Enhancing Well-Being and Resilience Through Emotion Regulation Strategies: DBT Skills Training for Early-Career Midwives.

Abstract

Midwives operate in emotionally demanding environments, involving complex interpersonal interactions and substantial work-related stress. This can be accompanied by risks of burnout, challenges to well-being, and retention issues, particularly among Early Career Midwives (ECMs). Despite extensive literature on sustainability challenges in the profession, research on emotion regulation (ER) abilities and targeted interventions remains limited. This pilot study evaluated the feasibility and preliminary efficacy of a psychoeducational Dialectical Behaviour Therapy Skills Training (DBT-ST) intervention, adapted for ECMs, to cultivate ER strategies within midwifery practice. The study was originally designed as a two-phase sequential design, incorporating a quasi-experimental pretest-post-test with follow-up, followed by a qualitative phase. However, COVID-19 related constraints necessitated a reduction to a pretest-post-test-only design, limiting the ability to assess longer-term intervention effects. The study utilised the Difficulties in Emotion Regulation Scale (DERS), Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), Emotional Labour Scales (ELS), Maslach Burnout Inventory (MBI), and Connor-Davidson Resilience Scale (CD-RISC) to measure outcomes. The intervention was delivered online over six weeks to ECMs at a National Health Service (NHS) maternity service. Findings demonstrated significant improvements in ELS scores and reductions in emotional exhaustion (MBI subscale), suggesting some positive changes in ER abilities. However, no significant changes were observed in DERS or MSCEIT scores, indicating that key ER challenges remained unaddressed. The reliance on an online format, small sample size, and the absence of a follow-up phase may have influenced these findings, suggesting the need for a more intensive or extended approach to achieve sustained ER improvements. The study provides preliminary evidence on the feasibility of DBT-ST within midwifery, but highlights limitations in intervention delivery, study design modifications, and measurable outcomes. Future research should explore larger samples, longitudinal designs with follow-up, and in-person delivery to optimise effectiveness and assess the long-term impact of DBT-ST on midwives’ emotional well-being in stable working conditions.