Date of Award

Spring 3-20-2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Major

Expressive Therapies

Abstract

A Neonatal intensive care unit (NICU) hospitalization reorganizes family life, yet siblings’ perspectives are rarely centered in NICU research. This phenomenological, art-based dissertation explores NICU siblings’ lived experience as revealed through the roles they created during engagement in dramatic reality. Eight child siblings of NICU patients participated in a storymaking and improvisational role-play intervention. Transcripts, participant artwork, and stories were examined through thematic analysis, and dramaturgical coding. Three central tensions organized children’s dramatic worlds: It’s Hard to be Together and It’s Hard to be Apart, I Want to be Free, but I am Trapped; I Want to Help and I Need Help. Four archetypal role-types mediated these tensions: The Bad One, The Vulnerable One, The Helper, and The Dreamer. Across narratives, The Bad One tended to generate conflict, The Vulnerable One carried its consequences, The Helper sought repair, and The Dreamer imagined restoration. The resulting Tensions and Role-types Model (TRM) demonstrates how children’s experiences of being a NICU sibling are not static, fixed states, but a dynamic, ever-evolving journey. Implications are discussed for drama therapists, child life specialists, and NICU teams seeking sibling-inclusive psychosocial supports within a broader family-integrated care framework.

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