Assessment acting as intervention: findings from a study of perinatal psychosocial assessment

Abstract

Objective: To consider how psychosocial assessment in the perinatal period may act as an intervention.Background: Psychosocial assessment has been introduced into routine antenatal care in several countries but there has been no consideration of 'measurement reactivity', the effects of such processes on those being measured. Methods:Psychosocial assessment as part of routine antenatal booking and by selfcompletion of a research questionnaire, followed by interview of a purposive sample of 22 women who scored above threshold on maternal stress measures. Interviews were conducted up to three times during pregnancy and the early postnatal period, to explore women's experiences and understandings of maternal stress and to obtain their views on antenatal psychosocial assessment and social support. Transcribed data and field notes were analysed using Framework Analysis. Results:The potential for assessment to act as an intervention varied across different settings (clinical practice and assessment in a research context), with different methods (selfcompletion and assessment as part of a consultation or interview), and across individuals.Measurement effects were pronounced through longitudinal involvement, interviewer style and concurrently assessing the origins of psychological health and coping strategies. Conclusion:The analysis illustrates how reflexivity can enable new and often unexpected findings to emerge. The findings raise important questions about how the role of the research(er) is constructed, particularly when evaluating interventions. Clinically, the findings have implications for how we view psychosocial assessment within care pathways.

Predicting Therapeutic Effects of Psychodiagnostic Assessment Among Children and Adolescents Participating in Randomized Controlled Trials

“…Thus, if conceptualized as an open-label single-arm trial of psychodiagnostic assessments, these results provide mild additional evidence for assessment as a therapeutic tool. These findings are consistent with prior studies reporting that systematic assessment of a target behavior improves that behavior (Baker et al, 2013; Darwin, McGowan, & Edozien, 2013). …”

“…People often experience improvements in mood after repeated administration of measures, with repeated measurement showing decreases in anxiety and depression scores, potentially due to the benefits of emotional expression and measurement as well as human contact (French & Sutton, 2010; Pennebaker, 1997). Darwin and colleagues (2013) analyzed qualitative responses to psychosocial assessment among pregnant women. They concluded that improvement occurred by increasing participants’ self-awareness and self- management strategies and inducing participants to seek further support from others.…”

Systematic review and meta‐analysis of non‐pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women

“…Most studies which reported lower participation rates from the initial sample population used anxiety and/or depression measures to assess participant eligibility and the majority of potential participants were referred by healthcare professionals. Darwin, McGowan, and Edozien () reported that women have concerns that psychological assessment may lead to unwanted interference from social services or healthcare professionals and such concerns may partly explain the lower consent rates into studies based on healthcare professional referral or psychological assessment. The rationale for applying inclusion criteria and referral should be clearly communicated to potential participants in a supportive context.…”

The impact of a referral card-based intervention on intimate partner violence, psychosocial health, help-seeking and safety behaviour during pregnancy and postpartum: a randomized controlled trial

“…their intentions), as doing so influences the likelihood and rates of performing that behaviour [98]. Indeed, IPV assessment can have a therapeutic value on its own and that the process of measurement changes the very thing being measured [33,99]. As described earlier, screening for IPV is not part of routine antenatal care in Belgium.…”