Evaluating the Effectiveness of Online 1-Day Peer-Delivered CBT-Based Workshops for Postpartum Depression

Abstract

Background: Postpartum depression (PPD) affects 1 in 5 mothers and birthing parents. Unfortunately, many personal, practical, and systemic treatment barriers hinder those with PPD to receive their preferred treatment (psychotherapy). This study aimed to assess the effectiveness of Online Peer-Delivered 1-Day Cognitive Behavioural Therapy (CBT)-Based Workshops at treating PPD and its common comorbidities and complications.

Methods: Participants were randomly allocated (1:1) to receive the 1-day workshop plus treatment as usual (TAU; experimental group) or TAU and placed on a waitlist to complete the workshop 12 weeks later (control group). Participants were eligible to participate if they were >18 years old, had an infant <12 months of age, and an Edinburgh Postnatal Depression Scale (EPDS) score >10. The workshop was a 1-day synchronous online, group CBT-based intervention delivered by two trained individuals who had recovered from PPD (i.e., peers). The primary outcome was change in PPD, assessed by the EPDS. Secondary outcomes included anxiety, mother-infant bonding, parenting stress, infant temperament, social support, and partner relationship discord.

Results: 202 participants were randomized to the experimental group and 203 to the control group. The intervention led to significant reductions in EPDS scores from 15.95 pre-treatment to 11.37 post-treatment (d=0.92, p<0.01) and was associated with higher odds of exhibiting a clinically significant decrease in EPDS scores (OR=2.03, 95%CI: 1.26-3.29, NNT= 5.77, 95%CI: 3.46-17.24). Statistically significant improvements were also seen in postpartum anxiety (d=0.76, p<0.01), infant-focused anxiety (d=0.48, p<0.001), parenting stress (d=0.42, p<0.001), and infant positive affectivity (d=-0.81, p<0.001).

Conclusion: Peer-delivered 1-day CBT-based workshops have the potential to improve PPD and its accompanying comorbidities and complications. The peer-delivered, brief, group, and online aspects of these workshops make it an ideal candidate for a low-intensity evidence-based treatment for PPD. This intervention is safe, engaging, and scalable, and has the potential to increase PPD treatment access.