Table 1.

Principles guiding sibling support in critical care.

Principle	Factors	Objective
Family as context	Family as defined by family (18)	Sibling support offered reflects the family's values, priorities, experience, understanding, tone, and preferences
	Family culture, roles, and expectations are unique to each family (19)
Strength-based	Families bring collective and individual strengths to the experience of critical illness hospitalization (20)	Approaches to sibling support acknowledge and build on the existing strengths of each individual and the family
Individualized	The needs of siblings will evolve throughout the experience (21)	Approaches and interventions for sibling support are specific to the individual, developmentally aligned, and fit the unique needs of each sibling
	Sibling age and stage impact needs (9)
Predictive and responsive	Family responses and needs vary and may be dynamic throughout the experience (10)	Sibling support anticipates predictable elements of the experience and responds to changes and unexpected situations
	Family and individual resources and capacity will vary through the course of the experience (22)	Ongoing assessment and adaptation of the plan for sibling support are performed
Fit to clinical situation	Critical illness experiences vary in their trajectory, uncertainty, risks, and outcomes	Sibling care is flexible and adapted to fit the current and predicted contexts of the clinical situation
	Goals of care and priorities can shift quickly or evolve over time
Ongoing and consistent	Transparent reciprocal information sharing is essential (10)	An individual or small number of consistent providers with dedicated time work to develop a trusting rapport with the sibling
	Opportunities to clarify and build cumulative understandings are important across the critical illness experience (21)	Continuity of therapeutic relationship and approach is provided for siblings across the critical care experience