Implementation of a Dialectical Behavior Therapy Caregiver Skills Group on an Acute Inpatient Unit for Youth

Dialectical Behavior Therapy (DBT) is a transdiagnostic evidence-based treatment, adapted for use with youth with suicidality and emotion dysregulation. There is increasing evidence of using DBT on psychiatric inpatient units for youth; however, there is little research on how to best incorporate families into DBT treatment in this setting.

The study's objective was to describe the implementation process and assess the feasibility and acceptability of a DBT skills group for caregivers on inpatient psychiatry units for children and adolescents.

Participants included 135 caregivers who attended at least one session of the caregiver DBT skills group. The implementation of the group was described using the Quality Improvement Framework. Of the total participants, 40 caregivers completed a post-training survey to measure satisfaction with the group. The survey included two open-ended questions; qualitative data were analyzed by coding themes of caregivers' responses. Additionally, feasibility was assessed by group attendance.

During the first phase of recruitment, an average of 1.83 caregivers attended each group. Due to low attendance, the recruitment strategy changed and an average of 2.84 attended groups during the second phase. Caregivers generally endorsed acceptability of the group with strong agreement that they were satisfied with the group, learned new skills, and would participate in the group again. Qualitative responses demonstrated that caregivers found the group beneficial. Additionally, responses highlighted recommendations for improvement, including offering the groups during convenient times and ways to increase access. In the 3^rd phase, accounting for feedback from the first two phases, average attendance increased to 4.65 participants per group.

This study provides preliminary support for the benefit of a weekly DBT skills group for caregivers to better incorporate families into therapeutic care while their child is on an inpatient psychiatric unit. More work is needed to increase feasibility of caregiver attendance.