Disclosures of sibling sexual behavior (SSB) usually affect all family members but there remains, however, a paucity in studies on therapeutical family interventions and how they can initiate changes in families. This study was designed to explore relational impacts of SSB disclosures, goals for therapy and interventions that helped a family initiate the recovery process after a SSB disclosure. A single case study design was used to analyze a family\'s long-term therapy process. Data on this N = 1 study comprised 18 interviews with involved therapists, five interviews with involved family members, therapy files, and notes on family sessions. Data was analyzed using a thematic approach. Relational traumas were experienced in broken relationships, relationships under pressure and damaged trust between family members. Therapy goals were to (1) recreate family\'s safety, (2) help the family process the SSB consequences and (3) restore trust and search for relationship healing. Appropriate interventions to target the goals included individual-centered psycho trauma treatment as well as interventions for the parents, the involved siblings, and the uninvolved siblings, followed by sessions between the involved siblings and with the whole family. Therapy outcomes were found in reduced individual trauma symptoms, a recreated sense of family safety, the start of relational trauma processing, and newfound forms of sibling/family relationships. This study provides a unique and comprehensive insight into a family\'s healing process after SSB disclosures from the perspectives of both professionals and family members. The effective interventions identified in this study may provide tools for therapists working with these families. This study may also offer greater insights into both the abusive and mutual types of SSB.

BACKGROUND: Sibling sexual abuse (SSA) is a pervasive form of intrafamilial sexual violence. A review of existing literature underscores ongoing challenges to comprehensive understanding of this offense due to definitional inconsistencies, small sample sizes, data constraints, methodological shortcomings including reporting practices, and a dearth of empirical scrutiny. Previous studies have relied on retrospective, non-representative, clinical, or homogeneous samples.
OBJECTIVE: The present work updates knowledge on SSA addressing several persistent limitations in previous studies and offering contemporary victim, offender, and incident-based profiles to promote avenues for future risk assessment, prevention, and intervention strategies.
METHODS: This study, both exploratory and descriptive, draws on the five most recent years (2018-2022) of data from the National Incident-Based Reporting System (NIBRS), the largest available dataset (N = 30,640), containing SSA incidents reported to law enforcement.
RESULTS: Significant sex differences were noted across age, race, victim injury, offense type, and relationship. Female victims were more likely to experience abuse from older siblings and were nearly 2.5 times more likely to be victimized as an adult than their male counterparts. Female victims were also more likely to report injury, yet less likely than male victims to experience forcible penetration during an SSA incident.
CONCLUSIONS: Findings substantiate the ongoing need for continued refinement of SSA definitional criteria, which, in turn, will lead to greater identification and reporting of incidents. Moreover, findings here underscore the importance of considering age and gender dynamics to guide risk assessment, intervention, and prevention strategies.

BACKGROUND: Sibling sexual abuse (SSA) is influenced by and occurs within an interconnected family system, because of this there is a growing move towards recognising SSA as a family issue. Families also play a vital role in the disclosure of SSA and in the aftermath of recovery. Nevertheless, a descriptive review consolidating the known family dynamics, characteristics, and responses associated with SSA is absent from research.
OBJECTIVE: A scoping review was conducted to synthesise known family characteristics and dynamics associated with SSA. The review also sought to explore how families respond following the disclosure/discovery of SSA.
METHODS: Arksey and O\'Malley\'s (2005) five-part scoping review framework was used. Web of Science, PsycInfo, ProQuest, Google Scholar and specialist journals were searched for empirical research and results were assessed for eligibility, leaving 28 studies in the final review.
RESULTS: SSA was related to: (1) family demographics, (2) a history of abuse and neglect within the family, and (3) household stressors and environmental factors. The review also found that families largely respond using strategies of minimisation.
CONCLUSIONS: Research and practice need to ensure that SSA is understood within the context of family dynamics and histories, in a way that may not be necessary when understanding other \'types\' of child sexual abuse (CSA). Consideration must be given to the fact that children affected by SSA can be situated in families where, as well as SSA, there is a history of abuse and neglect within the family, and various environmental stressors are present.

