One of the common characteristics of people diagnosed with borderline personality disorder, bipolar disorder, substance use disorder, eating disorder, and/or neurodevelopmental disorder is difficulty in emotion regulation (DER). Dialectical behavior therapy (DBT) created by M. Linehan, which has substantial clinical research support for its effectiveness as a cognitive behavioral approach for DER, is becoming increasingly accepted as the treatment of choice in the United States and Europe. In Japan, however, it is hardly practiced. Family members also have difficulties due to the impulsive behaviors of the person with DER. As a result, family members themselves develop DER, thereby making them ineffective in supporting the patient. This often results in a vicious cycle between the patient and the family members. To address this problem, application of DBT to family psychoeducation, such as DBT family skills training (DBT-FST) and family connections (FC), is in progress in the United States. In Japan, however, it has barely started. As a small-scale challenge, the authors have been conducting family psychoeducation, called the "Family Skills-up Group", since 2011 for the families of people with DER in Japan by adapting DBT-FST, FC, and family psychoeducation for schizophrenia. This report describes the "Family Skills-up Group", and considers issues and future possibilities of family psychoeducation for DER in Japan by reviewing qualitative research utilizing interviews with the participants.
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