DBT-Based Parenting Intervention for Emotional Disturbance

Recruiting at 1 trial location

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Stanford University

Disqualifiers: Acute psychosis, Neurological impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 7

Duration: 4 weeks

40 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether adding a special parent coaching program, the DBT-Based Parenting Intervention, can improve treatment outcomes for teens hospitalized due to suicidal thoughts or attempts. The trial compares standard hospital treatment with and without the additional parent coaching, which includes safety planning and parenting skills training. The goal is to determine if involving parents in this way can better support the teens' recovery and reduce future risks. Families may be suitable if the teen is currently hospitalized for suicidal reasons and at least one parent can participate in the coaching sessions. As an unphased trial, this study offers families the chance to contribute to innovative research that could enhance support for teens in crisis.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this DBT-Based Parenting Intervention is safe for parents and youth?

Research has shown that DBT-based programs, like the parenting program under study, are generally manageable for participants. Studies have found that parents and caregivers in DBT skills groups often experience overall improvement. These groups, tailored to local needs, have proven helpful for participants.

Other research found that teenagers who received DBT treatment showed a clear reduction in self-harm behaviors. This suggests that DBT-based methods can safely and effectively address emotional issues.

These studies have not reported major negative effects, indicating a positive safety profile. While this trial is a small initial study, evidence from past research provides reassurance about the safety of DBT-based programs. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the DBT-Based Parenting Intervention for emotional disturbances because it integrates specialized parenting strategies into traditional inpatient care. Unlike typical inpatient treatments that focus solely on the patient, this approach actively involves parents, teaching them Dialectical Behavior Therapy (DBT) skills to better support their child. This dual focus on both adolescents and caregivers is designed to improve overall treatment outcomes and family dynamics, offering a holistic approach to managing emotional disturbances.

What evidence suggests that the DBT-Based Parenting Intervention could be effective for emotional disturbance?

Research has shown that Dialectical Behavioral Therapy (DBT) effectively aids teenagers with emotional issues. Studies have found that DBT can reduce depression and improve emotional management for both young people and their parents. In this trial, one group of participants will receive a special DBT-based parenting intervention alongside standard inpatient treatment. This DBT program for parents has shown promise in reducing parents' depression and emotional challenges, positively impacting their children. Evidence also suggests that combining DBT with parenting skills can enhance emotional and relationship management, which is crucial for addressing youth suicide-related problems. These findings strongly support exploring how a DBT-based parenting program can help reduce suicidal behaviors in young people. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for youth aged 12-18, hospitalized for suicidal thoughts or self-harm at the Stanford unit of Mills Peninsula Medical Center. They must be in high school and living with parents who can participate. Both youth and parents should speak English well enough for treatment and assessments.

Inclusion Criteria

I am currently hospitalized for thoughts or actions related to suicide or self-harm.

At least one parent/guardian is willing to participate in the study intervention

Exclusion Criteria

I do not have a condition like severe mental illness or malnutrition that would stop me from participating fully.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Parents receive a 4-session DBT-based parenting intervention, including safety planning and behavioral parenting skills training

4 weeks

4 sessions (in-person or virtual)

Follow-up

Participants are monitored for changes in parent emotions and behaviors, and youth suicide-related outcomes

12 months

Assessments at baseline, 3, 6, and 12 months

What Are the Treatments Tested in This Trial?

Interventions

• DBT-Based Parenting Intervention
• Treatment as usual

Trial Overview The study tests a parent coaching intervention against standard care. The new approach includes safety planning, behavioral skills training, and help with follow-up care to see if it improves outcomes related to suicide in hospitalized youth.

How Is the Trial Designed?

Group I: PI+ Inpatient Treatment as Usual Experimental Treatment 2 Interventions

Standard inpatient treatment delivered in the context of an adolescent psychaitric inpatient unit plus an 4 session DBT-based parenting intervention PI) Intervention: Behavioral: DBT-Based Parenting Intervention

Group II: Inpatient Treatment alone Active Control 1 Intervention

No parenting intervention provided beyond what is part of the inpatient treatment as usual. Intervention: Behavioral: Treatment as Usual

DBT-Based Parenting Intervention is already approved in United States for the following indications:

Approved in United States as DBT-Based Parenting Intervention for:

• Suicidal ideation in youth
• Non-suicidal self-injury in youth
• Suicide attempts in youth

Who Is Running the Clinical Trial?

