Sibling therapy gains attention as experts weigh its risks and promise

A 2023 study in the Journal of Social and Personal Relationships analyzed 31,286 dyad-years and found that 17.5 percent were characterized by estrangement between siblings. Adult sibling therapy is drawing broader attention. NPR published a story on adult siblings in therapy in April 2024, and The Atlantic followed with a piece arguing that the practice is uncommon but may deserve a wider role.

Why the conversation is widening

The topic is no longer limited to private practice circles. Understanding Adult Sibling Therapy appeared in Psychology Today in 2025, and the National Council on Family Relations has an active Sibling Relationships Focus Group for 2024-2025, signs that sibling ties are being treated as a serious area of study rather than a niche concern.

Professional psychology has been flagging the issue for longer than the recent media attention suggests. The American Psychological Association ran Improving sibling relationships in March 2022, then returned to estrangement in April 2024 with a feature framing sibling conflict as something therapists can help sort through, whether the goal is repair or a healthier detachment.

Who seeks sibling therapy

The people most likely to seek this kind of therapy are adults carrying long-running conflict, not children in a one-off dispute. Some come because one or more sibling relationships have gone cold; others want help making sense of repeated blowups, inherited resentments, or the feeling that each conversation falls back into a childhood script. In those cases, therapy is less about teaching basic communication than about naming the roles each person still plays in the family system.

The clinical literature has recognized that siblings become especially important when the usual parental structure breaks down. A 1988 APA PsycNet book, Siblings in therapy: Life span and clinical issues, and later work such as Therapy with siblings in reorganizing families, describe sibling-focused treatment in settings where death, divorce, or separation leaves children without consistent parental support. That background still matters in adulthood because those disruptions can shape how brothers and sisters relate for decades.

What it can realistically address

Sibling therapy can help adults examine whether a relationship is salvageable, or whether the healthiest outcome is a clearer boundary. The APA’s April 2024 guidance on estrangement framed psychologists as able to help identify relationships worth salvaging or help heal the pain of detachment, which is a more realistic standard than promising reconciliation in every case. In practice, that means therapy may improve a relationship, or it may simply help people understand why it cannot be repaired in the form they once hoped for.

It can also be useful when the conflict is not just about poor communication. Current research and qualitative work on sibling estrangement point to unequal parental treatment, loyalty binds, and long-standing family narratives as common forces behind distance between siblings. Those patterns are hard to solve with a few sessions of better listening because they often reach back into childhood roles that both people have rehearsed for years.

What the evidence shows

The same 2023 study found that 28.1 percent of respondents experienced at least one episode of estrangement from any sibling.

There is also emerging intervention research, though much of it is still limited in scope. A 2025 Wiley study found that the SIBS intervention improved the quality of sibling relationships in a randomized control study, and a 2024 open trial of the same intervention for children with chronic disorders found benefits in siblings’ perceived relationship outcomes with their parents.

Where caution matters

The process can reopen conflict before it resolves anything, especially when the underlying issue is not a misunderstanding but a family history full of unequal treatment or old wounds that were never acknowledged. In that setting, a session can produce clarity, but it can also sharpen grief or disappointment if one sibling is ready for change and the other is not.

Sibling therapy is not a promise of reunion. It is a tool for deciding what kind of contact, if any, is possible after years of tension, and for lowering the damage when total repair is not on the table.