Abstract / Summary
Abstract Background Complex Post-traumatic Stress Disorder (C-PTSD) arises from early life adversity and relational trauma. Women face heightened mental health risks during the perinatal period, and those with C-PTSD often struggle with emotion regulation and relationships. Dialectical Behaviour Therapy (DBT) is evidence-based for such difficulties, yet its feasibility and acceptability in perinatal populations are underexplored. This study aimed to explore 1) the feasibility and acceptability of a DBT intervention, delivered in group format online to perinatal women with moderate to severe mental health conditions including C-PTSD, and 2) potential change indicators in key outcome measures, namely, emotion regulation and perceived mother-baby bond. Method A mixed-methods cohort design was used. Routine feasibility and outcome data (relating to mental wellbeing, mother-baby bond and emotion regulation) were analysed using descriptive statistics and the Reliable Change Index. Individual interviews were also conducted with group participants who were considered to have C-PTSD and clinicians/group facilitators to explore experiences of the intervention and recovery. Qualitative data were analysed using Reflexive Thematic Analysis. Results Data from 17 participants, including eight with C-PTSD, were analysed. Six DBT groups were run. The average attendance was 7.7 sessions (adjusting for early dropouts). Attendance rates were 4.26% for full completion, 38% for 75% and 61.9% for 50% completion. Outcome questionnaire scores improved across all measures, with significant gains in emotion regulation. Three themes, with eight sub-themes, were developed from interviews with six women with C-PTSD and four clinicians: 1) therapeutic foundations amid perinatal complexity, 2) holding the group - relationships and continuity and 3) finding the balance between access and connection. Conclusions Online DBT skills groups were feasible and acceptable for patients and clinicians. Participants showed notable improvements in emotion regulation. Findings support the continued use and further refinement of this intervention for perinatal women with C-PTSD.