Treating sibling incest using a family systems approach.

Mental health counselors are becoming more aware of sibling abuse in all of its forms. The literature addressing the nature of sibling abuse is increasing; however, there is little written about methods of treatment. Family systems theory as a framework for understanding the common family dynamics observed in families where there is sibling abuse is discussed. Lastly this paper presents a case example using family systems theory as a framework for conceptualizing and developing treatment.

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For many decades, mental health practitioners have been aware of the pervasive problem of child abuse. However, mental health professionals are only now beginning to become aware of other types of abuse within the family. One such type of abuse that is receiving increased attention is sibling abuse. Sibling abuse refers to emotional, physical, and sexual violence within a sibling dyad. It is ironic that this type of abuse has received little attention, given that it is now becoming increasingly recognized as the most common form of family domestic violence (Cole, 1990; Finkelhor, 1980; Gelles & Cornell, 1985; Gelles & Straus, 1988; Steinmetz, 1977; Straus, 1980; Straus, Gelles, & Steinmetz, 1980). What little attention has been paid to sibling abuse in the counseling literature (Ascherman & Sailer, 1990; DeJong, 1989; Finkelhor, 1986a; Smith & Israel, 1987) has generally focused on the dynamics between the perpetrator and victim rather than family or systemic dynamics (Wiehe, 1991). The purpose of this paper is to (a) review the literature on sibling abuse and (b) specify ways in which this abuse can be treated within a family systems theoretical framework.

SIBLING ABUSE

In response to the increasing awareness by professionals to child abuse and particularly child sexual abuse, literature began to appear covering virtually every aspect of the problem from prevention to treatment of the offender and the child. The dynamic initially researched and written about was adult-to-child abuse. As professional understanding developed, Finkelhor (1986a) questioned whether sexual contact other than father-daughter might be under-discovered due in part to the lack of theory to sensitize professionals to its occurrence. The subject of sibling abuse, particularly incest, has received minimal clinical attention. It is under reported, in part, due to the lack of research and theory development (Ascherman & Sailer, 1990; DeJong, 1989; Smith & Israel, 1987).

An understanding of sibling relationships illuminates the many ways in which sibling relationships are different than parent-child relationships. Siblings often provide the ongoing sense of family for each other. Brothers and sisters can provide one another with life's longest intimate relationship often outlasting ties with parents by 20 or more years. Siblings share more of their lives genetically and contextually than anyone else. Siblings share knowledge, perceptions, attitudes, beliefs, and feelings regarding each other, beginning when one sibling first becomes psychologically aware of the other (Briere, 1984; Trepper & Barrett, 1989). Family systems theory supports this understanding of sibling relationships as well as parent-child relationships as being an interactive, interdependent network in which the behavior of each individual or subsystem modifies that of the other individuals or subsystems (Minuchin, 1985). It is the intimacy of this interdependent network that, when it breaks down, fosters violence. Yet, even with the increasing awareness of family violence, systems thinking has not incorporated basic tenets of abuse trauma theory and practice. Most family system investigators of child abuse trauma continue to focus on father-daughter incest despite recognition that sibling incest and assault occur more frequently (Wiehe 1991), and that such a dynamic is part of a family interdependent network.

Occasional studies acknowledging the harmful effects of sibling maltreatment began to appear in the professional literature by the 1990s, with much confusion and uncertainty as to the definitions of sibling abuse (Abrahams & Hoey, 1994; Canavan, Meyer & Higgs, 1992). A review of the literature indicates the following to be commonly used definitions of the elements of sibling abuse (Briere, 1984; Campbell & Carlson, 1995; Cunningham & MacFarlane, 1991; Finkelhor, 1980, 1984; Friedrich, 1990; Tepper & Barrett, 1989; Wiehe, 1991). Sibling physical abuse consists of willful acts resulting in physical injury such as slapping, hitting, biting, kicking, tickling, smothering, choking, or more violent behavior that may include the use of an instrument (e.g., a stick, bat, gun, or knife.) Psychological/emotional abuse is one of the most prevalent forms of sibling abuse. It is difficult to define, often persists under the guise of teasing, and includes neglecting of a sibling, exposing a sibling to violence by peers or other siblings, ridiculing, insulting, threatening, terrorizing, belittling, and rejecting a sibling. Sibling incest is sexual contact between a sibling dyad that is experienced by the victim as traumatic. This includes sexual behavior for which the victim is not developmentally prepared, which is not transitory, and which is not motivated by age-appropriate curiosity. It may involve physical touching, fondling, indecent exposure, attempted penetration, intercourse by coercion or force, or oral and anal sex. Non-contact sibling incest may encompass behavior that is intended to sexually stimulate a sibling or the offender. It can include unwanted sexual references in conversation, indecent exposure, forcing a sibling to observe the other's sexual behavior, taking pornographic pictures, or forcing a sibling to view pornography.

