An Open Trial of In-Home CBT for Depressed Mothers in Home Visitation

Ammerman, Robert T.; Putnam, Frank W.; Stevens, Jack; Bosse, Nicole R.; Short, Jodie A.; Bodley, Amy L.; Ginkel, Judith B. Van

doi:10.1007/s10995-010-0691-7

Cited by 39 publications

(34 citation statements)

References 23 publications

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“…More specifically, some women expressed that the TAICBT program was helpful for parenting, resulted in greater enjoyment with childcare, and enhanced coping skills with respect to parenting. This finding corresponds with existing literature suggesting that face-to-face CBT for PPD may improve cognitions around parenting and child behavior (Ammerman et al 2011) and that TAICBT for PPD is effective at reducing parental stress and harsh parenting behaviors, as well as increasing parental satisfaction and efficacy (Sheeber et al 2012). It would be interesting to explore whether a TAICBT program with a module directly targeting parenting skills results in even greater parental benefits than a standardized TAICBT program, particularly for first-time parents.…”

Section: Discussionsupporting

confidence: 85%

Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study

Pugh

Hadjistavropoulos

Hampton

et al. 2014

Arch Womens Ment Health

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Postpartum depression (PPD) afflicts up to 15 % of women following childbirth and negatively impacts both mother and child. Therapist-assisted internet cognitive behavior therapy (TAICBT) is a promising intervention for the treatment of PPD; however, women's perceptions of TAICBT have not been examined. Responses to 10 open-ended questions from 24 women who received TAICBT for PPD were thematically analyzed. The majority of women expressed that the TAICBT program afforded flexibility, accessibility, and convenience, as well as anonymity and privacy. Some participants described the program as helping them take a step in the right direction and enhance their self-awareness and parenting skills. Participants also described having the internet therapist individualize their treatment. Challenges related to the TAICBT program were also identified by a minority of participants including managing time to log onto the program, the fast pace, completion of homework around childcare duties, and challenges of not having a face-to-face therapist. Participants also made suggestions for future programming. The large majority of participants consistently described their internet therapist favorably; however, challenges related to the internet therapy were also identified. Results should be integrated in the development of future programming.

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Section: Discussionsupporting

confidence: 85%

Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study

Pugh

Hadjistavropoulos

Hampton

et al. 2014

Arch Womens Ment Health

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“…An example for an office-based parenting intervention is Child-Parent-Psychotherapy (Lieberman & Van Horn, 2004), with a specific focus on trauma work for young children under 5 and their mothers affected by domestic violence or other serious trauma. Given high prevalence of maternal clinical depression among the mothers utilizing such home visiting programs, Ammerman and colleagues recently developed and tested an In-Home Cognitive Behavioral Therapy (IH-CBT) ad-on program for depressed mothers receiving home visitation, which demonstrated significant reductions in maternal clinical depression after 15 intervention sessions added to the home visitation (Ammerman et al, 2013; Ammerman et al, 2011). …”

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confidence: 99%

Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers

Muzik

Rosenblum

Alfafara

et al. 2015

Arch Womens Ment Health

139

102

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Purpose Maternal psychopathology and traumatic life experiences may adversely impact family functioning, the quality of the parent-child relationship and the attachment bond, placing the child’s early social-emotional development at risk. Attachment-based parenting interventions may be particularly useful in decreasing negative outcomes for children exposed to risk contexts, yet high risk families frequently do not engage in programs to address mental health and/or parenting needs. This study evaluated the effects of Mom Power (MP), a 13-session parenting and self-care skills group program for high-risk mothers and their young children (age <6 years old), focused on enhancing mothers’ mental health, parenting competence and engagement in treatment. Methods Mothers were referred from community health providers for a Phase 1 trial to assess feasibility, acceptability and pilot outcomes. At baseline, many reported several identified risk factors, including trauma exposure, psychopathology, poverty and single parenthood. 99 mother-child pairs were initially recruited into the MP program with 68 women completing and providing pre- and post- self-report measures assessing demographics and trauma history (pre-assessment only), maternal mental health (depression and PTSD), parenting and intervention satisfaction. Results Results indicate that MP participation was associated with reduction in depression, PTSD and caregiving helplessness. A dose response relationship was evident in that, despite baseline equivalence, women who attended ≥70% of the 10 groups (completers; N=68) improved on parenting and mental health outcomes, in contrast to non-completers (N=12). Effects were most pronounced for women with a mental health diagnosis at baseline. The intervention was perceived as helpful and user-friendly. Conclusions Results indicate that MP is feasible, acceptable and holds promise for improving maternal mental health and parenting competence among high-risk dyads. Further research is warranted to evaluate the efficacy of MP using randomized controlled designs.

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“…Home visitors often do not identify depression (Duggan, Fuddy, McFarlane et al, 2004), and depressed mothers rarely obtain mental health treatment even when the need is recognized (Tandon, Parillo, Mercer, Keefer, & Duggan, 2008). In response, Ammerman et al (2011) systematically adapted cognitive behavioral therapy to address the needs of depressed mothers receiving home visiting. In-Home Cognitive Behavioral Therapy (IH-CBT) is implemented by therapists who provide treatment concurrently with ongoing home visiting.…”

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confidence: 99%

Treatment of depressed mothers in home visiting: Impact on psychological distress and social functioning

Ammerman

Putnam

Altaye

et al. 2013

Child Abuse & Neglect

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Objectives Depression is prevalent in mothers receiving home visiting. Little is known about the impact of treatment on associated features of maternal depression in this population. The purpose of this study was to examine the impact of a novel, adapted treatment for depressed mothers in home visiting on psychological distress and social functioning. Methods In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat depressed mothers in home visiting. A randomized clinical trial design was used in which subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3 months postpartum were randomized into IH-CBT and ongoing home visiting (n = 47) or standard home visiting (SHV; n = 46) in which they received home visitation alone and could obtain treatment in the community. Measures of psychological distress, social support, and social network were measured at pre-treatment, post-treatment, and three-month follow-up. Clinical features of depression and home visiting parameters were examined as potential moderators. Results Subjects receiving IH-CBT reported decreased psychological distress at post-treatment (ES = 0.77) and follow-up (ES = 0.73). Examination of types of psychological distress indicated broad improvements at both time points. Those receiving IH-CBT reported increased social support over time relative to those in the SHV condition. Effect sizes were modest at post-treatment (ES = 0.38) but increased at follow-up (ES = 0.65). Improvements were seen in affiliative and belonginess aspects of social support, in contrast to tangible support which was statistically non-significant. Findings were not moderated by clinical features of depression or home visiting parameters. No group differences were found in size of and involvement with social networks. Conclusions IH-CBT is effective in reducing psychological distress and improving perceived social support in depressed mothers receiving home visiting. To the extent that mothers are better adjusted and feel socially supported, they are more available to their children and more amenable to home visiting services. IH-CBT is a feasible, readily adopted treatment that is compatible with multiple home visiting models. As a result it is a promising approach to help depressed mothers in home visiting. Additional interventions may be needed to support depressed mothers in building sizable and stable social networks.

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An Open Trial of In-Home CBT for Depressed Mothers in Home Visitation

Cited by 39 publications

References 23 publications

Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study

Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study

Mom Power: preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers

Treatment of depressed mothers in home visiting: Impact on psychological distress and social functioning

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