Massey University, 2019) Armstrong, KathleenThere is evidence to suggest a subset of siblings of children with serious chronic health conditions have a range of unmet psychosocial needs which can lead to adjustment difficulties and mental health problems. A review of needs-based support services available to siblings in Aōtearoa/New Zealand found this is an under-serviced area. The current research aimed to identify the unmet needs of siblings of children with cancer and serious chronic health conditions and contribute to the development of targeted support services that protect and promote health and wellbeing in siblings. An online survey design was used to identify the unmet needs of siblings of children with cancer, cystic fibrosis, and Type 1 diabetes mellitus. The final sample included 204 respondents across the three health conditions (cancer: n=84, cystic fibrosis: n=47, diabetes: n=73). Quantitative results show the average percentage of unmet needs for the total sample was very high (57.8%). Of the three health conditions, cancer had the highest average percentage of unmet needs (66.3%), followed by cystic fibrosis (53.0%), then Type 1 diabetes mellitus (48.6%). Of the seven domains ‘Information about my sibling/whānau member’s health condition’ had the highest number of unmet needs. A significant difference was found between the total mean percentage scores between males and females (p=.001). A comparison of siblings in the ‘cancer’ health condition with an Australian study found the domains were strongly correlated but the New Zealand sample was systematically higher. The qualitative results showed siblings were affected negatively (and potentially long- term) from: a lack of information; feeling ‘invisible’ and forgotten; feeling guilty for being the ‘healthy’ sibling; suppression of needs; disruption to the family; a lack of peer and familial support; and additional care-giving roles. The impacts of these issues can lead to depression, anxiety, post-traumatic stress symptoms and affect beliefs around self-worth. Recommendations arising from these findings point to the need for effective support for siblings including: information about their sibling’s health condition; professional support offered to them; support and understanding from peers, family and teachers; time with parents to feel valued and included; guidance on how to support their affected sibling; a safe space where they feel validated and can speak freely; and ‘time out’ with other siblings.