INTERPERSONAL PSYCHOTHERAPY FOR POSTPARTUM DEPRESSION

OVERVIEW

The Interpersonal Psychotherapy Program is a manualized therapy treatment developed to help recent mothers who are experiencing postpartum depression. The therapy program is a short-term intervention which lasts approximately 3 months and has previously been effective in treating postpartum depression. A randomized, experimental evaluation of the program found that it was effective in reducing parental stress but that it had no impacts on infant-outcomes such as infant emotionality, temperament, behavior problems, attachment security, or the quality of the parent-child relationship. The program was found to reduce levels of parental stress.

DESCRIPTION OF PROGRAM

Target population: Women with infants who are experiencing postpartum depression

The Interpersonal Psychotherapy Program is a standard, clinic-based therapy program for mothers who are experiencing postpartum depression. The program consists of weekly hour-long sessions which continue for 12 weeks. In each session, parents meet with a trained therapist to discuss the identification of depression, depression in the individual, and understanding depression's link to past and present relationships. Other topics addressed by the therapy sessions were loss of social/work relationships, conflict with partners and family, losses associated with birth, social role transitions, plans for treatment, and plans for termination of therapy and what to do if depression returns.

EVALUATION(S) OF PROGRAM

Forman, D. R., O'Hara, M. W., Stuart, S., Gorman, L. L., Larsen, K. E., & Coy, K. C. (2007). Effective treatment for postpartum depression is not sufficient to improve the developing mother-child relationship. Development and Psychopathology, 19, 585-602.

Evaluated population: 120 women and their infants who were experiencing postpartum depression as defined by DSM-IV, the Inventory to Diagnose Depression, and the Hamilton Rating Scale for Depression. Additionally, not part of the random assignment study, a non-depressed control group of 56 women were selected for a non-equivalent control group. Nearly all participants were non-Hispanic whites. The average age of mothers was 30.6 years, and, on average, mothers had received 15 years of schooling.

Approach: Mothers were screened for depression using three diagnostic tools for depression. After meeting criteria for major depressive episodes, 60 parents were randomly assigned to the Interpersonal Psychotherapy Treatment condition, and 60 were assigned to a waitlist control group which received no intervention. During the treatment period, mothers were instructed to stop using all psychotropic medications or receive any other treatments. The program began when infants were 6 months old and lasted for 12 weeks. Parents and children were visited before and after the treatment program was provided to the program group. At the baseline visit, mothers and infants were visited to confirm the presence of depression using self-report measures and interactions between mother and infant were videotaped. At 12 weeks, after those in the program group had completed treatment, mothers and children were again visited and observational data from video tapes and self-report data from questionnaires were collected. Participants were again assessed 18 months after the end of the program. Parents and infants were assessed on measures of parent-child interaction, parenting responsiveness, parenting stress, infant emotions, infant temperament, infant attachment security, and infant behavior problems.

Results: Attrition during the program was fairly low (89% completion). However, attrition was higher at the 18-month follow-up period where 90% of the mothers provided data on attachment security and only 67% provided data on temperament and behavior problems. There were no differences between those who provided data and those who did not except that those who completed all data collection were slightly more likely to have higher education levels.

At 6 and 9 months, mothers in the treatment group had lower levels of parenting stress than mothers in the waitlist control group. However, the program had no impacts on maternal responsiveness. The program also had no impacts on infant emotionality, infant temperament, behavior problems, or the quality of the parent-child relationship at any data collection period.

Non-experimental analysis showed that mothers in the treatment group still had higher levels of stress compared with non-depressed mothers in the comparison group.

SOURCES FOR MORE INFORMATION

Treatment manual is available from researcher Michael O'Hara upon request.

For more information on postpartum depression see: http://www.4therapy.com/consumer/conditions/item.php?uniqueid=7042&categoryid=415

References

O'Hara, M. W., Stuart, S., Gorman, L. L., & Wenzel, A. (2000). Efficacy of interpersonal psychotherapy for postpartum depression. Archives of General Psychiatry, 57, 1039-1045.

Program categorized in this guide according to the following:

Evaluated participant ages: infants / Program age ranges in the Guide: early childhood

Program components: clinic-based, provider-based, or miscellaneous; counseling/therapy; home visiting; parent or family component

Measured outcomes: social and emotional health and development; behavioral problems; mental health

Program information last updated 12/17/08