Although postpartum depression (PPD) affects about 15% of all women after the birth of a child, most women with PPD receive no treatment. One of the problems has been inadequate screening for perinatal mood and anxiety disorders. Over the last decade, there has been an emphasis on educating health care professionals to reliably screen for PPD; however, other obstacles to obtaining treatment remain. Many women cannot find appropriate treaters in their area. Others are not able to get childcare in order to attend weekly appointments. Given these limitations, it is important that we explore other types of interventions that might be used to reach and effectively treat women with PPD.
Last year we reported on Netmums which developed an online behavioral activation (BA) treatment that was specifically adapted to the concerns of postpartum women. BA is basically cognitive-behavioral therapy or CBT without the cognitive components; using only the behavioral components of CBT, has been shown to be as effective for treating depression as traditional CBT. In this study, women receiving the BA intervention improved with regard to depressive symptoms, anxiety, work and social functioning at post-treatment compared with women in the treatment as usual group. The effect sizes were large. The differences between the two groups remained significant at six months post-treatment.
A new study reports on another innovative treatment, therapist-assisted internet cognitive behavior therapy (TAICBT). In this pilot study, 24 women received TAICBT. The authors reported: “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.” Future studies will assess the efficacy of this intervention.
Ruta Nonacs, MD PhD
Pugh NE, Hadjistavropoulos HD, Hampton AJ, Bowen A, Williams J. Client experiences of guided internet cognitive behavior therapy for postpartum depression: a qualitative study. Arch Womens Ment Health. 2014 Aug 12. [Epub ahead of print]