Effectiveness of the family-based model of dialectical behavior therapy for both suicidal adolescents and young adults in an academic medical center.

BACKGROUND: Dialectical behavior therapy (DBT) is an effective approach to decreasing suicidal behaviors; the adapted, family-based model for adolescents (through 18 years old; DBT-A) also demonstrates efficacy. Data on higher dropout rates based on age, initial research on DBT with young adults in the community, and the theory that underlies DBT suggest that adaptations may also be appropriate for young adults. This study examines the effectiveness of DBT-A, presents preliminary data on delivering DBT-A to young adults (ages 18-26), and compares clinical characteristics, service utilization, and outcomes to adolescent clients (ages 13-17) to guide clinical considerations and future research on implementing DBT-A. METHODS: Data were collected from a DBT-A clinic and included results from semi-structured diagnostic interviews, chart review, and scores on self-report measures. The Suicide Ideation Questionnaire and Beck Depression Inventory (BDI), given at program entry, after completion of one rotation through the skills modules, and at graduation, were used to evaluate outcomes. Outcomes were benchmarked against prior DBT-A trials. Adolescents' and young adults' clinical characteristics, service utilization, and outcomes were compared. RESULTS: The effect size observed was smaller than in efficacy trials. Few differences were observed between teens (n = 87) and young adults (n = 45). Young adults were more likely to have participated in intensive services before DBT-A. They participated in fewer family sessions and graduated in fewer months compared to teens. CONCLUSION: This study supports the use of the family-based model of DBT for suicidal teens and young adults although future research is needed to improve the effectiveness of this model when implemented in real-world settings.

Introduction to using structured evocative activities in Functional Analytic Psychotherapy.

Functional Analytic Psychotherapy (FAP) focuses on what happens in session between clients and therapists in order to create more intense and curative therapeutic relationships. FAP may be used as a standalone treatment or as an adjunct to other therapies in order to maximize therapeutic gains through strengthened alliance and differential reinforcement. When it fits within a client's case conceptualization, FAP clinicians often choose to use structured, evocative activities to progress the therapy at a faster pace. This article provides a rationale for using structured evocative activities in FAP with concrete examples to facilitate clinicians' implementation of the exercises.

An emotion coaching parenting intervention for families exposed to intimate partner violence.

The current study describes a promising new emotion coaching (EC) parenting intervention for survivors of intimate partner violence (IPV) targeting emotion regulation (ER) and parent-child relationships. We discuss the development of an EC parenting intervention, outline its key elements, and use preliminary pilot data to illustrate how such a behavioral intervention can yield improvements in behavioral and physiological indices of ER (i.e., respiratory sinus arrhythmia [RSA]) and parent-child relationships and reductions in mental health difficulties in IPV-exposed mothers and their children. A 12-week skills-based EC parenting program was developed and administered in groups. Fifty mothers were assigned to intervention or waitlist groups. Physiological, observational, and questionnaire data were obtained pre- and postintervention. Because of the small sample size, effect sizes were examined for illustrative purposes of potential effects of the EC intervention. Relative to mothers in waitlist group, mothers in the intervention group showed (a) improvements in emotion awareness and coaching, (b) increases in ER as assessed by baseline RSA, (c) increased use of validation and decreased use of sermonizing/lecturing/scolding during parent-child interaction, and (d) increased sense of parenting competence. Relative to children of mothers in the waitlist group, children of mothers in the intervention group showed (a) increases in ER as measured by parent-report and baseline RSA, (b) decreases in negativity during parent-child interaction, and (c) decreases in depressive symptoms. Discussion highlights potential usefulness of an EC parenting intervention for populations at risk for ER and parenting difficulties. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Fathers' emotional awareness and children's empathy and externalizing problems: the role of intimate partner violence.

Emerging evidence suggests that fathers, more so than mothers, socialize emotions in a gender-stereotyped manner. Gender-stereotyped emotion socialization may be particularly pronounced in men perpetrating intimate partner violence (IPV), and may be detrimental to child adjustment, particularly for boys. This study explored the relation between fathers' socialization of children's emotions and child adjustment in families where IPV is present. We hypothesized that in families where there is IPV, fathers' awareness of their children's sadness and fear will be associated with negative child outcomes. Participants were 74 families recruited for a longitudinal study. Interview and questionnaire measures were used to assess IPV and fathers' emotional awareness when children were 5 years old. Child adjustment was measured when children were 16 years old. Results suggested that in families where there is IPV, fathers who were more aware of their children's fear had children who showed lower levels of empathy and higher levels of externalizing problems than children whose fathers were less aware of their fear, specifically for boys. Results are discussed in terms of gender socialization in families where there is IPV.

Exploring the impact of parental psychopathology and emotion regulation on evidence-based parenting interventions: a transdiagnostic approach to improving treatment effectiveness.

Parenting interventions, particularly those categorized as parent management training (PMT), have a large evidence base supporting their effectiveness with most families who present for treatment of childhood behavior problems. However, data suggest that PMTs are not effective at treating all families who seek services. Parental psychopathology has been identified as one important factor moderating their effectiveness, yet few PMTs pay explicit attention to the role of parental psychopathology in treatment. Given growing support for a transdiagnostic model of psychopathology, which posits that disruptions in emotions and emotion regulation (ER) may underlie various forms of psychopathology, one way to address the impact of parental psychopathology on PMT may be by targeting parental ER. This paper will review the available literature on PMT and parental psychopathology, as well as existing evidence on relations between ER and both parental psychopathology and parenting behaviors. The limited research on PMTs that include explicitly parent-focused components will be reviewed, and suggestions for augmenting existing PMT curricula by including intervention around parental ER will be presented.

Cortical activity and children's rituals, habits and other repetitive behavior: a visual P300 study.

This study examines the link between children's repetitive, ritualistic, behavior and cortical brain activity. Twelve typically developing children between the ages of 6 and 12 years were administered two visual P300, oddball tasks with a 32-electrode electroencephalogram (EEG) system. One of the oddball tasks was specifically designed to reflect sensitivity to asymmetry, a phenomenon common in children and in a variety of disorders involving compulsive behavior. Parents completed the Childhood Routines Inventory. Children's repetitive, compulsive-like behaviors were strongly associated with faster processing of an asymmetrical target stimulus, even when accounting for their P300 latencies on a control task. The research punctuates the continuity between observed brain-behavior links in clinical disorders such as OCD and autism spectrum disorders, and normative variants of repetitive behavior.