Self-injurious thoughts and behaviors (SITBs) among youth are a significant public health concern. While Dialectical Behavior Therapy (DBT) is currently the leading well-established treatment for youth experiencing SITBs, barriers to accessing and implementing effective care remain. Evidence-based treatments often emphasize the importance of involving caregivers and teaching skills to both youth and their families. However, caregiver-focused interventions also face challenges related to accessibility, implementation, and engagement.

 

To help address these gaps, this initiative brings together the Washington State Health Care Authority, NAMI Eastside Washington, clinicians, researchers, caregivers, and advocacy leaders to develop an online, asynchronous, evidence-based program for caregivers of high-risk youth. Through a collaborative community co-design process, the initiative aims to create a more accessible, engaging, and practical resource that reflects the needs and experiences of the families it is designed to support.

 

Central to the initiative is the involvement of caregivers with lived experience supporting youth who have received services for self-injurious thoughts and behaviors. Nine mothers from Washington State, 56% of whom identified as racial or ethnic minorities, participated in a three-step co-design process to help shape the program's content, format, and overall approach.

 

Throughout this process, caregivers provided feedback on topics drawn from Dialectical Behavior Therapy (DBT) and Parent Management Training (PMT), reviewed program outlines, and evaluated prototypes of the initial training modules. Their feedback highlighted the importance of creating a program that prioritizes caregiver self-care, connection, validation, and destigmatization, while incorporating real-life experiences and testimonials from other caregivers.

 

Caregivers also emphasized the need for flexible, easy-to-use learning opportunities, including shorter modules of approximately 30 minutes, audio narration, note-taking features, and content delivered in a warm, approachable tone rather than overly clinical language. These insights have helped guide the development of a program designed to fit more naturally into caregivers' lives while providing meaningful, evidence-based support.

 

By combining established therapeutic approaches with the perspectives of caregivers themselves, this initiative seeks to reduce barriers to accessing effective mental health resources, strengthen caregiver confidence and skills, and improve support for youth experiencing significant behavioral health challenges.

 

The long-term vision is to expand the program's reach across Washington State and beyond, making evidence-based caregiver education more accessible to families who need it most. Future opportunities include translating the program into additional languages, building partnerships with new organizations, expanding collaboration with NAMI Eastside Washington, and strengthening the program's ability to serve diverse communities.