(PS5-B42) What Do Parents Want from DBT-A? Examining Parental Pretreatment Expectancies and Delivery Format Preferences

Dialectical Behavior Therapy for Adolescents (DBT-A) is an acceptance and change-based treatment protocol that includes parent participation and has been shown to be effective with adolescents with emotionally dysregulation, suicidality, and self-injurious behaviors (Mehlum et al., 2014, 2016). DBT-A includes parents in several ways, including a multifamily skills group, provisional family therapy sessions, and phone coaching for parents (Miller et al., 2007; Rathus & Miller, 2015). Despite its demonstrated effectiveness, there is limited treatment acceptability data for DBT-A and even less investigation into the parent perspective. Pretreatment expectancies and preferences are two common factors associated with treatment acceptability that have been shown to influence treatment participation, adherence, and outcomes (Nock & Kazdin, 2001; Wymbs et al., 2015). The goal of the study was to assess parents’ pretreatment expectancies and preferences prior to entering an outpatient DBT-A program with their adolescents. Participants included 23 diverse primary caregivers (e.g., 26.1% Hispanic, 17.4% African American, 21.7% Native American, and 13% Asian American) of adolescents referred for DBT-A to either a group private practice or a community mental health clinic. Prior to starting treatment, participants completed two self-report assessment measures: the Parent Expectancies for Treatment Scale (PETS; Nock & Kazdin, 2001) and a preferences rating form that listed seven treatment format modifications as well as a preference for keeping the treatment as-is. Results indicated that parent participants showed a moderately high level of overall expectancies for DBT-A (M = 97.78, SD = 9.03). The highest-rated expectancies were related to the credibility of DBT-A as a valuable, worthwhile treatment and the large role of parent involvement in treatment. Additionally, parents had moderately high expectancies for child improvement (Child Improvement, M = 23.43, SD = 3.49) and moderate expectancies for parent involvement (Parent Involvement, M = 22.17, SD = 2.98). The four most preferred alternative format options were to add weekly skills training for individual families, weekly individual parenting skills sessions, weekly parent-only support groups, and weekly parent therapy sessions. The two least preferred treatment format options involved partially or fully separating parents and teens in multifamily skills groups. Understanding parents’ treatment expectations and preferences for DBT-A delivery format could aid clinicians in better orienting families to the treatment format rationale and the possibility of additional parent sessions as needed.