This paper reviews recent research into sibling sexual behaviour (SSB). This is an emerging professional and community issue that binds together a limited evidence base across research, practice and policy in psychology, criminology, politics, social work and policy studies. The review will demonstrate that a multi-disciplinary, life course, family system approach is the most effective way of starting to develop interventions to prevent and respond to this issue.
SSB has previously been researched as a form of intrafamilial abuse or sibling incest. As a result of this SSB is poorly and inconsistently defined as a concept, meaning that research, practice and policy are sometimes at odds with each other and need to pull together to develop a cohesive framing of the issue. This means that a lot of older research needs to be contextualised in new emerging frames of thinking and ways of working. Current research emphasises the importance of understanding the role of the family system in creating conditions where SSB can occur and its central role in preventing and stopping it from occurring. The research also stresses the importance of professionals understanding the family context of SSB and has the confidence to identify and work proactively with families in a multi-agency and cross-disciplinary way. The prevention of, and response to, SSB requires a multi-level, multi-disciplinary approach. Successful prevention of and response to SSB are as much about the family system as it is about the attitudes, behaviours and experiences of the siblings impacted by the abuse.

Sibling sexual harmful dynamics (SSHD) is a term used, in this study, to refer to childhood sexual behaviors that are inconsistent with age-appropriate curiosity, including sibling sexual abuse (SSA). Although SSA is a prevalent and long-lasting form of intrafamilial sexual abuse, it is the least reported, studied, and treated. This study aims to deepen the understanding of the disclosure process of this phenomenon in the Israeli Orthodox Jewish society, as perceived by those involved. Participants were adults from the Orthodox communities in Israel who experienced sexual interactions/abuse with one or more of their siblings. This qualitative constructivist-grounded theory study was based on semi-structured interviews with 24 adults from the Israeli Orthodox Jewish communities. Seven barriers to disclosure were identified and organized into three main categories: intrapersonal, including denial of the acts, guilt, and shame; interpersonal, including the sibling relationship and perceiving the sexual acts as routine; and cultural, including lack of sexual knowledge, the concept of modesty, and marriage prospects. In addition, we highlight the intersectionality between the different contexts of the SSHD. This study explored the barriers to disclosing SSHD in the siblings\' context and the context of the Jewish Orthodox communities. The findings contribute to understanding the unique aspects of the disclosure, as expressed in religious and cultural contexts, the sibling context, and their intersectionality. Cultural and religious sensitivity is crucial for practitioners, especially as issues of sexuality and sexual understanding stem from the related norms and values.

This study aims to contribute to the evaluation of online therapy during Covid-19 pandemic lockdowns, by exploring family therapists\' experiences of therapy for twelve Sibling Sexual Abuse (SSA) families in the Netherlands. Seven transcripts of interviews with highly specialised Dutch family therapists were analysed using thematic analysis (TA). Two main findings emerged from this study. First, the Dutch therapists reported no acute worries about their clients\' sexual safety during the pandemic lockdowns. Nonetheless, the switch to online therapy for the SSA families created concern regarding victim safety in speaking out freely at home. Second, while the sudden switch to online therapy enabled SSA therapists to stay connected with their SSA families, therapists experienced a decline in therapy quality and in their own well-being. In the therapists\' experience, it was almost impossible to conduct their most fundamental interventions online, such as intervening in family relationships.

Although sibling sexual abuse (SSA) may be the most common type of intrafamilial sexual abuse, it has not been widely studied. The lack of studies makes it very difficult for clinicians to create a comprehensive framework about this complex phenomenon, particularly in comparison with other forms of intrafamilial sexual abuse, such as father-daughter incest. SSA is still underrecognized and underdisclosed but it has the potential to be every bit as harmful as sexual abuse by a parent. The topic rarely finds its way into the more general psychiatry or social work literature. It is imperative to increase healthcare practitioners\' awareness of this complex subject to improve their ability to listen to, detect, and manage the disclosures of SSA in adolescent populations. This paper presents vignettes of three 13-to-15-year-old adolescent girls who disclosed SSA during inpatient hospitalization in an adolescent psychiatric and medicine department. These cases illustrate the complexity of SSA, which has been associated with a wide spectrum of both mental and physical symptoms. Adolescent victims of SSA experience serious distress, with various and numerous psychiatric manifestations, including but not limited to depression and suicide attempts, addictive behaviors, post-traumatic stress symptoms, and eating disorders. Physical symptoms should also alert practitioners: adolescent survivors are more likely to be affected by somatic complications such as sexually transmitted diseases, chronic pain, urogenital symptoms, and nutritional disorders. We offer some recommendations to improve the detection and support of distressed adolescents disclosing SSA. Listening to them and offering a protective multidisciplinary response can limit the lasting damage and contribute to the repair process.

