Effectiveness of Dialectical Behavior Therapy–Informed Family Therapy on Family Functioning and Emotion Regulation in Adolescents with Emotional Dysregulation
Keywords:
Family therapy, dialectical behavior therapy, family functioning, emotion regulationAbstract
Objective: This study investigated the effectiveness of DBT-informed family therapy on family functioning and emotion regulation in adolescents with emotional dysregulation in Tabriz, Iran.
Methods and Materials: A quasi-experimental pretest–posttest design with control group and 3-month follow-up was used. Participants were 40 adolescents (aged 13–18 years) with clinically significant emotional dysregulation, referred to outpatient counseling centers in Tabriz, and one or both of their parents. Eligible families were selected through purposive sampling and then randomly assigned to intervention (n = 20) or wait-list control (n = 20) groups. The intervention group received 10 weekly DBT-informed family therapy sessions focusing on mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and validation within family interactions. All participants completed standardized measures of family functioning and emotion regulation at baseline, post-treatment, and follow-up. Data were analyzed using repeated-measures ANOVA and effect size indices.
Findings: Families in the intervention group showed significantly greater improvement in overall family functioning and adolescent emotion regulation compared to the control group at post-test. These gains were largely maintained at 3-month follow-up.
Conclusion: DBT-informed family therapy appears to be an effective approach for improving family functioning and emotion regulation among adolescents with emotional dysregulation in Tabriz. Integrating DBT principles into family-based interventions may enhance culturally sensitive clinical practice in Iranian adolescent mental health services.
Downloads
References
Amiri, S., Shalchi, B., Malek, A., Pour Hasan, S., & Bakht Shokuhi, Z. (2024). Developmental family functioning and conduct disorder symptoms in teenagers: The function of cognitive emotion regulation. International Journal of School Health, 11(4), 241-250. https://intjsh.sums.ac.ir/article_50243.html
Badanfiroz, A. (2025). Comparison of the Effectiveness of Dialectical Behavior Therapy and Emotion-Focused Therapy on Communication Patterns and Marital Intimacy in Marital Infidelity Among Women. Jarac, 7(1), 127-137. https://doi.org/10.61838/kman.jarac.7.1.15
Boustani, M. M., Mazzone, E., Hodgins, J., & Rith-Najarian, L. (2024). Dialectical behavior therapy programming for adolescents: A systematic review and meta-analysis of clinical and implementation outcomes. Journal of Clinical Child & Adolescent Psychology. https://www.tandfonline.com/doi/abs/10.1080/15374416.2024.2426142
Dallenbach, M. L., Moeller, K., & Givens, A. (2025). Does duration of dialectical behavioral therapy for adolescents (DBT-A) skills groups affect outcomes: A rapid review. Child and Adolescent Social Work Journal, 42(3), 285-298. https://doi.org/10.1007/s10560-024-00961-4
Fleischhaker, C., Böhme, R., Sixt, B., Brück, C., Schneider, C., & Schulz, E. (2011). Dialectical behavioral therapy for adolescents (DBT-A): A clinical trial for patients with suicidal and self-injurious behavior and borderline symptoms with a one-year follow-up. Child and adolescent psychiatry and mental health, 5, 3. https://doi.org/10.1080/15374416.2024.2426142
Freed, R. D., Rubenstein, L. M., Daryanani, I., Olino, T. M., & Alloy, L. B. (2016). The relationship between family functioning and adolescent depressive symptoms: The role of emotional clarity. Journal of youth and adolescence, 45(3), 505-519. https://doi.org/10.1186/1753-2000-5-3
Goldstein, T. R., Axelson, D. A., Birmaher, B., & Brent, D. A. (2007). Dialectical behavior therapy for adolescents with bipolar disorder: A 1-year open trial. Journal of the American Academy of Child & Adolescent Psychiatry, 46(7), 820-830. https://doi.org/10.1007/s10964-016-0429-y
Kothgassner, O. D., Goreis, A., Robinson, K., Huscsava, M. M., Schmahl, C., & Plener, P. L. (2021). Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: A systematic review and meta-analysis. Psychological medicine, 51(7), 1057-1067. https://doi.org/10.1097/chi.0b013e31805c1613
Lin, S. C., Pozzi, E., Kehoe, C. E., Havighurst, S., Schwartz, O. S., Yap, M. B. H., Zhao, J., & Whittle, S. (2024). Family and parenting factors are associated with emotion regulation neural function in early adolescent girls with elevated internalizing symptoms. European Child & Adolescent Psychiatry, 33(12), 4381-4391. https://link.springer.com/article/10.1007/s00787-024-02481-z
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press. https://doi.org/10.1017/S0033291721001355
Mehlum, L., Tørmoen, A. J., Ramberg, M., Haga, E., Diep, L. M., Laberg, S., Larsson, B. S., Stanley, B. H., Miller, A. L., Sund, A. M., & Grøholt, B. (2014). Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: A randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53(10), 1082-1091. https://doi.org/10.1007/s00787-024-02481-z
Mehlum, L., Tørmoen, A. J., Ramberg, M., Haga, E., Diep, L. M., Stanley, B. H., Miller, A. L., Sund, A. M., & Grøholt, B. (2019). Long term effectiveness of dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior. Journal of Child Psychology and Psychiatry, 60(10), 1112-1122. https://doi.org/10.1016/j.jaac.2014.07.003
Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. Guilford Press. https://doi.org/10.1111/jcpp.13077
Naziri, A., & Hooman, F. (2025). The role of family functioning and emotional expressiveness in predicting anxiety in adolescent girls. Preventive Care in Nursing & Midwifery Journal, 15(1), 37-45. http://nmcjournal.zums.ac.ir/files/site1/user_files_eafc2e/hooman-A-10-945-2-683f87a.pdf
Parandeh Shirvan, S., Kamrani, M., & Asgharipour, N. (2024). The effect of emotion regulation training based on dialectic behavior therapy on aggression and quality of life in Ibn-Sina Hospital staff, Mashhad, Iran. Evidence Based Care, 14(3), 17-24. https://doi.org/10.61882/pcnm.15.1.33
Paulus, F. W., Ohmann, S., Möhler, E., Plener, P. L., & Popow, C. (2021). Emotional dysregulation in children and adolescents with psychiatric disorders: A narrative review. Frontiers in Psychiatry, 12, 628252. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.628252/full
Rizvi, S. L., Bitran, A. M., Oshin, L. A., Yin, Q., & Ruork, A. K. (2024). The state of the science: Dialectical behavior therapy. Behavior therapy, 55(6), 1233-1248. https://doi.org/10.3389/fpsyt.2021.628252
Smith, L., Hunt, K., Parker, S., Camp, J., Stewart, C., & Morris, A. (2023). Parent and carer skills groups in dialectical behaviour therapy for high-risk adolescents with severe emotion dysregulation: A mixed-methods evaluation of participants' outcomes and experiences. International journal of environmental research and public health, 20(14), 6334. https://doi.org/10.1016/j.beth.2024.02.006
Whitener, M., Khazvand, S., Carson, I., Martin, A., Salyers, M. P., Cyders, M. A., Aalsma, M. C., & Zapolski, T. C. B. (2025). Acceptability and Efficacy of an Adapted School-Based Dialectical Behavioral Therapy Skills Group for Adolescents: A Qualitative Perspective. Inquiry the Journal of Health Care Organization Provision and Financing, 62. https://doi.org/10.1177/00469580251314279
