The impact of including babies on the effectiveness of dialectical behaviour therapy skills groups in a community perinatal service

Abstract

Background: Perinatal mental illnesses are a major public health issue, which untreated can have devastating impacts on women and their families. Problems with emotion regulation are a common feature across perinatal mental illnesses. Aims: This study sought to evaluate the impacts of dialectical behaviour therapy (DBT) skills groups for mothers and babies in a community perinatal service. We hypothesised that community perinatal DBT skills groups that included babies would reduce distress and improve emotional regulation. Method: A mixed-methods within-subjects design was utilised with outcome measures collected pre- and post-intervention. Qualitative interviews exploring mothers’ experiences of bringing their baby to group were also conducted. Results: Results indicated that DBT skills groups significantly improved levels of psychological distress and emotional regulation. Conclusions: Community perinatal DBT skills groups are effective when babies are present. Moreover, benefits of including babies were identified, under the themes of Self as Mother, Shared Experience, and Impact of Babies.

Applications of dialectical behavioural therapy in the perinatal period: A scoping review

“…Outcomes were measured using the 18-item Difficulties in Emotion Regulation (DERS-18; Victor & Klonsky, 2016) and Living with Emotions (LES; Durrant et al, 2007) scales; both measures have demonstrated adequate psychometric properties. Across both studies, significant improvements in emotion regulation were observed (p's < .001); while no effect size was reported by Greaves et al (2021), Wilson and Donachie (2018) indicated a large effect (Cohen's d = .93) following their DBT-informed skills programme.…”

“…clinical psychologist, psychiatrist, clinicians and clinical graduate students). In two studies, the intervention was co‐facilitated by a mental health specialist and a perinatal nurse practitioner with the goal of providing integrated perinatal health care (Greaves et al, 2021; Wilson & Donachie, 2018). Only four studies discussed the providers training in DBT (Greaves et al, 2021; Kleiber et al, 2017; Sved Williams et al, 2021; Wilson & Donachie, 2018).…”

“…In two studies, the intervention was co‐facilitated by a mental health specialist and a perinatal nurse practitioner with the goal of providing integrated perinatal health care (Greaves et al, 2021; Wilson & Donachie, 2018). Only four studies discussed the providers training in DBT (Greaves et al, 2021; Kleiber et al, 2017; Sved Williams et al, 2021; Wilson & Donachie, 2018). In three of these studies, formal DBT training was required prior to group facilitation, and in one, the lead clinician was an accredited DBT provider.…”

“…Additionally, two studies assessed outcomes related to emotion dysregulation, a primary target of DBT (Greaves et al, 2021; Wilson & Donachie, 2018). Outcomes were measured using the 18‐item Difficulties in Emotion Regulation (DERS‐18; Victor & Klonsky, 2016) and Living with Emotions (LES; Durrant et al, 2007) scales; both measures have demonstrated adequate psychometric properties.…”

“…These modifications were added to reduce childcare-related barriers to treatment, support skills generalisation and increase infants' exposure to an enriched environment. In addition,Greaves et al (2021) invited participants to bring babies to group to reduce caregiving-related barriers to treatment.Finally,Kleiber et al (2017) added a peer mentorship component to the DBT skill class. Individuals who completed the group were invited to attend future groups as 'mentors', who could share their experiences with DBT skills and provide peer support.…”