Evaluating Interventions for Mothers with Postpartum Depression and their Infants
Postpartum depression (PPD) has been identified as the most common complication of pregnancy and childbirth, and can affect nearly one in five new mothers. In addition to symptoms of depression, anxiety, and guilt, PPD can have negative implications for parenting, mother-infant interactions, and child development. While both individual psychotherapy and psychotropic medications have been found effective for addressing a mother’s symptoms of PPD, these types of treatments are not typically successful in improving the relationship between the mother and infant. Only dyadic treatments involving the parent and child, which address the mother’s individual therapeutic needs as well as her interactions with her baby, have the potential to positively impact the mother-infant relationship.
A recent study by Boston University Assistant Professor Ruth Paris, former Boston University graduate researcher Rendelle E. Bolton, and Jewish Family and Children’s Service of Greater Boston’s Eda Spielman analyzes the treatment process of the mother-infant relationship. The article, “Evaluating a Home-Based Dyadic Intervention: Changes in Postpartum Depression, Maternal Perceptions, and Mother-Infant Interactions,” appears in Volume 32 of the Infant Mental Health Journal.
Similar to other forms of depression, women with PPD experience sadness, agitation, extreme fatigue, preoccupation, and suicidal ideation. Within the mother-infant relationship, interactions can be strained. Infants may be less likely to initiate or maintain connections, and mothers may be less likely to demonstrate positive affect and sensitivity to their infant’s needs.
“We understood from a clinical perspective the importance of working with the baby and the mother over the course of the treatment,” Paris said. “We hoped to assess systematically whether this dyadic multifaceted approach was reaching its’ desired goals of decreasing the mother’s depression and anxiety, and improving mother-infant interactions.”
The study aimed to examine the efficacy of Early Connections, a home-based dyadic therapy for mothers with PPD and their infants. Utilizing data from an evaluation of this multifaceted therapy, the article reports findings focused on changes in maternal mood, perceptions of the mothering experience, and mothers’ relationships with their infants.
The group’s study was part of an academic-community partnership aimed at researching innovative clinical practices based in real-world mental health agency settings. Community agency supervisors and academic researchers worked collaboratively over a two-year period to develop a research study that would address clinicians’ questions regarding the impact of their specific intervention, highlight best practices for home-based services, and further the infant-parent psychotherapy field.
“The process of working together to develop the study, – academic researchers and community clinicians, was central to our project,” Paris said. “Ultimately, these types of collaborations produce the most valid and useful findings.”
The treatment approach studied in the article has two major goals: reduction of PPD and improvement in the mother-infant relationship. Results demonstrate that Early Connections shows promise in both aims, improvement on mothers’ self-reports of psychological distress and positive changes in mother-infant interactions. Linking the two was a mother’s’ improved perception of her own parenting experience. If she felt better as a mother, more attuned to her baby and skilled at caring for him, she tended to feel less distressed and the mother-infant interactions were improved.
“We believe that dyadic therapy with mothers and babies has the potential to ameliorate the distress caused by the PPD for the individual mother and also to help her improve her relationship with her baby,” Paris said. “Individual treatments can’t take on both of these crucial issues.”
– Jason L. London