Cynthia Clarfield, Psy.D., is a 2017 graduate of the PsyD Program in Clinical Psychology at Antioch University, Seattle

Dissertation Committee

Mary Wieneke, Ph.D., Committee Chair

Jane Harmon-Jacobs, Ph.D., Committee Member

Barbara Lui, Ph.D., Committee Member

Phil Cushman, Ph.D., Other


Interpretative Phenomenological Analysis, IPA, adolescence, siblings, addiction, substance use, substance abuse, siblings of substance users, siblings of substance abusers, siblings of addicts

Document Type


Publication Date



There has been a rising interest in addiction medicine and addiction treatment in both the medical and behavioral health science fields. Research suggests having a family member with a substance abuse problem has negative impacts on both physical and mental health (Orford, Copello, Velleman, & Templeton, 2010a). Despite advances toward understanding the experiences of family members affected by a loved one's addiction, the siblings of substance abusers have been largely excluded from scientific research and literature. As a result, little is known about how siblings experience the impacts of a brother or sister's addiction; even less is known about the experiences of adolescent siblings sharing a home with a substance-abusing sibling.

The purpose of this study was to explore the experiences of and meanings made by adolescents living with the phenomenon of a sibling's addiction. Five adolescents participated in a semi-structured interview exploring the question: What is it like to be the brother or sister of a person with a substance abuse problem? Interpretative Phenomenological Analysis was used to analyze data and six themes were identified: personal impact; familial impact; social impact; coping strategies; shared ways of knowing, being, and seeing; and ways of understanding.

The results indicated siblings experience profound emotional and relational impacts, which include stress, anxiety, sadness, and anger as a result of the trauma, betrayal, and grief associated with a sibling’s substance abuse. Experiences of invalidation within the family and stigmatization within the community were associated with strained relationships and increased isolation. A comparison of the results to existing research on adult siblings of substance abusers revealed the negative impacts experienced by adolescent siblings of substance abusers continue into adulthood. Participants’ ability to identify and describe these negative impacts directly contributes to the health care field's current dearth of data on the subject. Results challenge the misconception that siblings of substance abusers are "doing fine"; and highlight an opportunity for researchers and treatment providers to expand their knowledge of this largely underrepresented population. Participants' perspectives on expanding interventions for affected family members to include the siblings of substance abusers are also discussed. This dissertation is available in open access at AURA, and Ohio Link ETD Center,


Cynthia Clarfield, Psy.D., 2017

ORCID #ID 000-0001-5601-8822