Ghosts in the waiting room: Understanding the impact of CAMHS-based psychoanalytic psychotherapy on biological sibling relationships when one child is in treatment and others are on the waiting list? A qualitative study of parents’ perspectives

The aim of this study is to explore the impact of CAMHS-based psychoanalytic psychotherapy on sibling relationships when one child is accessing treatment and others remain on the waiting list. Four caregivers of siblings who have lived experience of this dynamic over a period of at least one year in a CAMHS clinic were interviewed using a semi-structured technique. Verbatim transcripts of the interviews were then analysed using Interpretative Phenomenological Analysis (IPA) to examine the parents’ perspectives of the siblings’ experience when one was receiving treatment and one waited. Four Group Experiential Themes (GETs) were identified, each providing a rich description of both siblings and carers lived experience. They are: Sibling Inequality and the Struggle to be Seen; The Burden of Care and Blurred Identity; Navigating Systems of Support and Disappointment and Making Sense of Past Trauma in Present Relationships. Key findings suggest that institutional practices, such as waiting lists, can actively re-produce feelings of rivalry and exclusion. This highlights the fact that sibling inequality is not merely a component of the internal world, but one that can be co-constructed by external social and institutional frameworks. The research also illuminated the invisible weight borne by parents and kinship carers, demonstrating how systemic failings can intensify the burden of care.