Dialectical behavior therapy skills training for African American pregnant women with ACEs: a pilot study of feasibility, acceptability, and mental health barriers and attitudes

Background: Toxic stress contributes to socioeconomic and racial health disparities that persist across generations. Developing and implementing prenatal interventions that reduce toxic stress and associated comorbidities is warranted. Dialectical Behavior Therapy (DBT) Skills Training group interventions have demonstrated efficacy for depression and posttraumatic stress disorder (PTSD) and are scalable in diverse settings. Implementing DBT skills group interventions for African American pregnant women with adverse childhood experiences (ACEs) and current depression or PTSD symptoms is novel and has the potential to interrupt the intergenerational cycle of toxic stress by improving maternal mental health. Yet, much remains to be understood about barriers that may impact feasibility.