Managing sibling referrals: Ethical considerations for integrated pediatric primary care.

Abstract

Objective: Physicians in integrated primary care settings often refer siblings to the same pediatric psychologist. The objective of this article is to assist psychologists in ethical decision making regarding such referrals, which, if accepted, mean entering multiple relationships. Method: Ethical issues related to sibling referrals, including risk for harm and ways to avoid it, as well as potential benefits, are discussed in the context of the APA's Ethics Code and relevant literature. Results: An ethical decision-making framework for evaluating sibling referrals is applied to case examples. Conclusions: Pediatric psychologists must thoughtfully evaluate sibling referrals to identify when accepting sibling referrals is a reasonable risk. Use of a framework can facilitate decision making. Implications for Impact StatementWhen pediatric psychologists provide individual therapy to more than one child from the same family, there are ethical risks. However, having siblings receive services from the same psychologist is efficient and improves access to care. This article reviews ethical risks and benefits of providing individual therapy to siblings and proposes a decision-making framework to aid pediatric psychologists in deciding how to proceed given sibling referrals.