Integrating Dialectical Behavior Therapy (DBT) Skills and Parenting for Emotionally Dysregulated Parents: Intervention Development
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Date
2024-08-07
Authors
Everett, Yoel
Journal Title
Journal ISSN
Volume Title
Publisher
University of Oregon
Abstract
Parental emotion dysregulation (ED) is linked to less effective parenting behaviors that are associated with increased child emotional and behavior problems. There is a lack of integrated adult mental health + parenting interventions that can improve these interlinked domains in families experiencing clinical-level symptoms. Integrating Dialectical Behavior Therapy (DBT) Skills with parenting may be a promising, transdiagnostic treatment approach to intervening on parental ED and parenting. This dissertation aimed to advance intervention development in this area.In study 1, an integrated DBT Skills + Parent Training (DBT Skills + PT) group therapy intervention for parents of preschoolers was developed and tested in a case study with dually-dysregulated parent-child dyads. The study used idiographic analyses of repeated measures of parental ED, child ED and parenting quality to evaluate changes throughout treatment. In study 2, the intervention was pilot tested with parents struggling with ED and substance misuse. Study 2 examined changes in parent, child and parenting outcomes, and evaluated feasibility, implementation and acceptability of DBT Skills + PT. Group-level analyses of pre-post effects, idiographic individual-level analyses of cascading effects between parental ED, parenting and child behavior, and qualitative analyses of participant feedback were all conducted. Across both studies, parents reported improvements in their ED, their children’s behavior and emotion regulation, and their parenting, often with large effect sizes.
The pattern of changes varied across parents. Some showed a cascading effect and others showed evidence of bidirectional effects of children’s behavior on parent outcomes. Parents had high rates of attendance, good implementation of skills, and found the intervention highly acceptable. Study 3 coded video-recorded sessions of Standard DBT Skills Training for mothers with severe ED to identify skills mothers reported were helpful to improving parenting. Mindfulness and Emotion Regulation skills were useful to increasing positive parenting and Distress Tolerance skills were useful to decreasing negative parenting behaviors. Study 3 findings can aid in selection of DBT Skills to include in an abbreviated version of DBT Skills + PT. Together, these three studies lay the groundwork for a larger scale randomized controlled trial to test the effectiveness of DBT Skills + PT.
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Keywords
Dialectical Behavior Therapy, Emotion dysregulation, Intervention development, Parent mental health, Parenting