Even though the professional community was becoming more informed and educated to these phenomena, violent acts between siblings were still not coming to the attention of the authorities. In surveys of randomly selected families, it was found that there were high levels of physical acts between siblings and that violent acts between siblings occurred more frequently than between parent-child or partner to partner. Survey data indicated that 53 out of every 100 children per year attack a brother or sister. Estimates are that 35% of all girls have been sexually abused; the perpetrators generally are males and many include siblings. Abusive behavior between siblings is excused as sibling rivalry, and mandatory reporting of these incidents is not required. Had these incidents occurred outside the family they would have been considered assaults (Finkelhor 1984; Gelles & Cornell, 1985; Steinmetz 1977; Straus 1980).

To receive the attention of the social welfare system or courts, a parent or the victim must be willing to file assault charges against the perpetrating sibling (Finkelhor, 1986b). Cole (1990) states that many incidents go unreported because feelings of embarrassment and shame connected with the event prevent the perpetrator, victim, and parents from talking about it. This type of family secret keeping is also seen in the parent-child incest dynamic and is an example of how the action of one family member impacts the actions of all others in the interdependent network of a family.

The published findings of an initial study of violence in American families, based on a sample of over 2,000 families and titled Behind Closed Doors, (Steinmetz 1980; Straus et al., 1980), noted that Americans highly value their freedom, including the freedom to raise their children according to their values. Historically, the philosophy that has developed is "What happens at home is the family's business."

Wolfe (1987), on the other hand, states that psychological maltreatment between siblings is more common than violence or incest and leaves longlasting scars on sibling victims and survivors. By its very nature, psychological maltreatment is more difficult to recognize and document and is suspected to be more damaging to a child than physical injuries. Detecting psychological abuse is difficult because it is accepted as a normal occurrence in most sibling interactions and is seen as rivalry. Many parents and professionals tend to discount sibling psychological maltreatment and minimize its importance because it leaves no physical signs (Kolko, Kazdin, & Day, 1996). As a result of the infrequent reporting of this type of violence and the lack of research and theory development, many clinicians may not directly and routinely assess for sibling abuse. Rather they often rely on spontaneous self-disclosure or indirect signs (APA Task Force, 1996). That mental health practitioners do not routinely assess for sibling abuse is further complicated by the fact that they may not have been educated and sensitized to the signs of such a family dynamic.

DYNAMICS OF SIBLING SEXUAL ABUSE

Relatively few studies of sibling abuse or child abuse trauma incorporate a systemic approach to assessment or treatment, aside from a few exceptions. These systems researchers collectively maintain that any type of child maltreatment is not the result of a single factor, but rather the consequences of interactions among multiple factors and systems. Developmental levels of the individual child, sibling, and family system all affect the potential for abuse. A systems perspective that is informed by the literature on abuse trauma is crucial for understanding the dynamics of sibling abuse (Belsky 1993; Friedrich, 1990; Gil, 1996; Trepper & Barrett, 1989). Friedrich proposes an integrated model that subsumes current systems theories and adds perspectives from attachment theory (Alexander, 1992; Dunn, 1993; Finkelhor & Browne 1986), behavioral/emotion regulation (Giarreto, 1982), learning theory (Alexander, 1985) and self-perceptive/development (Kolko et al., 1996).

In the clinical literature, a great deal of speculation exists about the fact that abuse begets abuse; that is, those children who are abuse victims become victimizers. In a review of this literature, it is apparent that such conclusions, drawn from data in retrospect, are based on many adult offenders' reporting early abuse and sexual contact with adults or older children (Alexander, 1985; Giarreto, 1982; Johnson, 1988, 1989). Approximately 30% of adjudicated offenders of children and adolescents report having experienced physical, emotional, or sexual abuse during childhood or adolescence (Garland & Dougher, 1990). Wiehe (1991), in his book Perilous Rivalry, posits that the reason some older siblings use abuse to control their younger siblings is because their parents do. Sibling abuse and incest cannot be considered an isolated problem but should be understood as a manifestation of family dysfunction (Mayer, 1994). In severe sibling abuse or incest, individual pathology also complicates the picture. Incest with a younger sibling by an older sibling is motivated largely by urges to satisfy underlying emotional needs for nurture and comfort rather than a need for sexual gratification. With the older offending sibling unconscious needs and conflicts are expressed covertly through the abusive behavior (Friedrich, 1990).