BACKGROUND: Harmful sexual behavior (HSB) is sexual behavior exhibited by children and adolescents that is developmentally inappropriate and/or harmful or abusive towards themselves or others. Victims of children with HSB are commonly siblings. Multiple professionals may be involved in cases of youth HSB involving siblings, which places Children\'s Advocacy Centers (CACs) in a key position to directly address intrafamilial HSB. Approximately 25% of all cases seen at CACs in the U.S. are youth-initiated HSB. However, no known research has examined how CAC professionals approach decision-making and response to intrafamilial and sibling HSB, particularly across regions and cultures.
OBJECTIVE: To examine the perspectives of professionals from three separate CACs in Israel, eastern U.S., and southwestern U.S. regarding their decision-making and response process for sibling HSB.
METHODS: Thirty-seven multidisciplinary team members from the three CACs, including representatives from child welfare, law enforcement, family advocacy, mental health, and the court system, among others, participated in the study.
METHODS: Participants completed focus groups that asked them to discuss how their system would respond to a vignette case. Dedoose was used for thematic analysis.
RESULTS: Using qualitative thematic analysis, results indicate all sites perceived sibling HSB as a family crisis, and they prioritized establishing safety and providing therapeutic interventions. Differences across sites were on how to establish safety and when to use legal actions.
CONCLUSIONS: The study draws attention to the influences that formal policy and community contexts have on CAC decision-making, particularly around the availability of evidence-based treatments and caregiver engagement.

Although sibling sexual abuse (SSA) is one of the most common forms of sexual abuse, it has been particularly neglected in previous research. Hence, characteristics of this form of abuse and its longer term implications are not well understood. The aims of the current review were to precisely characterize the phenomenon of SSA and to condense the implications known to date of SSA on survivors. We included 15 studies with a total sample size of 14,680 individuals. Our results indicate that SSA has some unequivocal features such as an early onset, an extended duration and frequency, and a particularly high intensity (i.e., involvement of coercion, force, superiority, and manipulation). Our findings also revealed that SSA is linked to later depression, anxiety, impaired self-esteem, and sexual functioning. The findings of the current review suggest that (1) SSA is common, (2) SSA has various negative effects on survivors\' mental health, and that (3) SSA and its implications have been and to date are marginalized in research and practice. Results are discussed with a special focus on clinical implications.

Despite being a complex phenomenon with potentially significant short- and long-term consequences for all involved including siblings, parents and the family as a whole, sibling sexual abuse (SSA) has not received sufficient empirical and clinical attention. Practitioners are often left to cope without appropriate guidance.
This study aimed to compare staff perspectives and experiences of working with sibling sexual abuse cases across two Child Advocacy Centers (CACs) within different countries and different cultural and legal contexts.
Participants were staff members from two Child Advocacy Centers: one in Jerusalem, Israel, and the other in Montgomery County, Pennsylvania, United States of America.
This qualitative cross-cultural comparative study analyzes staff experiences of sibling sexual abuse cases based upon 14 focus groups, in Jerusalem (N = 7) and Montgomery County (N = 7).
Findings reveal that both CACs focused on parents, the parents\' negative emotional responses to SSA, and the impossible nature of their predicament. The Montgomery County CAC tended to emphasize the needs of the victim while being attuned to the legal proceedings, whereas the Jerusalem CAC emphasized supportive therapeutic responses for the whole family.
The differences across the two Child Advocacy Centers are related to the different legal and cultural contexts of the two CACs and underscore the need to review what may be the most appropriate policy and practice response to SSA that does not itself cause further harm.