Integrating dialectical behavior therapy with child and parent training interventions: A narrative and theoretical review.

Abstract

There is growing interest among researchers and clinicians in incorporating one of the most efficacious treatments for improving emotion regulation, dialectical behavior therapy (DBT), into parenting interventions, with the explicit purpose of improving parental well-being so as to positively impact children's social-emotional outcomes. Integrations of DBT and parenting interventions have ranged considerably, as there is extensive variability across studies in the selection of parenting interventions and the extent to which the DBT concepts are incorporated, the content modified, or the dosage abbreviated. The primary goal of this narrative review is to synthesize the accumulation of DBT and parent intervention literature with an eye toward improving future treatment development efforts in this area, as well as current clinical practice. Public Health Significance StatementThe public health need to integrate parenting interventions with dialectical behavior therapy (DBT) is increasingly evident as many parents in parenting interventions have difficulties with regulating their own emotions, which interferes with their ability to acquire and enact effective parenting behaviors. Many adults receiving DBT are parents and also need help with parenting, but their clinician may not be equipped with the training to optimally assist in this domain. This article is directly focused on these topics and aims to fill a critical gap for DBT clinicians and parenting interventionists, as well as treatment development researchers.

The Building Regulation in Dual-Generations Program (BRIDGE): A Mixed-Methods Feasibility Pilot of a Parenting Program for Depressed Mothers of Preschoolers, Matched with Dialectical Behavior Therapy Skills

“…Despite the identification of unmet needs for mothers with MI and their children, there are limited programs that effectively support both maternal and child mental health to ultimately prevent intergenerational transmission [ 8 ]. A lack of programming that integrates maternal mental health and parenting support poses significant obstacles for mothers given the logistics of attending two separate programs and the challenges of learning two different sets of therapeutic techniques [ 9 ]. Programs that only target adult MI reduce maternal mental health symptoms but have limited effects on child outcomes [ 10 ].…”

“…Mothers who also struggle with interpersonal relationships (e.g., attachment anxiety) [ 15 ] are particularly vulnerable to these program outcomes. We and others have previously advocated for the value of addressing both maternal mental health and parenting needs to maximize long-term impacts of interventions on child mental health [ 4 , 9 , 14 ]. Adaptations of existing parenting programs (e.g., Triple-P, Family Check-Up) have largely included minor adaptations designed to target maternal depression, while some mental health programs have likewise included minor adaptations relevant to the parenting context [reviewed in: 14; 9].…”

“…DBT has emerged as promising transdiagnostic treatment for MIs that include emotion regulation difficulties (e.g., depression, anxiety, traumatic stress, and eating disorders), which have been identified as underlying mechanisms of psychopathology [ 16 – 18 ]. Many aspects of developmentally supportive parenting also require mothers to have effective emotion regulation skills to both limit over-reactive responses and teach children about their own emotions, which makes the integration of DBT with parent training a promising approach for addressing intergenerational needs [ 9 ].…”

Effectiveness of a Web-Based Intervention on Parental Psychological Flexibility and Emotion Regulation: A Pilot Open Trial

“…DBT intervention for parenting is included in adaptation for children (DBT-C) and adolescents (DBT-A), with improvement in depressive symptomatology, behavioral problems and functioning [ 53 ]. Although these adaptations are child-oriented, they include a parenting module that aims to create a validating environment and influence behavior [ 54 , 55 ].…”

“…Although these adaptations are child-oriented, they include a parenting module that aims to create a validating environment and influence behavior [ 54 , 55 ]. Other DBT-informed interventions, such as parental intervention with DBT strategies, have shown positive effects on emotion regulation, reduced affective symptoms, increased maternal acceptance, and parental practices [ 53 ].…”