Stanford University

Lead Sponsor

Trials

2,527

Recruited

17,430,000+

Published Research Related to This Trial

Dialectical behavior therapy (DBT) is effective for various mental disorders by specifically targeting emotion dysregulation, a common issue across many psychological conditions.

DBT's application has expanded to include improving parenting quality, which can help prevent psychopathology in children, highlighting its versatility and potential benefits beyond traditional diagnostic categories.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Identifying novel applications of dialectical behavior therapy: considering emotion regulation and parenting. Zalewski, M., Lewis, JK., Martin, CG.[2022]

Dialectical Behavior Therapy for adolescents (DBT-A) has shown promising improvements in treating borderline personality disorder, but there is a need for more research to establish its effectiveness, especially regarding family involvement in treatment.

Innovative approaches, such as integrating smartphone-based assessments and interventions into DBT-A, could enhance therapy by providing timely skills and improving therapist-patient interactions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Meeting report of the 2nd German dialectical behavior therapy for adolescents network meeting. Hammerle, F., Bürger, A., Kaess, M., et al.[2020]

In a study involving 216 families, maternal mental distress was found to negatively impact the effectiveness of Brief Parent Training (BPT) in reducing conduct problems in children, regardless of whether they received BPT or a comparison intervention.

Lower levels of maternal distress were associated with fewer conduct problems reported by both parents and teachers, highlighting the importance of addressing maternal mental health to improve outcomes for children with conduct issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Maternal mental distress influences child outcomes in brief parent training. Kjøbli, J., Naerde, A., Bjørnebekk, G., et al.[2020]

Dialectical behaviour therapy for adolescents (DBT-A) was effectively implemented in publicly funded mental health services in Ireland, involving 54 clinicians and 84 adolescents over a 16-week program.

Participants in the DBT-A program showed significant reductions in self-harm, suicidal thoughts, and depression, along with decreased hospital admissions and emergency visits, indicating its efficacy in treating emotional and behavioral dysregulation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Innovations in Practice: Dialectical behaviour therapy for adolescents: multisite implementation and evaluation of a 16-week programme in a public community mental health setting. Flynn, D., Kells, M., Joyce, M., et al.[2020]

Parents and carers of adolescents in a DBT-A program reported significant improvements in their distress levels and family communication after participating in a 6-month skills group intervention, with 41 participants completing the study.

Qualitative feedback from participants highlighted positive changes in family dynamics and personal well-being, suggesting that parental involvement in DBT-A can enhance the overall effectiveness of the treatment for adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Parent and Carer Skills Groups in Dialectical Behaviour Therapy for High-Risk Adolescents with Severe Emotion Dysregulation: A Mixed-Methods Evaluation of Participants' Outcomes and Experiences. Smith, L., Hunt, K., Parker, S., et al.[2023]

Dialectical behavior therapy (DBT) is an effective treatment for individuals with borderline personality disorder, specifically targeting life-threatening behaviors like suicide attempts and self-injury.

DBT incorporates various strategies for risk management and safety planning, such as diary cards and phone coaching, to help clients commit to reducing harmful behaviors throughout their treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Risk management in dialectical behavior therapy: Treating life-threatening behaviors as problems to be solved. Alba, MC., Bailey, KT., Coniglio, KA., et al.[2022]

In a study involving 60 mothers and their children aged 2 to 7, those who received in vivo coaching during parent-child interactions showed significant improvements in parenting skills compared to those who did not receive coaching.

The results indicate that in vivo feedback is a crucial mechanism for enhancing parenting abilities, as it led to skill gains that were independent of the parents' initial abilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Coaching parents to change: the impact of in vivo feedback on parents' acquisition of skills. Shanley, JR., Niec, LN.[2011]

Mothers with Borderline Personality Disorder (BPD) reported that parenting is a significant source of stress, often accompanied by feelings of guilt and uncertainty, highlighting the need for targeted support in this area.

