The purposes of this project were to (a) provide a nonpharmacologic,
evidence-based intervention for first-time
mothers at risk for PPD and to (b) determine if women’s
scores in the EPDS change after participation in the intervention.
The intervention was an 8-week, short-term psychotherapy
group offered by an advanced practice psychiatric
nurse to first-time mothers. The project was approved by the
Institutional Review Board for protection of all participants.
Sample. A total of 202 women gave birth on the postpartum
unit during the 3-week recruitment period for this project. All
202 women completed the EPDS, and 24 women were then
recruited for participation in the project. All 24 women completed
EPDS within 3 days after having given birth to their
first child and had a score of 11 or higher on the EPDS.Ascore
of 11 or higher triggered a psychiatric evaluation, which was
established by hospital policy to determine fitness for discharge
from the postpartum unit. After completing a psychiatric
screening, eligible women were approached by a
postpartum nurse to determine if they were interested in participating
in the group psychotherapy intervention. These eligible
women then discussed their interest with the advanced
practice psychiatric nurse whowould be leading the intervention
groups, and the women were given details about the
groups. Sixteen (Table 1) of the 24 women chose to participate
in one of two short-term psychotherapy intervention
groups.
The age range of participants was between 20 and 38,with a
mean age of 28.5 years. More than 68% of the women were
between 26 and 30 years old. Thirteen, or 81.25%, of the
women were married; two women had a significant other;
and one woman was single. The majority of the women were
Catholic (62.5%), and all 16 women were Caucasian. More
than 92% had at least a high school education,with more than
86% having completed a 4-year college degree. Ten (62%) of
the women worked outside their homes in a variety of professional,
technical, and service industry roles.
With regard to previous mental health treatment, six participants
(37.5%) had some experience with previous mental
health treatment.Fourwomen had participated in counseling
or psychotherapy, and two women had used psychotropic
medications previously. None of the participants had previously
been hospitalized for psychiatric treatment.None of the
women were taking psychotropic medication during the
intervention. Six of the participants had been previously diagnosedwith
depression. All 16women had given birthwithin 1
month before the start of the group intervention, with 5
women giving birth to male children and 11 giving birth to
female children.
Women who did not participate decided against participation
because of childcare issues, concerns about length of the
commitment to the group, and/or lack of interest in participating
in a group-related activity. Each participant was
randomly assigned to one of the two short-term group psychotherapy
intervention groups. The remaining women who
did not meet the criteria for participation or who decided not
to participate in the intervention were referred to other
mental health services within the community. Screening for
the project took place inMay 2010.