A Video-Delivered Family Therapeutic Intervention for Perinatal Women With Clinically Significant Depressive Symptoms and Family Conflict: Indicators of Feasibility and Acceptability

Cluxton-Keller, Fallon; Hegel, Mark T.

doi:10.2196/41697

Cited by 4 publications

(4 citation statements)

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“…The results of the preliminary pilot study of REST with home-visited families showed that it significantly reduced maternal depressive symptoms and family conflict [24]. Although the participants in this study had an overall higher level of education and greater financial security than those who participated in other studies of REST [24][25][26], the severity levels for maternal depressive symptoms and family conflict are similar. This study expands the existing research on REST to explore its impact on perinatal anxiety.…”

Section: Framework Of Fbccmmentioning

confidence: 57%

“…A preliminary pilot study of REST showed that it was feasible and acceptable for socioeconomically disadvantaged families [24]. A pilot randomized trial is currently underway that is testing REST's impacts on depression and family function in a more diverse population of families [26], and the results will be published in a subsequent journal paper.…”

Section: Principal Resultsmentioning

confidence: 99%

“…Our research on perinatal depression guided the development of the FBCCM that includes 2 components. The first component is a video-delivered family therapy treatment (Resilience Enhancement Skills Training [REST]) [24][25][26] that is summarized in this section. REST is informed by Dialectical Behavior Therapy (DBT) Skills Training [27] and includes systemic interventions [28] to address conflict.…”

Section: Framework Of Fbccmmentioning

confidence: 99%

“…The selection of VCT was dependent on the participant's bandwidth consumption limits. This study used the same technology training procedures for REST participants that were used in other studies [24][25][26].…”

Section: Framework Of Fbccmmentioning

confidence: 99%

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A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study

Cluxton-Keller¹

2023

JMIR Pediatr Parent

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Background Untreated perinatal depression and anxiety can have detrimental consequences on family function. Logistical barriers prevent many perinatal women from accessing treatment, and these barriers are compounded for women residing in rural areas. This paper describes a Family-Based Collaborative Care Model (FBCCM) that is designed to bypass barriers to increase access to care for depressed and anxious perinatal women in rural regions of the United States. The FBCCM includes the following two components: (1) a 10-session video-delivered family therapy treatment for perinatal depression and anxiety and (2) a video-delivered infant care provider training on addressing the parenting needs of depressed and anxious mothers. Objective This paper describes the feasibility of implementing the FBCCM with families and infant care providers. Findings are presented on the preliminary effectiveness of the video-delivered family therapy treatment in reducing maternal depressive and anxiety symptoms, and family conflict. Methods This pilot study was carried out using an implementation-effectiveness hybrid trial design without a comparison group. Changes in maternal depressive symptoms, maternal anxiety symptoms, and family conflict were measured at posttreatment, 3 months, and 6 months later. Results On average, mothers (n=24) attended 9.79 (SD 1.02) sessions. On average, their family members (n=24) attended 9.42 (SD 1.28) sessions. A total of 31 infant care providers attended the training on addressing the parenting needs of depressed and anxious mothers. Mothers reported a significant reduction in depressive symptoms (P<.001) and anxiety symptoms (P<.001) from baseline to the 6-month follow-up. Mothers reported a significant reduction in conflict (P<.001), and their family members also reported a significant reduction in conflict (P=.007) from baseline to the 6-month follow-up. Conclusions The findings from this study provide support for the feasibility and preliminary effectiveness of the FBCCM. The findings will be used to inform a larger study of the FBCCM.

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Section: Framework Of Fbccmmentioning

confidence: 57%

Section: Principal Resultsmentioning

confidence: 99%

Section: Framework Of Fbccmmentioning

confidence: 99%

Section: Framework Of Fbccmmentioning

confidence: 99%

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A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study

Cluxton-Keller¹

2023

JMIR Pediatr Parent

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Video-Delivered Family Therapy for Perinatal Women With Depressive Symptoms and Family Conflict: Feasibility, Acceptability, Safety, and Tolerability Results From a Pilot Randomized Trial

