Maternal-infant mental health: postpartum group intervention

Abstract

Dyadic interactions associated with maternal depression and anxiety may perpetuate maternal mental illness and impact infant attachment. Individual and maternal-dyadic therapies are effective but resource intensive. We assessed feasibility, acceptability, and preliminary efficacy of a newly developed maternal-infant dyadic group therapy intervention. This was an open-label pilot study targeting mothers with mood or anxiety disorders, and their infants aged 6 to 12 months. We conducted three 12-week groups combining evidence-based maternal and mother-infant dyadic strategies to enhance mood, insight, parenting, and mentalizing capacity. We measured recruitment and retention rates, reasons for nonparticipation, and missed sessions. Acceptability of the intervention was assessed via questionnaires and semi-structured interviews. Efficacy outcomes were the Parenting Stress Index (PSI), Edinburgh Postnatal Depression Scale (EDPS), and the Beck Anxiety Inventory (BAI), measured pretreatment and posttreatment. The feasibility and acceptability were excellent. There was a significant reduction in mean depressive symptom scores (t 3.31; p 0.008 sig) and a trend toward decreasing anxiety scores (t 1.96; p 0.08). The total PSI score decreased, approaching statistical significance (t 2.23; p 0.057). Enhanced insight, parenting capacity, affect regulation, and positive interaction with baby were supported with self-report surveys and interviews. This resource-efficient novel mother-baby dyadic group intervention shows excellent feasibility, acceptability, and has good preliminary efficacy results. It has the potential to improve depression, anxiety, affect regulation, parenting, and maternal mentalization.

Therapist-Supported Internet-Based Cognitive Behavior Therapy for Stress, Anxiety, and Depressive Symptoms Among Postpartum Women: A Systematic Review and Meta-Analysis

“…In addition, evidence indicates that the coexistence of stress, anxiety, and depressive symptoms occur during the postpartum period [17]. Timely and efficacious intervention is important during the postpartum period, especially when considering the adverse short- and long-term maternal health outcomes and child development outcomes [22-24]. Strong evidence supports that CBT is effective for treatment and prevention during the postpartum period [25].…”

A systematic review of randomized controlled trials of interventions designed to decrease child abuse in high-risk families

“…Two studies have assessed the efficacy and cost differential of postpartum groups as compared to home visits. The studies suggest that groups can improve parenting knowledge (McNeil & Holland, 1972) and maternal mental health (de Camps Meschino, Philipp, Israel, & Vigod, 2016) at a lower cost. However, these studies did not measure the impact upon child abuse events, and neither study was an RCT.…”

Experiences of Postpartum Women after Mindfulness Childbirth Classes: A Qualitative Study

“…Findings from a pilot randomized clinical trial of a mindfulness program for breastfeeding mothers suggested benefits of increased self‐efficacy, improved mood, and increased self‐compassion . A small pilot study of an intervention that included a mindfulness component for mothers with mood or anxiety disorders who had 6‐ to 12‐month‐old infants showed significant reduction in depression scores (t = 3.31, P = .008) …”

“…29 A small pilot study of an intervention that included a mindfulness component for mothers with mood or anxiety disorders who had 6-to 12-month-old infants showed significant reduction in depression scores (t = 3.31, P = .008). 30 Four of the participants described significant medical complications that affected their pregnancy, birth, or postpartum recovery. Unlike other approaches to childbirth education, MBCP does not promise a particular childbirth experience or outcome.…”