The Role of Family Intervention in Improving Individual and Family Functioning in DBT for Adolescents

Abstract

Having a child struggle with suicidal or self-injurious behavior is a major challenge: families are rarely prepared to handle such difficulties and the role of family interventions has been largely neglected. Utilizing a randomized control trial design with a waitlist control group (WL), the present study tested the effectiveness of Family Connections (FC) in: 1) improving adolescent individual outcomes, 2) improving family functioning, and 3) reducing parent distress and burden, and increasing their ability to cope. 112 families were recruited from an adolescent residential treatment facility that provides comprehensive Dialectical Behavior Therapy (DBT). Adolescents completed measures of individual and family functioning early following admission (T1), one-month post FC or at the end of a waiting period (T2), and within seven days of discharge (T3). Parents completed measures of individual and family functioning at T1, and again at T2. Results showed that adolescents whose parents were randomly assigned to FC had better treatment gains, and reported greater improvement in parent-child communication. Specifically, adolescents in the FC condition reported decreased difficulties with emotion dysregulation, above and beyond gains achieved through standard DBT treatment. Additionally, parents in the FC condition were rated by their teens as more validating, less invalidating and more emotionally available four weeks after participating in FC. Changes in validating and invalidating responses were correlated with treatment outcomes. These findings suggest the importance and effectiveness of interventions specifically designed for parents and of FC in particular.