Online group therapy with public health nurses reduces post-partum depression and anxiety

A baby in a woman's lap as they sit in front of a laptop computer. The adult's face is not in the frame.

'Life-changing' sessions with public health nurses not only improved mother-infant relationships, they also offered a way to increase access to PPD treatment, McMaster researchers found. (Stock image)

Mothers with post-partum depression (PPD) can be successfully treated in group sessions run by public health nurses, according to new research led by McMaster University in collaboration with Niagara Region Public Health (NRPH).

The study, published July 24 in the Journal of Clinical Psychiatry, showed that mothers who participated in the group therapy also showed stronger relationships with their infants.

Up to one in five new mothers is affected by PPD. Left untreated, it can become an ongoing depressive illness. PPD rates increased during the pandemic, further highlighting the need for effective, accessible treatments for mothers who experience it.

Researchers assigned 159 mothers with babies younger than 12 months old to receive nine weeks of online group cognitive behavioural therapy (CBT) for PPD in 2020 and 2021, alongside the current standard of care.

They were compared to a control group of mothers who received the current standard of care alone, which is psychotherapy and sometimes antidepressants.

Researchers examined the effects of the intervention on maternal depression, anxiety, social support and the mother-infant relationship immediately post-treatment, as well as six months later.

Mothers who received the group CBT enjoyed a clinically significant reduction in PPD and anxiety, as well as better relationships with their infants.

“This is the first time anyone has shown that public health nurses can deliver effective online group psychotherapy for mothers with postpartum depression,” said Ryan Van Lieshout, associate professor of the department of Psychiatry and Behavioural Neurosciences and the Canada Research Chair in Perinatal Health.

“Since public health nurses are frequently a first point of contact for many mothers with postpartum depression, this treatment is scalable and has the potential to substantially improve access to effective treatment for mothers with PPD worldwide.

“Given the current shortage of mental health-care resources, having public health nurses treat PPD could complement existing services and improve access to care for those who need it.”

After this trial and a similar one earlier, a quarter of Ontario public health units have integrated or are planning to integrate CBT strategies into their regular practice and programming, Van Lieshout says

Structured psychotherapy sessions including CBT and interpersonal psychotherapy are first-line treatments for PPD and are generally preferred over antidepressant medications.

“Clients have shared that the Niagara program, Steps to Wellness Before and After Baby, is life-changing,” said Christina Bradley, a public health nurse at NRPH.

“It validates the struggles of perinatal mood disorder and equips parents with multiple strategies to positively impact their mental health.”

“As a facilitator of this program, it is a privilege to be part of their journey and see the changes that happen,” Bradley said.

“On more than one occasion, participants have expressed that they are beginning to feel like themselves again. This program makes a difference.”

The study was supported by the Canada Research Chairs program.

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