Group cognitive behavioral intervention for postnatal depression

Abstract

Learning Objective #1: review the effectiveness of group cognitive-behavioral intervention program for postnatal depression based on research evidence. Learning Objective #2: discuss a short intervention program for postnatal depression using cognitive-behavioral approach. Cognitive-behavioral therapy (CBT) is an empirically validated form of psychotherapy that has been shown to be effective for depression in over 350 outcome studies. This study aims to report a group cognitive-behavioral program developed based on systematic review of its effectiveness in reducing the depressive symptoms for postnatally depressed women. A comprehensive literature review was undertaken on four databases in the electronic searching: CINAHL (1982 to 2007), Medline (1950 to 2007), PsycINFO (earliest to 2007), and Cochrane Library 2007, Issue 2 (earliest to 2007). Inclusion criteria were: 1) primary studies; 2) studies with full text; 3) studies that focus on depression during the postpartum period; and 4) interventional studies using cognitive-behavioural approach to reduce depressive symptoms. Studies were excluded if they: 1) are review studies or meta-analysis; 2) focus on antenatal or perinatal depression; and 3) employ intervention for prevention of PPD.

The intervention consisted of 4 weekly 2-hour sessions for women in groups of 10 to 12. All participants are screened with Edinburgh Postnatal Depression Scale on the second day and then by phone follow-up on 5th day after delivery. Those scored 10 or above are eligible for participation. Conducting CBT in group for postnatal depression was found to be as effective as conducting it individually with additional advantage of cost-saving and benefits of group dynamics. With empirical evidence, CBT is a clinically effective and cost-effective choice of treatment for postnatally depressed women. Implication for clinical practice will also be discussed.