Managing Sibling Referrals: Ethical Considerations for Integrated Pediatric Primary Care

Stacy S. Forcino, L. Michelle Grimes, Brett R. Kuhn

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
JournalClinical Practice in Pediatric Psychology
StateAccepted/In press - 2023


  • ethics
  • integrated primary care
  • multiple relationships

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Clinical Psychology
  • Applied Psychology


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