Culturally adapted DBT parent coaching for Chinese families of adolescents with mental disorders: a mixed-methods...

Parents of adolescents with mental disorders frequently experience elevated levels of psychological distress, often in settings where structured support for caregivers is limited. Dialectical Behaviour Therapy (DBT) offers a skills-based framework that may strengthen caregivers' emotion regulation and improve family functioning, yet culturally adapted parent-focused programmes remain underexamined in China. This study evaluated the feasibility and preliminary effectiveness of a culturally adapted DBT parent coaching programme for Chinese parents of adolescents with mental disorders.

A mixed-methods, single-arm feasibility design was used, in which 42 parents of adolescents with mental disorders participated in a 10-week culturally adapted DBT parent coaching programme consisting of weekly online group sessions and offline homework practice. Quantitative data were collected at baseline (T1), post-intervention (T2), and three-month follow-up (T3) using validated measures of depression, anxiety, stress (DASS-21), emotion regulation (ERQ), and family functioning (SCORE-15). Paired t-tests and linear mixed-effects models were conducted to examine immediate and longitudinal changes. Qualitative data were obtained through semi-structured interviews with a purposive subsample and analysed using thematic analysis to explore participants' experiences and perceived changes.

Significant reductions were observed in parents' depression, anxiety, and stress at post-intervention, alongside improvements in overall family functioning and the strengths and difficulties dimensions of the SCORE-15 (P < 0.05). Longitudinal analyses showed patterns consistent with sustained improvement from T1 to T3 in negative emotional symptoms, family functioning, and cognitive reappraisal, with qualitative findings supporting increased use of mindfulness, acceptance, and more constructive communication within families. Interview themes reflected motivations for participation, perceived personal and relational changes, and suggestions for programme refinement.

The findings provide preliminary support for the feasibility and acceptability of a culturally adapted DBT parent coaching programme in the Chinese context. Improvements observed across quantitative and qualitative indicators suggest that the programme may offer a useful, skills-based resource for supporting caregiver wellbeing and aspects of family functioning. Within a cultural environment that places substantial emphasis on parental responsibility yet offers limited formal support, DBT parent coaching appears to be a contextually relevant and potentially valuable approach that warrants further evaluation through controlled and comparative study designs.