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

Abstract

Early exposure to maternal depression is a key risk factor for child mental illness (MI), but there are limited programs that interrupt intergenerational transmission. The BRIDGE “Building Regulation in Dual GEnerations” Program treats maternal MI using Dialectical Behavior Therapy Skills with a paired curriculum that promotes non-reactive and emotionally validating parenting designed to improve child mental health and ultimately prevent MI.This pilot feasibility trial (n=28 dyads) included mothers and their preschool-aged children. The 20-week program was completed in a group-based format using mixed methods questionnaires and interviews. Results indicate high feasibility and acceptability (86% retention). Consistent improvements were seen across program targets and outcomes including maternal depression (d = 1.02) and child mental health (d = 1.08), with clinically significant symptom reductions for 85% of clients. Mothers with higher adversity exhibited greater reductions in parenting stress. Qualitative results highlighted efficacy in promoting positive parent-child relationships, rewarding parenting experiences, competence, and child development. Evidence suggests high feasibility and accessibility for BRIDGE in addressing intergenerational mental health needs. There was strong satisfaction with the program material and efficacy across key outcomes. BRIDGE holds promise for offering a transdiagnostic approach to preventing child MI in families of at-risk preschool aged children.

Protocol for a randomized control trial of the Building Regulation in Dual Generations Program (BRIDGE); Preventing the intergenerational transmission of mental illness in at-risk preschool children

“…Two pilot studies have been conducted to evaluate BRIDGE. 35,36 In a pre-post feasibility study, mothers with depression (n = 28) completed an in-person, 16-week trial of BRIDGE. 36 The intervention demonstrated good feasibility, with high retention (86% retention) and significant reductions in maternal depression (d = 1.02) and child MI (d = 1.08).…”

“…35,36 In a pre-post feasibility study, mothers with depression (n = 28) completed an in-person, 16-week trial of BRIDGE. 36 The intervention demonstrated good feasibility, with high retention (86% retention) and significant reductions in maternal depression (d = 1.02) and child MI (d = 1.08). In focus groups conducted at post-test, participants indicated that they were generally satisfied with the program.…”

“…In focus groups conducted at post-test, participants indicated that they were generally satisfied with the program. 36 Mothers expressed that they found the parenting skills complementary to the DBT skills, with one participant stating, "Because I understood the DBT language… it made it easier for me to understand it when we did it with children and the way it applies is just amazing." In compliance with public health recommendations to reduce in-person contact and physical distance during the COVID-19 pandemic, a second pilot study was run to evaluate the efficacy of BRIDGE delivered via telehealth using asynchronous psychoeducational videos alongside synchronous weekly group sessions.…”

“…Based on participant feedback from earlier iterations of BRIDGE, participants will not be asked to complete DBT Skills Diary Cards. 36 DBT videos developed and recorded by our research team will provide information to participants with the goal of targeting mental health symptomatology. Video content was drawn from concepts outlined in the DBT Skills Training Manual 2 nd Edition.…”

The Building Emotional Awareness and Mental health (BEAM) program developed with a community partner for mothers of infants: Protocol for a feasibility randomized controlled trial

“…The BEAM program was designed to promote intergenerational well-being through the treatment of maternal mental illness and preventing child mental health concerns, by integrating parenting and self-compassion skills with UP modules (16,18). The interrelated skills are designed to increase supportive parenting behaviors and promote maternal-child bonding to disrupt each of the theorized mechanisms of environmental risk transmission (e.g., positive emotional modelling, improved relationships, support for children's distress, reduced conflict (15,38).…”