Cognitive Behavioural Therapy for Postpartum Depression

Overseen By Ryan Van Lieshout, MD, PHD

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: McMaster University

Disqualifiers: Bipolar, Psychotic, Substance use, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 9

Duration: 9 weeks

172 Participants Needed

Trial Summary

What is the purpose of this trial?

The primary objective of this study is to determine if online group cognitive behavioral therapy (CBT) for maternal postpartum depression (PPD) added to treatment as usual (TAU) leads to greater improvements in infant emotion regulation (ER) than maternal receipt of TAU alone immediately post-treatment and 6 months later. This study will also aim to determine what mechanisms PPD treatment leads to changes in infant ER.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It seems like you can continue your usual treatment while participating in the study.

What data supports the effectiveness of the treatment Group Cognitive Behavioural Therapy (CBT) for Postpartum Depression?

Research shows that group cognitive behavioural therapy (CBT) can effectively reduce symptoms of postpartum depression, improve social support, and enhance the mother-infant relationship. Studies indicate that a significant number of women experience meaningful improvements in depressive symptoms and other related areas after participating in group CBT sessions. ^{1 2 3 4 5}

Is group cognitive behavioural therapy (CBT) safe for postpartum depression?

Group cognitive behavioural therapy (CBT) has been studied for postpartum depression and other conditions, and it is generally considered safe for humans. The research shows that it can effectively reduce symptoms of depression, anxiety, and stress, with no significant safety concerns reported. ^{4 5 6 7 8}

How does group cognitive behavioural therapy (CBT) for postpartum depression differ from other treatments?

Group cognitive behavioural therapy (CBT) for postpartum depression is unique because it allows multiple women to receive therapy together, which can reduce costs and waiting times compared to individual therapy. It also provides social support and improves mother-infant bonding and partner relationships, making it a less resource-intensive and more accessible option for many women. ^{2 4 5 8 9}

Research Team

Ryan Van Lieshout, MD, PhD

Principal Investigator

Mcmaster

Eligibility Criteria

This trial is for English-speaking women over 18 living in Ontario with postpartum depression, as indicated by an EPDS score of at least 10. Their infants should be aged between 4-8 months. Women with bipolar disorder, current psychotic disorders, substance abuse issues, or certain personality disorders cannot participate.

Inclusion Criteria

Have an EPDS score of 10 or more

Live in Ontario (the primary WHCC catchment area)

I am a woman aged 18 or older.

Exclusion Criteria

Current psychotic disorder

History of antisocial or borderline personality disorder.

History of substance or alcohol use disorder

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a 9-week online group Cognitive Behavioral Therapy (CBT) intervention for Postpartum Depression (PPD) delivered via Zoom

9 weeks

9 visits (virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessments of maternal anxiety, infant temperament, and emotion regulation

6 months

Treatment Details

Interventions

• Group Cognitive Behavioural Therapy (CBT)

Trial Overview The study tests if adding online group cognitive behavioral therapy (CBT) to the usual treatment helps improve how babies manage their emotions better than just the usual treatment alone. The effects will be checked right after and six months post-treatment.

Participant Groups

Group I: Treatment (9-week online CBT group) Experimental Treatment 1 Intervention

Participants assigned to the treatment group will continue to receive any healthcare they might already be receiving (e.g. family doctor, midwife, Obstetrician/Gynecologist, etc.) and participate in a 9-week group Cognitive Behavioral Therapy (CBT) intervention for Postpartum Depression (PPD) delivered via Zoom by two trained psychologists, social workers, nurses, and/or psychiatrists.

Group II: Control (treatment as usual) Active Control 1 Intervention

The control group will receive standard postnatal care from their obstetrician, midwife, and/or family physician

Who Is Running the Clinical Trial?

McMaster University

Lead Sponsor

Trials

936

Recruited

2,630,000+

Findings from Research

Group support based on cognitive behavioral therapy (CBT) for postnatally depressed mothers significantly improved their self-esteem and self-worth.

This approach addresses barriers to treatment, potentially reducing high dropout rates seen in traditional group or clinic-based therapies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Innovation:CBT-based support groups for postnatal depression. Alexander, P.[2018]

A 9-week group cognitive-behavioral therapy (CBT) intervention delivered by peers significantly reduced symptoms of postpartum depression (PPD) and anxiety in 73 mothers, with improvements remaining stable at a 6-month follow-up.

The intervention also enhanced mother-infant bonding and reduced feelings of rejection and anger, suggesting it not only addresses mental health symptoms but also improves the overall mother-infant relationship.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer-Delivered Cognitive-Behavioral Therapy for Postpartum Depression: A Randomized Controlled Trial. Amani, B., Merza, D., Savoy, C., et al.[2022]

In a study of 34 women with perinatal depression, 80% experienced significant improvement in their depressive symptoms after participating in a 9-week group cognitive behavioral therapy (CBT) program.

The group CBT also led to meaningful improvements in social support, mother-infant bonding, and partner relationship quality, suggesting it is an effective and resource-efficient treatment option for women with perinatal depression and psychiatric comorbidities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the effectiveness of a brief group cognitive behavioural therapy intervention for perinatal depression. Van Lieshout, RJ., Yang, L., Haber, E., et al.[2019]

Cognitive Behavioral Therapy (CBT) is effective in reducing perinatal maternal depression, anxiety, and stress, with significant improvements observed both immediately after treatment and in the long term, based on a meta-analysis of 79 studies.

CBT alone showed strong short-term effects for perinatal anxiety and stress, and long-term benefits for depression and anxiety, indicating its versatility and effectiveness across different treatment modalities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Li, X., Laplante, DP., Paquin, V., et al.[2022]

A one-day cognitive behavioral therapy (CBT) workshop significantly reduced postpartum depression (PPD) scores in 461 mothers and birthing parents, with participants showing three times higher odds of clinically significant improvement compared to those receiving treatment as usual.

The workshop also led to decreased anxiety and improved mother-infant relationships, while being cost-effective, suggesting it could be a valuable addition to perinatal care models.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

In-person 1-day cognitive behavioral therapy-based workshops for postpartum depression: a randomized controlled trial. Van Lieshout, RJ., Layton, H., Savoy, CD., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Public Health Nurse-delivered Group Cognitive Behavioural Therapy for Postpartum Depression: A Randomized Controlled Trial. [2023]

2. England pubmed.ncbi.nlm.nih.gov

Innovation:CBT-based support groups for postnatal depression. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Peer-Delivered Cognitive-Behavioral Therapy for Postpartum Depression: A Randomized Controlled Trial. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Is group cognitive behaviour therapy for postnatal depression evidence-based practice? A systematic review. [2021]

5. Austria pubmed.ncbi.nlm.nih.gov

Evaluating the effectiveness of a brief group cognitive behavioural therapy intervention for perinatal depression. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. [2022]

7. Austria pubmed.ncbi.nlm.nih.gov

Group treatment for postpartum depression: a systematic review. [2018]

8. England pubmed.ncbi.nlm.nih.gov

Group cognitive behavioural therapy for postnatal depression: a systematic review of clinical effectiveness, cost-effectiveness and value of information analyses. [2021]

9. England pubmed.ncbi.nlm.nih.gov

In-person 1-day cognitive behavioral therapy-based workshops for postpartum depression: a randomized controlled trial. [2023]