Cluxton-Keller,

Hegel,

Donnelly

et al. 2023

JMIR Form Res

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Background Although individual-level treatments exist for pregnant and postpartum women with depression, family conflict is a significant factor that can contribute to the development and severity of perinatal depressive symptoms. Yet, there is a lack of research on family therapy for perinatal women with moderate to severe depressive symptoms and family conflict. Further, research is needed on the feasibility, acceptability, safety, and tolerability of family therapies for perinatal depression that are delivered using Health Insurance Portability and Accountability Act–compliant videoconferencing technology (VCT). Objective This paper describes the feasibility, acceptability, safety, and tolerability of a VCT-based family therapeutic intervention, Resilience Enhancement Skills Training (REST), for perinatal women with moderate to severe depressive symptoms and moderate to high conflict with their family members. Methods This paper includes data from an ongoing randomized trial that compares an experimental family therapeutic intervention (REST) to standard of care (VCT-based problem-solving individual therapy) for the treatment of moderate to severe depressive symptoms in perinatal women with moderate to high family conflict. Both interventions were delivered by masters-level therapists using VCT. A total of 83 perinatal women and their adult family members (N=166 individuals) were recruited for participation in the study. Feasibility, defined as therapist adherence to ≥80% of REST session content, was assessed in audio-recorded sessions by 2 expert raters. Acceptability was defined as ≥80% of families completing REST, including completion of ≥80% homework assignments and family report of satisfaction with REST. Completion of REST was assessed by review of therapist session notes, and satisfaction was assessed by participant completion of a web-based questionnaire. The Beck Depression Inventory-Second Edition was administered to perinatal women by research assistants (blind to study group assignment) to assess safety, defined as a reduction in depressive symptoms during the treatment phase. The Family Environment Scale-Family Conflict subscale was administered by therapists to participants during the treatment phase to assess tolerability, defined as a reduction in family conflict during the treatment phase. Results On average, the therapists achieved 90% adherence to REST session content. Of the families who started REST, 84% (32/38) of them completed REST, and on average, they completed 89% (8/9) of the homework assignments. Families reported satisfaction with REST. The results showed that REST is safe for perinatal women with moderate to severe depressive symptoms, and none discontinued due to worsened depressive symptoms. The results showed that REST is well tolerated by families, and no families discontinued due to sustained family conflict. Conclusions The results show that REST is feasible, acceptable, safe, and tolerable for families. These findings will guide our interpretation of REST’s preliminary effectiveness upon completion of outcome data collection. Trial Registration ClinicalTrials.gov NCT04741776; https://clinicaltrials.gov/ct2/show/NCT04741776

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A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study (Preprint)

Cluxton-Keller¹

2023

Preprint

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BACKGROUND Untreated perinatal depression and anxiety can have detrimental consequences on family function. Logistical barriers prevent many perinatal women from accessing treatment, and these barriers are compounded for those in rural areas. This article describes a Family-Based Collaborative Care Model (FBCCM) that is designed to bypass barriers to increase access to care for depressed and anxious perinatal women in rural regions of the United States. The FBCCM includes two components: 1) a 10 session video-delivered family therapy treatment for perinatal depression and anxiety; and 2) video-delivered infant care provider training on addressing the parenting needs of depressed and anxious mothers. OBJECTIVE This article describes the feasibility of implementing the FBCCM with families and infant care providers. Findings are presented on the preliminary effectiveness of the video-delivered family therapy treatment in reducing maternal depressive and anxiety symptoms, and family conflict. METHODS The study was carried out using an implementation-effectiveness hybrid trial design, without a comparison group. Changes in maternal depressive symptoms, maternal anxiety symptoms, and family conflict were measured at post-treatment, three-months and six-months later. RESULTS Nearly all mothers (96%; 23 out of 24) attended all of the video-delivered family therapy sessions. On average, mothers’ family members (n=24) attended 90% of the sessions. A total of 31 infant care providers attended the training on addressing the parenting needs of depressed and anxious mothers. Mothers reported a significant reduction in depressive symptoms (P < .001) and anxiety symptoms (P < .001) from baseline to the six month follow-up. Mothers reported a significant reduction in conflict (P < .001), and their family members reported a significant reduction in conflict (P = .007) from baseline to the six month follow-up. CONCLUSIONS The findings from the current study provide support for the feasibility and preliminary effectiveness of the FBCCM. The findings will be used to inform a larger-scale study of the FBCCM.

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A Video-Delivered Family Therapeutic Intervention for Perinatal Women With Clinically Significant Depressive Symptoms and Family Conflict: Indicators of Feasibility and Acceptability

Cited by 4 publications

References 31 publications

A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study

A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study

Video-Delivered Family Therapy for Perinatal Women With Depressive Symptoms and Family Conflict: Feasibility, Acceptability, Safety, and Tolerability Results From a Pilot Randomized Trial

A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results From a Pilot Study (Preprint)

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