Comparing the efficacy of standard telehealth and psychoeducation-enhanced treatment groups in a Dialectical Behaviour Therapy and Parenting intervention: The Building Regulation in Dual-GEnerations [BRIDGE] program

Background: The COVID-19 pandemic created challenges for families of young children, with high rates of maternal mental health challenges and parenting stress. Past research draws an important link between the long-standing toll on the wellbeing of mothers, as well as the intergenerational impact for children when mothers suffer from mental health concerns. Objective: The current study aimed to demonstrate the uptake and utility of an accessible online treatment, which brings together Dialectical Behavior Therapy (DBT) and emotion-focused parenting practices, named The Building Regulation in Dual-GEnerations (BRIDGE) Program. We examined two telehealth-adapted versions of this transdiagnostic mental health & parenting program, in a non-inferiority trial.Methods: A mixed-methods pilot study design was used to explore the impacts of these two treatment versions. Participants (N = 40) were mothers of preschool-aged children, with an average child age of 4.30 years. Mothers all had persistent, recurring depression, with the majority of mothers also experiencing a co-occurring disorder (i.e., anxiety, post-traumatic stress disorder [PTSD], alcohol/substance disorder or past manic episode). Mothers participated in one of two group therapy versions (group-based telehealth or psychoeducational video-enhanced group-based telehealth) and were asked to complete practice homework between sessions. Mothers completed weekly mood and parenting stress symptom monitoring, in addition to a pre- and post-program assessment.Results: Both online treatment offerings demonstrated a strong retention (92.3%) of participants and a clinically significant change in depression in 78.8% of mothers. There was a program-wide improvement in DBT skill use and improvements in effective coping and stress management. Significant medium effects were found on parenting stress and child mental health. Overall, there were benefits found in both study arms and minimal differences across groups. Mothers described enjoying the groups and found the peer support they received to be of utmost importance to their participation and symptom improvement. Despite being connected only virtually, mothers felt heard, supported, and valued by other members of the group.Conclusions: Maternal depression and effective parent-related coping can both be effectively targeted in a transdiagnostic treatment. Virtual treatments, including both traditional virtual therapy groups and psychoeducation video-enhanced in-group therapy offerings can provide mothers with a sense of belonging, support, and improvement in their mental health and parenting.