GROUP PSYCHOTHERAPY FOR FIRST‐TIME MOTHERS AT RISK FOR POSTPARTUM DEPRESSION

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Overview of the article

• The article’s objective was to implement 8-week short-term group psychotherapy as a nonpharmacological evidence-based intervention for first-time mothers who have high chances of developing postpartum depression (PPD). It will determine if these first moms partake in the group therapy; their Edinburgh Postnatal Depression Scale (EPDS) score will change.
• Postpartum depression (PPD) is an emotional and mental disorder newly delivered mothers go through after having babies. The disorder requires immediate recognition to initiate appropriate medical and pharmacological interventions to prevent further complications.

Postpartum depression (PPD) is a common complication of childbearing associated with a mood disorder that develops within a couple of weeks of delivery. Symptoms include tiredness, lack of energy, inability to eat adequately, lack of interest in caring for self, the baby, and other activities. Further signs include losing or gaining weight, unable to sleep properly or adequately, and suicidal ideations or tendencies (Dlamini, Mahanya, Dlamini & Shongwe, 2019). PPD has a significant adverse effect on the mother to interact appropriately with her child resulting in an inability to care for herself and the baby. To prevent PPD, It is of great importance to scrutinize newly delivered moms early immediately following delivery to identify women with predisposing factors that can lead to PPD and initiate prompt and efficient treatment. Encouraging women to participate in group psychotherapy will serve as a nonpharmacological intervention that is effective and evidenced-based in decreasing the chances of developing postpartum depression (Pessagno & Hunker, 2013).

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Group Discussed/Participants/Reasons for selection

• Affected group are Women within age group of 20 and 38 and fist-time moms.
• The participants were 24 women
• All 24 women completed the Edinburgh Postnatal Depression Scale within three days of childbearing with a score of 11 or higher on the EPDS, which necessitate the need for psychiatric evaluation.
• All are first-time mom and are at risk of experiencing PPD

 

 

The group that qualifies to participate in the psychotherapy is first-time new moms who just delivered new babies and 24 in number. The psychotherapy will last for eight weeks and will serve as a platform for moms with high chances of developing PPD to socialize among themselves.

 

The postpartum period starts immediately following childbirth to the first six weeks after delivery, including significant hormonal changes (Sharma & Sherkhane, 2018). These 24 newly delivered first-time moms completed the Edinburgh Postnatal Depression Scale (EPDS) within three days after giving birth.

 

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Setting of the Group, Frequency and Duration of the therapy

• The setting was a community hospital in New Jersey. The hospital maintains the policy of screening all postpartum moms for PPD within 72 hours post delivery.
• The group comprises of eight women that meets every week for eight weeks.
• The therapy session commences from one month of discharge from the hospital with a duration of 90 minutes per therapy session.

These 24 newly delivered first-time moms have a minimum score of 11 on the EPDS. According to the hospital policy, a mom with an 11 or higher score in EPDS will need psychiatric evaluation for the hospital to determine that mom is fit for discharge from postpartum unit.

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Curative Factors/Exclusion Criteria

• The Curative factors to this group include to provide adequate support and instill hope and knowledge about postpartum depression in new mothers.
• Ensure stable and steady financial security
• Ensure there is an absence of underlining mental health problems and complications of childbirth.
• Exclusion criteria include women with childcare issues, women that are worried about the length of commitment to the therapy and women with no interest in group related activities.

Women with careers that ensure a stable and steady income source can afford to provide care and other financial expenses, thereby ensuring a typical postpartum experience with a decreased risk of PPD. While consequences of inadequate income sources, lack of a job, financial constraint, and poverty can lead to mental ill-health (Dlamini, Mahanya, Dlamini & Shongwe, 2019). Women who have their babies naturally with no complications and have no predisposing factors to emotional or mental instability are more satisfied and contented with lower chances of developing PPD (Ezzeddin, Jahanihashemi, Zavoshy & Noroozi, 2018).

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Outcomes of Study and Translation into Practice

• The outcome indicates a significant decrease in the EPDS score (less than 11).
• Women with low EPDS score most likely, may not develop postpartum depression.
• Other literature written by other researchers supports the findings of this study as an evidence-based practice.
• The outcome of this study can be implemented/utilized clinically in my client group.

 

At the end of the study, the result shows that lower numbers on the EPDS scores (less than 11); the implication is that moms with lower numbers on their EPDS scores may not develop PPD. The outcome of this study supports the use of group therapy as an approach or intervention to provide nonpharmacological intervention to first-time moms that may likely develop PPD to eliminate stigma. The outcome of this study also supports the use of group psychotherapy as a tool to scrutinize newly delivered moms immediately following delivery to identify on-time women with predisposing factors that can lead to PPD and initiate prompt and efficient treatment (Pessagno & Hunker, 2013).

