Parenting for Families at Risk: A Systematic Review of the Role of Dialectical Behaviour Therapy Skills Training for Maltreatment Prevention

Parents with histories of psychopathology, trauma, and systemic stressors are at elevated risk for emotion dysregulation, a modifiable driver of child maltreatment. Dialectical behaviour therapy (DBT) offers transdiagnostic skills that may reduce this risk; however, the evidence for DBT-informed parenting interventions has not been synthesized. This Preferred Reporting Items for Systematic Reviews and Meta-analyses-guided systematic review examined how such interventions are designed, implemented, and evaluated. PubMed, PsycINFO, and MEDLINE were searched from inception to February 2026. Eligible studies were empirical evaluations of DBT-informed parenting programmes for caregivers of children, reporting parent, parenting, or child outcomes; case studies and non-empirical reports were excluded. Of 109 full texts screened, 14 studies met the inclusion criteria. Studies were coded for intervention characteristics, DBT module coverage (including the use of behaviour chain analysis [BCA], risk of bias (ROBINS-I), and parent and parenting outcomes. Interventions were typically brief (6-14 weeks), group-based, and clinician-delivered; all included mindfulness, and most included emotion regulation, distress tolerance, and interpersonal effectiveness. Notably, only one study explicitly reported utilizing BCA. Caregivers showed reductions in emotion dysregulation, depression, anxiety, and parenting stress, alongside decreases in coercive or harsh parenting and gains in validation, effective discipline, and parent-child communication. Evidence was derived primarily from small, uncontrolled pilots; risk of bias was commonly rated as serious, and the overall certainty of evidence was low. Rigorous controlled trials with diverse caregivers are needed. DBT-informed parenting programmes show promise for reducing risk factors associated with maltreatment.