2 - (SYM 33) Adapting Dialectical and Behavior Therapy Skills for Pregnancy and Postpartum

The perinatal period is a time of significant emotional vulnerability, with as many as 1 in 5 postpartum women  estimated to experience a perinatal mood and anxiety disorder (PMAD). The impact of these disorders can have significant consequences for postpartum individuals, as suicide is one of the leading causes of maternal mortalinty in the 12 months following birth (Lindahl et al., 2005). One of the possible explanations for the increased levels of psychological distress during this time is the recognition that the perinatal period is a time when an individual experiences significant biological and social changes which can strain emotion regulation capacity.  This aligns with the underlying theory of distress that is posited by Dialectical behavior therapy (DBT). Specifically, DBT posits that heightened emotionality combined with an invalidating environment leads to dysregulation, and DBT is a frontline treatment for emotional dysregulation as well as suicidal ideation and self-harm behaviors. Given this fit, there is an emerging body of evidence that DBT can be a helpful intervention during this period (Hellberg et al., 2023). This is critical as evidence suggests that more severe emotional dysregulation and suicidal ideation is not fully addtressed by traditional CBT (Agako et al., 2021). 

This presentation provides an evidence-based overview of the current rationale for utilizing DBT in the perinatal period and will discuss some of the major adaptations of DBT which have been published (Bresky et al., 2021). Additionally, this presentation will discuss clinical learnings from the author’s clinical experience of utilizing DBT skills with the pregnant and postpartum population for over a decade, including learnings from a recent pilot study examining the effectiveness of a DBT skills group for pregnant and postpartum women. The talk will emphasize the ways in which the underlying DBT philosophy matches the needs of this population, supporting increased emotional regulation and skills use. Specific examples of how to adapt DBT skills will also be presented so that attendees will leave with concrete tools that can be applied in their practice.