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Limitations of the Study

• The use of nondirective group process style that allows members of the group to focus more on relationship
• Though the study has some limitations; it will not impact the ability to utilize the findings of the study
• The benefits outweigh the shortcomings because one of the outcomes is developing a psychotherapy group that is evidence-based in lowering chances of PPD in first time moms that are just delivered.

The shortcomings of this study will not limit implementing positive outcomes in a clinical setting. Studies from other researchers support the findings’ results based on the available evidence (Pessagno & Hunker, 2013).

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References

• • Dlamini, L. P., Mahanya, S., Dlamini, S. D., & Shongwe, M. C. (2019). Prevalence and factors associated with postpartum depression at a primary healthcare facility in Eswatini. South African Journal of Psychiatry, 25(1), 1-7.
  • Ezzeddin, N., Jahanihashemi, H., Zavoshy, R., & Noroozi, M. (2018). The Prevalence of Postpartum Depression and Its Association with Food Insecurity among Mothers Referring to Community Health Centers. Iranian journal of psychiatry, 13(4), 280.
  • Pessagno, R. A., & Hunker, D. (2013). Using Short‐Term Group Psychotherapy as an Evidence‐Based Intervention for First‐Time Mothers at Risk for Postpartum Depression. Perspectives in psychiatric care, 49(3), 202-209.
  • Sharma, P., & Sherkhane, M. S. (2018). Prevalence and risk factors of postpartum depression in women–a cross-sectional study.

 

 

 

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Postpartum depression (PPD) is a common complication of childbearing associated with a mood disorder that develops within a couple of weeks of delivery. Symptoms include tiredness, lack of energy, inability to eat adequately, lack of interest in caring for self, the baby, and other activities. Further signs include losing or gaining weight, unable to sleep properly or adequately, and suicidal ideations or tendencies (Dlamini, Mahanya, Dlamini & Shongwe, 2019). PPD has a significant adverse effect on the mother to interact appropriately with her child resulting in an inability to care for herself and the baby. To prevent PPD, It is of great importance to scrutinize newly delivered moms early immediately following delivery to identify women with predisposing factors that can lead to PPD and initiate prompt and efficient treatment. Encouraging women to participate in group psychotherapy will serve as a nonpharmacological intervention that is effective and evidenced-based in decreasing the chances of developing postpartum depression (Pessagno & Hunker, 2013).

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The group that qualifies to participate in the psychotherapy is first-time new moms who just delivered new babies and 24 in number. The psychotherapy will last for eight weeks and will serve as a platform for moms with high chances of developing PPD to socialize among themselves.

 

The postpartum period starts immediately following childbirth to the first six weeks after delivery, including significant hormonal changes (Sharma & Sherkhane, 2018). These 24 newly delivered first-time moms completed the Edinburgh Postnatal Depression Scale (EPDS) within three days after giving birth.

 

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These 24 newly delivered first-time moms have a minimum score of 11 on the EPDS. According to the hospital policy, a mom with an 11 or higher score in EPDS will need psychiatric evaluation for the hospital to determine that mom is fit for discharge from postpartum unit.

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Women with careers that ensure a stable and steady income source can afford to provide care and other financial expenses, thereby ensuring a typical postpartum experience with a decreased risk of PPD. While consequences of inadequate income sources, lack of a job, financial constraint, and poverty can lead to mental ill-health (Dlamini, Mahanya, Dlamini & Shongwe, 2019). Women who have their babies naturally with no complications and have no predisposing factors to emotional or mental instability are more satisfied and contented with lower chances of developing PPD (Ezzeddin, Jahanihashemi, Zavoshy & Noroozi, 2018).

*

 

At the end of the study, the result shows that lower numbers on the EPDS scores (less than 11); the implication is that moms with lower numbers on their EPDS scores may not develop PPD. The outcome of this study supports the use of group therapy as an approach or intervention to provide nonpharmacological intervention to first-time moms that may likely develop PPD to eliminate stigma. The outcome of this study also supports the use of group psychotherapy as a tool to scrutinize newly delivered moms immediately following delivery to identify on-time women with predisposing factors that can lead to PPD and initiate prompt and efficient treatment (Pessagno & Hunker, 2013).

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The shortcomings of this study will not limit implementing positive outcomes in a clinical setting. Studies from other researchers support the findings’ results based on the available evidence (Pessagno & Hunker, 2013).