Feasibility and Effectiveness of 1-Day Online Cognitive Behavioral Therapy-Based Workshops for the Prevention of Postpartum Depression

Abstract

Objectives: To assess the feasibility and effectiveness of an online 1-day cognitive behavioural therapy (CBT)-based workshop in the prevention of postpartum depression (PPD) Methods: In Study 1, data was analyzed from a cohort of 38 birthing parents in the form of a pre-test-post-test pilot study. The ability to develop a 1-day prevention intervention, with feasible study design, recruitment, and retainment strategies that was acceptable to participants was assessed and effect sizes were preliminarily measured in preparation to develop a future full-scale randomized control trial (RCT). In Study 2, a parallel-group RCT was utilized to examine a new group of 124 participants split into either the experimental or control group. Participants received the workshop plus treatment as usual (TAU; experimental group) or TAU alone (control), Major depressive disorder (MDD) diagnosis, levels of PPD symptoms, anxiety, social support, mother-infant relationship quality, and infant temperament was assessed at one, two, and three months postpartum. Results: In Study 1, a 1-day prevention intervention for PPD that was deemed acceptable to study participants was successfully developed. The online 1-day CBT-based workshops for preventing PPD were feasible in terms of study design based on participant recruitment speed and retention rate. In Study 2, trial recruitment was stopped after 25% of the expected sample size was recruited as fewer than 10% of participants in either group developed MDD at three months postpartum. Data were collected up to three months postpartum in those already enrolled. Among all enrolled participants (n=124), a trend toward larger reductions in EPDS scores was seen in the experimental group at two months postpartum (p=0.06). Participants with baseline Edinburgh Postnatal Depression Scale Score ≥7 in the experimental group showed larger, statistically significant reductions in PPD and anxiety at two months postpartum. Conclusion: The studies in this thesis suggest that the 1-day online CBT-based workshop could have potential as an intervention for preventing PPD in birthing parents considered higher-risk. Keywords: Postpartum depression, pregnancy, perinatal care, prevention and control, cognitive behavioural therapy, mental disorders