FAMILY SYSTEMS THEORETICAL FRAMEWORKS

Obviously there is the need to continue to formulate hypotheses about the psychological constructs that contribute to offending behaviors. The following is a consideration of the most common family dynamics that may be part of the force behind the motivation for a child to become abusive to a sibling. Some of these theories are taken from the studies of adolescent offending behaviors and may have limited applicability to younger physically abusive and sexually acting-out children. Nonetheless, they have some value and are worth considering. The fact that there is so little in the research literature about the pre-adolescent abusive and sexually acting-out child, despite the growing numbers of reported cases of sibling abuse, further supports the need for additional research.

In cases of physical and sexual abuse, family dynamics have more similarities than differences (Alexander, 1985; Friedrich, 1990; Gelinas, 1988). Individuals in families that physically and sexually abuse tend to have low self-esteem, high impulsivity, low frustration tolerance, an inability to identify or meet needs, a lack of problem-solving skills, affective and expressive problems, communication deficits, feelings of helplessness and futility, frequent and unresolved losses, and isolation. Additionally, abusive and incestuous families have high levels of personal, social, and economic stress; substance abuse; and exaggeration of patriarchal norms. Sexually and physically abusive families tend to develop and sustain unrewarding or problematic adult relationships that may include periods of estrangement. Intimacy is further compromised by periods of physical, verbal, and emotional abuse as well. Parenting skills are characterized by high levels of frustration, punitive or harsh child-rearing styles, or triangulation. Gelinas further characterizes these families as having long-standing relational patterns of unfairness which progressively converge and focus on the child who becomes the primary victim. Gelinas also states that the incestuous family engages in parentification. A child is persuaded to assume, through the covert behaviors of the unfair power-wielding parent, premature and excessive caretaking responsibilities in the family. The message in such parentification is that the parentified child has similar power and control over the siblings, and abuse of the sibling becomes a means to relieve anger, hurt, and frustration. Should sexual duties become part of the caretaking of the parent by the parentified child, sibling sexual abuse often becomes part of the dynamic.

In these families there is much pain (Alexander, 1985; Gelinas, 1988; Gil, 1996). Often all family members share feelings of distress. No one cares about them, no one listens to them, they are alone, and they are helpless to change anything. The family members experience isolation, despair, and futility. No one within the family has the emotional ability to take care of the self let alone one another. When families cannot change these patterns, symptoms emerge, often in the form of abuse. The abuse may take the form of parent-to-parent, parent-to-child and child-to-child. In cases of domestic violence between adults or physical/sexual abuse of and between children, the symptom is obviously violence. Seemingly, for lack of other ways to manage pain because of a history of violence in family relationships, these families resort to hitting, biting, kicking, and other physical expressions of anger. Lenore Walker (1984) has described a cycle of violence that develops and which organizes the family's functioning. The momentum of the family's functioning is a pattern of hitting and forgiving; sequences of pain and comforting are metaphors for underlying issues.

Family members who make emotional contact with each other through violent interactions learn behaviors designed to perpetuate the symptoms. Finkelhor & Browne (1986) state that abused children are taught and, therefore, learn to behave in sexually inappropriate ways. Offending siblings exchange attention and affection for sex as a means of meeting their nurture needs or they withhold punishment in exchange for sex as a means of power and control. In either case, the child learns to perform sexual acts for a variety of reasons. It is also suggested that the child learns that sexual behaviors can modulate anxiety and promote feelings of safety and well-being, despite the subsequent feelings of shame, confusion, or guilt.

Stierlin (1973) and Gil (1996) explain the dynamics of families where children abuse children in the following way. They discovered that, in families with covert dysfunctional patterns, the parent had a hidden desire that was somehow transmitted to the child; and the child was acting it out for the parent. Gil observed this process in a physically abusive family in which the mother had singled out her 4-year-old for physical abuse. The mother was highly dysfunctional and alternately rejected and punished her children without apparent cause. All of the children longed for her approval. By identifying the 4-year-old as being problematic and by making statements of aggression and physical punishment about the child, she transmitted her desire to her 12-year-old son. Eventually the 12-year-old beat the 4-year-old severely. This put the 12-year-old in his mother's good graces for some time. In a matter of sibling incest, Gil, also relays the case wherein the father set up his 13-year-old son as the perpetrator. The father would make sexual statements about his daughter, even implying sexual desire for her. Eventually, the 13-year-old son raped his 11-year-old old sister.

