Therapy Topic Preferences for Emerging Adults Who Have a Parent with Mental Illness: A Modified Delphi Study

Background: Emerging adults aged 18–25 years who have a parent with mental illness face increased risks to their mental health and wellbeing, yet few interventions are tailored to their support needs. Compassion-based approaches may be relevant, yet little is known about whether this group perceives therapy topics informed by these approaches as helpful or how they would prioritise them. This study identified and prioritised compassion-informed therapy topics that emerging adults with lived experience perceived as helpful. Methods: A two-round modified Delphi study was conducted with emerging adults aged 18–25 years living in Australia who were raised by a parent with mental illness and/or substance misuse concerns. In Round 1 (n = 25), participants rated eight topics informed by Compassion-Focused Therapy and Mindful Self-Compassion and provided open-text feedback, which was analysed using content analysis, and informed six additional topics. In Round 2 (n = 15), participants rated the additional topics and ranked the original eight by perceived helpfulness. Consensus was defined as ≥80% agreement. Results: Eleven of 14 candidate topics achieved consensus, with healthy relationships and reducing self-criticism among the highest-priority topics. Endorsed topics spanned three areas: (i) relationships, caring and responsibility; (ii) self-criticism and self-compassion; and (iii) understanding and responding to internal experiences. Conclusions: Emerging adults who have a parent with parental mental illness perceived a range of compassion-informed therapy topics as helpful for addressing their support needs. These findings may inform content selection for a tailored intervention for this at-risk group. Endorsement patterns further suggest that therapy content may be perceived as more helpful when it is linked to recognizable personal experiences and concrete ways of responding.