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The project addresses a significant and largely unmet need within the mental health care system: the systematic exclusion of siblings from therapeutic and support services for individuals living with mental illness and trauma.
Worldwide, current mental health treatment models primarily focus on the individual receiving care and, in some cases, parents or primary caregivers. Siblings, despite often sharing lifelong emotional bonds and playing a vital role in family functioning, are rarely included in assessment, treatment planning, or therapeutic interventions. This exclusion persists even though siblings are frequently and profoundly affected by a brother or sister's mental health challenges. As a result, healthy siblings often experience unrecognized and unsupported emotional distress, including anxiety, guilt, grief, caregiver burden, feelings of isolation, and secondary trauma. Many assume significant emotional and practical responsibilities within the family without access to structured support, education, or coping resources. At the same time, individuals living with mental illness may be unable to benefit from one of the most enduring and influential sources of support available to them: a healthy and engaged sibling relationship.
The need for this project emerged directly from experience gained through previous mental health group-based interventions supported by a Rotary Global Grant. During this work with individuals living with mental illness and their families, including siblings, it became evident that while group settings provide valuable support, education, and normalization, they are not sufficient to address the deeper relational dynamics that exist within families. Participants consistently reported that existing mental health services are largely individual-focused, with limited or no structured therapeutic space dedicated specifically to sibling relationships.
Both families and clinicians identified a significant gap in dyadic (sibling-to-sibling) therapy, despite broad recognition that sibling relationships are among the most enduring and influential family bonds across the lifespan. Participants noted that while group interventions offered meaningful opportunities for connection and shared learning, they could not replace the need for focused therapeutic work addressing sibling-specific concerns, including shared trauma, family role dynamics, emotional burden, communication challenges, and the long-term impact of mental illness on family relationships.
Research and clinical experience demonstrate that positive sibling relationships can strengthen resilience, improve emotional regulation, enhance social support networks, and increase engagement and continuity in treatment. The lack of sibling involvement therefore represents a missed opportunity to improve recovery outcomes and strengthen family well-being.
This gap creates two critical community needs:
1. Support for healthy siblings, who often carry substantial emotional and practical burdens without formal recognition, education, or therapeutic assistance.
2. Enhanced family-centered treatment models that leverage sibling relationships to improve clinical outcomes, strengthen family cohesion, and reduce long-term strain on mental health and social service systems.
Members of the benefiting community played a direct role in identifying these needs and shaping the proposed solution. Through participation in Rotary-supported group programs, individuals living with mental illness, their siblings, family members, and clinicians provided ongoing feedback regarding the strengths and limitations of existing services. Their experiences highlighted the absence of dedicated therapeutic interventions focused on sibling relationships and underscored the importance of creating a structured space where siblings could work together on issues affecting both their individual well-being and their relationship.
In response to this community-identified need, the project team developed the concept of a specialized clinic dedicated to sibling dyadic therapy. The clinic is designed to complement existing individual and group-based services by providing a focused, evidence-based, relationship-centered therapeutic model that directly addresses the needs of siblings within families affected by mental illness and trauma.
The proposed project will also address the need for clinician training in family-systems, trauma-informed, and relationship-based approaches that reflect the complexity of real-world family dynamics. By strengthening sibling relationships and increasing meaningful family involvement in treatment, the project seeks to improve individual recovery outcomes, enhance overall family resilience, and contribute to stronger, more supportive communities. Importantly, the clinician training program developed from this project can be adopted worldwide.
Rotarians will play an active role throughout the planning, implementation, oversight, and future expansion of the project. Building on Rotary's longstanding commitment to community health and family well-being, both the Host and International Sponsor clubs will contribute expertise, resources, and leadership to ensure the project's success.
The Host Sponsor in Israel will provide ongoing project oversight and coordination, working closely with clinical partners, community stakeholders, and participating families to ensure that project activities remain responsive to identified community needs. The Host Sponsor will be responsible for ensuring that all activities are conducted in full compliance with Rotary International Global Grant requirements and standards. In addition, the Host Sponsor will manage grant funds, maintain transparent financial oversight, ensure adherence to approved budgets and procedures, and submit all required monitoring and reporting documentation.
Rotarians will also support community outreach and awareness efforts, helping to publicize the program and recruit eligible participants and families. Through their extensive community networks, Rotarians will assist in increasing awareness of the importance of sibling inclusion in mental health care and help ensure that the project reaches those who can benefit most from the services provided.
Following completion of the pilot phase in Israel, Rotarians will play a key role in evaluating outcomes, sharing lessons learned, and disseminating findings within Rotary and professional networks. International Sponsors will support efforts to explore adaptation and replication of the model in other communities and countries, helping to extend the project's impact and contribute to the development of innovative family-centered mental health services worldwide.
Timeline:
Step 1 Preparation and Setup: The project will begin with establishing the Sibling Integration in Therapy Clinic at Ariel University, including preparation of clinical space, procurement of equipment, development of protocols, and securing ethical and institutional approvals. Clinical and research staff will be recruited and trained in the sibling-dyadic therapeutic model. 1-2 months
Step 2 Participant Recruitment and Intake: Eligible participants (individuals with mental illness and their healthy siblings) will be identified and recruited through Ariel University, Be'er Ya'akov Psychiatric Hospital, and community referrals. Initial intake assessments will be conducted to evaluate clinical needs, sibling relationship dynamics, and baseline measures. 3- 6 months
Step 3 Clinical Intervention Phase: Participants will receive structured therapeutic services, including dyadic sibling therapy, individual sessions, and group interventions when appropriate. Treatment will be delivered using a family-systems and trauma informed approach, with ongoing clinical supervision and documentation. 4-18 months
Step 4 Monitoring and Evaluation: (Throughout Intervention Phase) Standardized assessment tools will be used to measure outcomes such as symptom reduction, sibling relationship quality, caregiver burden, and family functioning. Data will be collected at baseline, during treatment, and post-intervention. (Throughout Intervention Phase)
Step 5 Analysis and Model Development: Clinical and research data will be analyzed to evaluate effectiveness and impact. Findings will be used to refine the therapeutic model and develop structured manuals and clinical guidelines. (Throughout Intervention Phase)
Step 6 Training and Dissemination: A formal training program for clinicians will be developed, including manuals, workshops, and training materials. Results will be disseminated through academic publications, professional forums, and Rotary networks, with the goal of enabling replication of the model in other settings. (Throughout Intervention Phase)
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