In families where there are covert dysfunctional patterns, two important themes exist. One, the parent is frustrated, helpless, and in pain; and two, the parent has chosen a child to meet his or her needs in order to feel superior, in control, and comforted. Although the parent does not act on these impulses he or she may convey the desires to a second child, who is triangulated to act on the parent's behalf. Stierlin (1973) points out that while this conveying of desires lacks a formal name, it could be described as a process of transmission whereby the parents, consciously or unconsciously, relay desires or frustrations to their offspring. The children in turn do not seem able to allow the feelings to lie dormant and, instead, act them out on behalf of the parent.

Lane (1991), on the other hand, discusses a type of learned response style in the child who molests his or her sibling. She found that adolescent offenders who begin their physically or sexually abusive behaviors during pre-adolescence are exhibiting coping styles that are characterized by power or control seeking dynamics. These dynamics are already habituated and ingrained from the behaviors they have witnessed or experienced in their homes. Lanes views these aggressive behaviors as a learned response, that is, as a compensatory response style which occurs because of their prior victimization and constitutes an irresponsible use of power to master the trauma.

Agreeing with Lane (1991), Terr (1981) and others support the trauma reenactment theory. Terr states that sibling assault or molestation can be seen as trauma re-enactment. Such re-enactment is more problematic in that children seek to repeat the elements of the traumatic events with other children; that is they attempt to do to their brother or sister what has been done to them. The trauma model asserts that traumatic events need to be processed in order for an individual to return to healthy functioning. Van der Kolk, (1989) agrees and specifies that, repeated, trauma is experienced on behavioral, emotional, physiological, and neuroendocronological levels. He further explains that compulsive repetition of the trauma usually is an unconscious process that provides a temporary sense of mastery over the event. The repetition of the trauma, whether it provides a sense of mastery or even pleasure, ultimately perpetuates chronic feelings of helplessness and a sense of being bad and out of control. The traumatic events have overwhelmed the child and feelings of helplessness, terror, anxiety, and vulnerability are persistent. When the child plays or acts the feelings out, there may be an attempt at mastery or a more full integration of the trauma experience. In this manner the child moves from a passive to an active role, (i.e., helpless victim to dominant perpetrator), and a temporary relief may follow (Freud 1920/1954; Garland & Dougher, 1990; Schwartz, 1991;Terr, 1981). Van der Kolk emphasizes that clinical experience has shown that mastery rarely happens, but instead such repetition causes further suffering for the victims and those around them.

Lastly, when considering contributing factors to the motivation behind sibling abuse, one additional dynamic bears discussion: the emotionally barren family (O'Brien 1991). In such a family, the environment is one of emotional deprivation; physical affection and nurturing behaviors are nonexistent. Children are neglected by their parents and left physically and emotionally unattended for extended periods of time. The parents in these families may be drug dependent, emotionally immature, infantilized, or otherwise low functioning. They are in great emotional pain and often have a childhood history of severe deprivation themselves. These parents are unable to give what they have not experienced. Parents may be so needy that a role reversal occurs in which parents turn to their children to get their own needs met (De Jong, 1989). Children in these environments make great efforts to meet the needs of their parents, frequently show remarkable perseverance, and take charge. These children may then turn to their siblings for the comfort and physical nurturing so necessary for their development. De Jong's findings suggest that the physical or emotional absence of one or both parents plays a significant role in intensifying the mutual dependency and sexual curiosity of brothers and sisters. O'Brien supports De Jong in pointing out that, in emotionally barren families, children suffer pain from acts of omission rather than commission. As a result, he says, they may be vulnerable to seeking out sexual contact as a natural extension of trying to get their intimacy needs met.

CASE ILLUSTRATION: THE WILLIAMS FAMILY

Presenting Background

Confidentiality and privacy are always a critical concern when discussing client cases. In this case illustration, all names and other identifying information have been changed to protect all individuals involved. Mark, a 13-year-old, was referred into treatment by Child Protective Services after sexually abusing his 11-year-old sibling, Lisa. Mark's mother had called the police when she discovered the fact that Mark had been abusing Lisa for the previous 6 months. Lisa told her mother about the abuse when Mark was away from home at band camp. Lisa remarked to her mother that she was sleeping better with Mark away. When pressed for details, Lisa confided that she did not have to worry about Mark coming into her bed in the middle of the night and" bothering me." When pressed for more details, Lisa reluctantly told her mother that Mark touched her genitals and would insert his fingers into her vagina and anus. She also pleaded with her mother to not be angry with Mark as he always told "me he loved me" when he came into her bed.

