DBT skills + parent training for preschool parents with emotion dysregulation and substance misuse

Parenting and substance use recovery often intersect, as many adults accessing substance use disorder (SUD) treatment are also parents. Critically, parental SUDs are a risk factor for poorer parenting behaviors, with downstream impacts on child mental health. However, extant evidence-based interventions do not target proximal, parent-specific relapse risk factors (e.g., parental emotion dysregulation [ED], parenting stress), and relapse risk remains high. We sought to address this by integrating best practices in SUD, ED, and parenting interventions to expand reach and improve outcomes. This pilot study assessed feasibility, acceptability, and preliminary efficacy of a 20-week Dialectical Behavior Therapy Skills + Parent Training (DBT Skills + PT) telehealth group intervention for parents in SUD remission with elevated ED. Participants were 12 parents (11 mothers) of preschool-aged children (5 female). Intervention feasibility (i.e., attendance, attrition, diary card compliance) and acceptability (i.e., satisfaction, skills use) were high. All treatment-completers maintained their SUD remission and reported large reductions in ED, child behavior problems, negative parenting behaviors, and parenting stress. Quantitative results were corroborated by qualitative feedback provided at an exit interview. The present findings support further larger scale testing of DBT Skills + PT as a promising intervention for parents in SUD remission with elevated ED, with prospective intergenerational impacts.