The study identified a strong desire among mothers with BPD for parenting issues to be more integrated into their Dialectical Behavior Therapy (DBT) skills training, suggesting potential modifications to enhance treatment effectiveness for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Qualitative Assessment of the Parenting Challenges and Treatment Needs of Mothers with Borderline Personality Disorder. Zalewski, M., Stepp, SD., Whalen, DJ., et al.[2020]

In a study involving 100 parents of adolescents undergoing dialectical behaviour therapy for adolescents (DBT-A), significant reductions in parental burden, grief, and stress were observed after a 16-week program, indicating the therapy's positive impact on parents as well as their children.

Parents reported that the skills learned in the DBT-A program were beneficial for both their own needs and those of their child, suggesting that involving parents in the therapy can enhance overall family well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An evaluation of the skills group component of DBT-A for parent/guardians: a mixed methods study. Flynn, D., Gillespie, C., Joyce, M., et al.[2023]

Behavioral parent training (BPT) is an effective treatment for ADHD, improving both child behavior and parenting practices, as well as reducing parenting stress and enhancing classroom behavior.

Despite its effectiveness, research on BPT for ADHD is less comprehensive than for other disorders like oppositional defiant disorder (ODD) and conduct disorder (CD), highlighting the need for further studies to understand factors affecting treatment outcomes, especially given the high comorbidity between ADHD and these disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancements to the behavioral parent training paradigm for families of children with ADHD: review and future directions. Chronis, AM., Chacko, A., Fabiano, GA., et al.[2019]

Behavioral Parent Training (BPT) is the standard treatment for young children (ages 3 to 8) with disruptive behavior disorders and may also help reduce internalizing problems and improve family dynamics.

The review explores the mechanisms by which BPT may lead to broader treatment effects, including alleviating caregiver depressive symptoms, suggesting that understanding these mechanisms could enhance future clinical research and practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cascading effects of BPT for child internalizing problems and caregiver depression. Gonzalez, MA., Jones, DJ.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3037874/

Dialectical Behavioral Therapy for Adolescents (DBT-A) We tested the main hypothesis of our study; that Dialectical Behavioral Therapy for Adolescents is an effective treatment for these patients.

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1077722920301073

Pilot Test of a DBT-Based Parenting Intervention for ... Results showed that parents who received the intervention reported reductions in parent self-reported depressive symptoms, emotion dysregulation, caregiver ...

3. researchgate.net researchgate.net/publication/394953478_Investigating_the_Efficacy_of_a_Dialectical_Behavioral_Therapy-Based_Parenting_Intervention_A_Randomized_Controlled_Trial

Investigating the Efficacy of a Dialectical Behavioral ... Objectives The present study aimed to investigate the effectiveness of a dialectical behavioral therapy (DBT)-based parenting intervention ...

4. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12441813/

Integrating Dialectical Behavior Therapy Skills and Parent ... In this case study, a 24-week DBT Skills + PT intervention for emotionally dysregulated parent-preschooler dyads was delivered to three parents. We evaluated ...

5. onlinelibrary.wiley.com onlinelibrary.wiley.com/doi/10.1111/cpsp.12363

Integrating dialectical behavior therapy with child and ... Emotional regulation and interpersonal effectiveness as mechanisms of change for treatment outcomes within a DBT program for adolescents.

6. withpower.com withpower.com/trial/phase-suicide-3-2021-0fb5e

DBT-Based Parenting Intervention for Emotional Disturbance The purpose of the present study is to conduct a pilot randomized clinical trial (RCT) of a parent coaching intervention for parents of youth hospitalized ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10379026/

Parent and Carer Skills Groups in Dialectical Behaviour ... Discussion: Parents and carers who attended a dedicated DBT skills groups, adapted for local needs, reported improvements in their wellbeing, as well as ...

8. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11177375/

Evaluation of dialectical behavior therapy for adolescents ... The findings of the current study are promising as the participants reported considerably reduced self-harm behavior after DBT-A treatment.

9. researchgate.net researchgate.net/publication/371066322_Dialectical_behavior_therapy-based_interventions_for_externalizing_problems_among_adolescents_A_meta-analysis

Dialectical Behavior Therapy-Based Interventions for ... We conducted a meta-analysis evaluating change in externalizing symptoms among adolescents in DBT-based interventions across 17 studies (with 25 data points).

10. sciencedirect.com sciencedirect.com/science/article/pii/S2949732924000176

Review: Evidence-Based Psychosocial Treatments for ... This review examines well-established interventions for childhood irritability and aggression as well as newer interventions with a growing evidence base.