When Mrs. Williams called the police, she was very distressed about what had happened and was very vocal about her anger with her son. Her statements of anger and implications that Mark and other men were alike, and in some way not to be trusted, were documented in the police report as was her request that he be taken out of the house and sent to jail as soon as possible. Mark was brought home early from band camp. When questioned by the police and a Child Protective Services worker, Mark admitted to the sexual abuse. He appeared to have remorse for his behavior. The recommendation was for Mark to obtain counseling in an adolescent offender's program. He went to live with an uncle during this time.

Family History

The mental health counselor initially met with Mr. and Mrs. Williams and Mark. Mrs. Williams' intense anger towards her son was very apparent. She made statements alluding to the fact that she had expected this type of behavior from Mark. When she was asked what made her think that, she told her own history of sexual abuse. She was very insightful as she spoke, yet she spoke with little to no affect. She talked about her victimization as if she were talking about a total stranger. She was factual, yet disengaged from her feelings as she related her years of sexual abuse. She described her father as a sick monster and as a disgusting creature, always adding that most men were the same as her father. Mrs. Williams revealed she had been abused by her father from the age of 8 until she was 16. Mrs. Williams' mother had been severely injured in an auto accident and left disabled, spending most of her time in bed and unavailable to anyone. At 16, Mrs. Williams ran away from home and married her first husband. She discussed her first husband with great anger and disgust. She described him as being lazy and being sexually perverted. Any desire for sex qualified him as a sexual pervert. At that point she indicated her second husband, Mr. Williams, knew his place when it came to sex, meaning that they had sex only when she initiated it. Mr. Williams spoke very little during the interview. When directly addressed, Mrs. Williams would often answer for him. He offered that the children were Mrs. Williams' and that he was just a "fill in for their father." Mrs. Williams preferred the parenting be left to her. Clearly, it was important to Mrs. Williams to be in control. When Mrs. Williams was asked to talk about her daughter, Lisa, she painted her as charming, sweet, very bright and friendly.

During the interview Mark sat quietly. He was often tearful. Mrs. Williams had distanced herself from Mark sitting as far away from him as possible. When the mental health counselor spoke with him, he admitted to the sexual abuse and seemed remorseful. He stated that he knew he needed help and was willing to do what was required of him. In a private interview it was learned that Mrs. Williams had often admonished him to not undress near or look at or touch his sister in any way. He recalled a time when he was young, perhaps 5-years-old or so, when his mother caught him touching his penis. She wrapped his hands together at night to prevent him from touching himself. He told of his mother telling him and his sister the details of her own sexual abuse. He stated that hearing the details made him uncomfortable and curious as well.

Conceptualization 

Considering this case within a family systems framework indicated that both parents contributed to the symptomatic acting out of the family's problems. Most importantly, Mrs. Williams had a history of sexual abuse that was unresolved. Her factual description of her abuse and her incongruent affect with the events described indicated that the abuse had been compartmentalized and not integrated. As a result, the issues became intertwined within her present intimate relationships. It was very important that she remain in control in her relationships with men because the loss of control represented danger. After her first marriage, Mrs. Williams had selected a compliant man who allowed her control of their sexual encounters and other matters as well. She had made attempts to dominate her son Mark by viewing him as inherently perverted. She also treated her children differently: Lisa was the good child, and Mark was identified as the bad child. It is possible, therefore, that sibling jealousy existed and that Mark harbored anger and resentment towards his sister, a common factor in sibling sexual abuse.

Mark sexualized his anger in part as a result of his mother's explicit information about her own abuse. His mother's attempts to guard against such happenings, inadvertently, contributed to a climate within the family in which Mark merged sexual impulses with aggressions. He behaved in the ways his mother viewed as predictable for males. Lisa's victimization allowed Mrs. Williams an opportunity to be the responsible mother that her mother was not. This scenario, Mrs. Williams protecting Lisa and pushing Mark away, was her way of addressing her own victimization and need to be protected.

Mr. Williams' role was more covert, but important. His failure to confront his wife's beliefs about men, and Mark in particular, contributed to the sexual climate Mrs. Williams had created in the family. In time, it was learned that Mr. Williams had been in a physically abusive home in which his alcoholic mother had violent angry outbursts. This vulnerability to outbursts kept him compliant.

