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Child / Adolescent - Anxiety

Do You See What I See? Bringing Awareness to Parental Invalidation as Step towards Cultivating Joy for Adolescents Engaging in Dialectical Behavior Therapy: A Cross-Sectional Analysis

(PS3-C71) Do You See What I See? Bringing Awareness to Parental Invalidation as Step Towards Cultivating Joy for Adolescents Engaging in Dialectical Behavior Therapy: A Cross-sectional Analysis

Friday, November 17, 2023

11:30 AM – 12:30 PM PST

Location: Regency Ballroom, Level 7

Author(s)

HB

Hannah E. Byrnes, None

Researcher
Center for Cognitive and Dialectical Behavioral Therapy
Lake Success, New York

Co-Author(s)

Shannon M. Walsh, Psy.D.

Clinical Psychologist
center for cognitive and dialectical behavior therapy
New york, New York
MK

Miri Korbman, Psy.D.

Licensed Clinical Psychologist
Center for Cognitive and Dialectical Behavior Therapy
New York, New York

Over the past decade, Marsha Linehan's Dialectical Behavior Therapy (DBT), has been adapted and empirically validated as a treatment for adolescents presenting with difficulties regulating emotion. Marsha Linehan theorizes that emotional dysregulation can arise from a relational pattern between a biological sensitivity to heightened emotion and an invalidating environment. Invalidation is defined by its delegitimizing of a adolescent's valid emotional experience, in our case, by the parent. While patients report invalidation occurring within their home settings, research on how to operationalize an invalidating environment is scarce. Studies that have attempted to operationalize invalidating environments have typically assessed experiences of the patient only, using self-report measures. The first purpose of this preliminary study is to further understand invalidating environments by comparing parents’ report of adolescent depression and anxiety symptoms with their adolescents’ self-report. The second purpose was to assess parent and child report of mindful awareness at the start of treatment, as we hypothesize that differences in mindful awareness can contribute to parents intentionally or unintentionally invalidating their child. The 66 participants in this study included 33 adolescents and one of their corresponding parents at the start of treatment, after they were enrolled in a full-model DBT program for adolescents and families in an outpatient setting. Independent t-tests were conducted to compare the parent’s perception of their adolescent’s symptoms of depression and anxiety to the adolescent self-reported symptoms. It was found that parents significantly underestimated their children’s anxiety (t(57)=(4.063), p < 0.001; d=1.062) and depression (t(46)=(8.176), p < 0.001; d=2.360), compared to the adolescent self-report of symptoms. These results are significant in our preliminary analysis because parents' lack of awareness of their adolescent’s symptoms can be contributing to verbal invalidation in the home. Of note, unlike we hypothesized, there was a significant difference in the mindfulness awareness, with parents demonstrating greater ability to focus on the present moment (t(52)=(-7.654), p < 0.001; d=-2.083) compared to their adolescents. While these factors will be further studied in future analyses to understand invalidation, it is possible that parents assume their adolescents have similar capabilities to be mindful as themselves, which leads to higher expectations or invalidation of the adolescent’s current capabilities prior to treatment. With improved awareness of both parent and adolescent’s observation of symptoms, and improved communication, treatment goals can be accurately tailored to fit the family needs, leading to more validation and joy within the home setting.