Therapy for Siblings of Children with PANS PANDAS

How therapy can help support a sibling of a child with PANS PANDAS

Sibling Therapy ASPIRE PANS PANDASCounseling can serve many purposes and each family’s specific needs should drive goals. Children with siblings with special needs often have many challenges and struggles in common. These siblings experience an array of stressors and feelings that can increase their risk for significant emotional and behavioral problems and functional impairments. One can be proactive by seeking counseling while these events unfold. This can help ensure a more positive outcome for the child by nurturing their needs while they are young and still vulnerable.

Four Ways Therapy Can Support Siblings of PANS PANDAS Children

Allows a safe space for siblings to share their feelings about the situation openly

Children may not be willing to share their feelings with their parents honestly. They may feel like doing so will make them more of a burden to the already stressed parent, and therefore, they often suppress negative emotions. The sibling may feel guilty about having such negative feelings, and therapy can help normalize these emotions. A sibling support group allows siblings to see they are not alone in their struggle with these feelings. Support groups also help them feel connected and feel less isolated when they share with others with similar lives.

Educates the child and raises awareness about the sibling’s condition

Educating children on their sibling’s condition allows for a deeper understanding of how and why their sibling’s behaviors and medical condition have affected the entire household. Children may feel confused and reluctant to ask questions about their sibling and their illness. Their acceptance and ability to tolerate behaviors they may feel are annoying or stressful may improve if they understood the “whys” about this disorder. Information about their sibling’s condition should always be age-appropriate and as simple as possible for them to understand it better.

Provides an hour devoted only to them to allow for some small talk and make them feel important

Four Ways Therapy Can Support Siblings of PANS PANDAS ChildrenThe undivided attention during a therapy session can help nurture a child’s needs. Each session doesn’t always have to be serious and goal-oriented. The rapport between the therapist and child can serve an essential purpose in the child’s life. Siblings can feel pushed aside at home when they always have to take the back seat to meet their sibling’s needs. This time set aside for them will allow them to share anything they may not have an opportunity to share at home. It could be how they scored some points for their team in gym class or how they enjoyed a new book the teacher read aloud at school. Activities and accomplishments that may seem trivial can be of great importance in a child’s world.

Teaches them coping strategies when situations become very stressful at home

Children often easily absorb negative energy and stress in their environment. They may feel a need to find a way to alleviate stress for the parent. When a sibling does this repeatedly, it can lead to parentification, which is when a child feels obliged to act as a parent to their own sibling. They need to be relieved of feeling that sense of responsibility and be permitted to remove themselves when circumstances become intense in the home. They should be encouraged to retreat to their bedroom or any space in the home that will allow them to feel safer. Create a plan to help that works for the entire family. For younger kids, there may be a designated space in the home they can occupy in these moments. For older kids, their bedroom may be an appropriate place for them to be in while they use headphones to “tune out” the noise when things escalate in the home. Children need to have a safe spot in their home when situations with their siblings become very stressful.

More Sibling Support


Lori Phelan, LMSW

Sibling Therapy Lori Phelan ASPIRE PANS PANDASLori Phelan, LMSW lives on Long Island, NY. She studied Psychology at SUNY at Stony Brook as an undergraduate and graduated with a Master’s in Social Work in 2000. Lori worked as an in-home ABA provider for children with Autism Spectrum Disorder and was a parent trainer for 19 years. She worked as an Autism Specialist/Social Worker for Sachem Central School District for eight years. Lori is the mother of 2 daughters with PANS since; her daughters were diagnosed in 2015. Her current plans include working as a therapist to serve families navigating PANDAS/PANS. Lori likes to hike, cook, do yoga, study nutrition, and play Rummikub with the family in her free time.


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One comment to Therapy for Siblings of Children with PANS PANDAS

  1. Debbie Phelan
    April 9, 2021

    Lori I wish all the best. I am sure you will be a huge help for the parents who need the support you will give. It must be rewarding to give comfort to these parents. Love you❤️

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