Treatment

From this family systems perspective, it would have been pointless to provide therapy for Mark without treating the rest of the family. The mental health counselor met with each person separately establishing a therapeutic relationship and listening to their perception of this family problem. Then, after assessing the family dynamics, the issues were addressed with the Williams in individual therapy, subsystem therapy, and family therapy. In addition, Mark participated in group therapy for adolescents who had sexually offended; family and subsystem sessions occurred only after the group therapist verified their safety.

Individual sessions. In Mark's individual therapy, treatment focused on (a) the many negative beliefs he had internalized about males through expressing anger, hurt, fear and sexual feelings in positive, nonaggressive ways; and (b) his secondary victimization as a result of his mother's repeated and detailed accounts of her abuse, with his feelings of violation and anger at this mother, being processed and resolved. Both parents had histories of childhood abuse that had resulted in emotional vulnerabilities and issues such as intimacy and power in relationships. Mark's abuse of Lisa brought back memories for each of them, which each addressed in individual sessions. In her sessions, Mrs. Williams, a very hurt and angry woman, worked intensively on her reactions to Lisa and her own confused thoughts and feelings about her victimization. She admitted that she was disappointed that Mark was born male and that she had never felt motherly towards him. She worked through her negative feelings for her son, men in general, and her father. As her anger lessened, she replaced those feelings with sadness and despair at the helplessness and isolation she experienced during those years of abuse. Eventually she also worked through the feelings of anger and disappointment at her mother's inability or perhaps unwillingness to protect her. Lisa's initial sessions addressed her concern that she had hurt her mother and had done something wrong by telling her about the sexual abuse. She was more upset about her mother's rage against Mark and his absence than she was about the abuse; however, Lisa eventually understood that her greater concern for her mother's feelings and rage was a way to avoid dealing with her feelings.

Subsystem sessions. In the parental subsystems sessions, the parents worked on the lack of intimacy and struggle for control that characterized their relationship. Mrs. Williams had asserted control by failing to encourage or even allow Mr. Williams to function in a parental role. Mr. Williams responded and asserted covert efforts at control by keeping a physical and emotional distance from everyone in the family. Working together, the Williams established expectations for themselves as a couple and as parents.

Regarding the sibling subsystem, Mark had cause to resent his sister because of the preferential treatment she received by their mother. This treatment, of course, was not Lisa's fault, and Mark came to understand that. It appeared that Mark sexualized his anger most likely because of his mother's detailed descriptions of her own victimization and the implied lessons of gender roles (i.e., males as aggressive and abusive). Lisa was confused and fearful about what she perceived she had done to Mark. She had continued to believe that, had she not told her mother of the abuse, Mark would not have had to leave the family and no one would have to be going through what this family was dealing with. She learned that Mark was not angry with her and that he could be accountable for harming her.

Family sessions. Family therapy focused on integrating into the family dynamics the greater understandings that each had learned about themselves and the family as a whole. An accountability session allowed Mark to take responsibility for molesting his sister and to apologize to Lisa for hurting her emotionally and physically. A similar kind of accountability session provided Mrs. Williams the much needed opportunity to be accountable to Mark and to hear his feelings of hurt and abandonment as a result of her obvious preference for Lisa. She was also able to help Lisa in letting go of the belief that she had been responsible for Mark having to leave the family. Mark assisted in that as well by owning his behavior. Lisa's issue was working through her feelings of anger towards her brother and her mother. Not surprisingly the children had feelings of anger toward their step-father for not having participated fully within the family. Mr. Williams responded to this by making a commitment about how he would now be present within the family. The remaining family sessions dealt with building and rebuilding trust, establishing boundaries, creating parental expectations for the children's and their own behavior, and creating prevention strategies. The family was reunited after 18 months of therapy.

CONCLUSION

In summary, it is clear that in all the family dynamics discussed here there is severe parental dysfunction, with boundaries being enmeshed or disengaged and with parents reacting to children as if they were either mates or small adults. Aggression is modeled, and children do not receive the appropriate care and guidance needed to successfully complete their developmental tasks. It would be premature, however, to create a linear cause and effect model for molesting and assaultive behavior in children toward their siblings. Continued research and reporting of a family systems approach to intervention and treatment will not only benefit families but the counseling profession.

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Cora Haskins, LPC, NCC, is a mental health clinician in practice with a family services agency. She is also a doctoral student, School of Education and Human Services, Oakland University, Rochester, MI. E-mail: [e-mail] The author would like to thank James T. Hansen, Ph.D., of Oakland for his direction, guidance, and support.