Feasibility of a parent-only DBT skills group in public mental health services: a pilot implementation study

War-related mass trauma and large-scale terrorist attacks disproportionately affect clinically vulnerable adolescents, exacerbating self-harm and suicidality while burdening under-resourced public mental health systems. This study evaluated the feasibility and preliminary efficacy of a parent-only Dialectical Behavior Therapy (DBT) skills group within routine care. We hypothesized that the parent-only DBT skills group would be associated with improved parental emotion regulation, decrease helplessness and family conflict, and indirectly reduce adolescent risk behaviors.

A 20-session DBT group was delivered to 41 parents of 32 adolescents aged 12-18 presenting with severe emotion dysregulation, self-harm behaviors, and/or a history of suicide attempts. Parental outcomes were assessed at baseline, post-intervention, and 3-month follow-up; adolescent clinical improvement was rated using the CGI-S 3-6 months post-treatment. Adolescent clinical severity was evaluated using the CGI-S, rated by independent clinical assessors fully blinded to participant identity, assessment time points, and duplicate cases.

Of the 43 parents who began the parent-only DBT skills group, 41 (95.3%) completed the intervention. Intervention participation was associated with significant reductions in parental helplessness and family power struggles. These family-level improvements coincided with clinician-rated global clinical improvement among adolescents at 3-6 months post-treatment.

Findings support the feasibility and scalability of a targeted, parent-focused DBT adaptation. This model offers a viable clinical model for overburdened public mental health systems treating high-risk adolescents, and may be especially relevant during ongoing war and collective trauma, when clinical needs intensify while resources remain limited.