Online 1-Day Cognitive Behavioural Therapy-Based Workshops to Prevent Postpartum Depression
Maternal, Child & Mental Health
Postpartum depression (PPD) affects up to 1 in 5 birthing parents, yet just 10% of those affected receive treatment. While the US Preventive Services Task Force recommends that pregnant persons at high-risk for PPD be provided with preventive counseling interventions, no scalable, evidence-based treatments capable of preventing PPD exist. Existing interventions often involve 12-15 weekly sessions which are difficult to attend for many pregnant people and so adherence rates are very low. 1-day CBT-based workshops have the potential to overcome these limitations, can accommodate up to 30 participants at a time and could be delivered by a range of different healthcare professionals. Only brief, efficient interventions that can be upscaled are likely to have an impact on PPD at a population level. If effective, 1-day CBT-based workshops for preventing PPD could be scaled to reduce its prevalence in Ontario and beyond.
Background: Postpartum depression (PPD) affects up to 20% of birthing parents, yet just one in ten of these individuals access evidence-based treatment. The US Preventive Services Task Force recommends that all pregnant persons at high-risk for PPD be provided with preventive counseling interventions. However, few evidence-based treatments exist and because most require 3 months of weekly sessions, they tend to have low adherence rates. Given this background, the objective of this project was to develop and test a 1-day cognitive behavioural therapy-based workshop to prevent PPD.
Method: 124 pregnant persons living in Ontario and in the 3rd trimester of pregnancy with ≥1 risk factor for PPD (i.e., high-risk) were randomized to receive the workshop plus treatment as usual (TAU) or TAU alone. Each workshop was delivered by two trained facilitators (social workers, nurses or registered psychotherapists). During pregnancy and at 1 month postpartum, we compared levels of PPD, anxiety, stress, and social support. The mother-infant relationship and infant temperament were also assessed postpartum.
Results (CONSORT): The results reported here are based on interim analyses undertaken at 1 month postpartum. Participants were 32.5 years-old and 31 weeks pregnant at enrolment. 67% were White and 52% were taking antidepressants. Participant satisfaction with the workshop was high. At 1 month postpartum, 21% of those in the control group and 16% in the workshop group had probable depression, while 21% of control participants experienced a mood deterioration compared to 18% in the treatment group. There were no differences in changes in anxiety, stress, or social support, nor in the mother-infant relationship nor infant temperament between groups.
Conclusions: While well-tolerated, few differences were noted between workshop and control groups at 1 month postpartum. Scheduled follow-ups will also take place at 2 and 3-months postpartum.