A Therapeutic Playgroup for Depressed Mothers and Their Infants: Feasibility Study and Pilot Randomized Trial of Community Hugs

Abstract

Symptoms of depression negatively impact on mother-infant relationships and child outcomes. We evaluated a novel, 10-session mother-infant therapeutic playgroup-Community HUGS (CHUGS)-which combines cognitive and experiential components through psychoeducation, play, music, and movement. Participants were mothers experiencing a range of postnatal mental health difficulties, including depression, with infants ≤12 months of age. However, the aim was not to treat maternal depression but to ameliorate associated problems in the mother-infant interaction. In the feasibility study, all participants received CHUGS. In the pilot randomized controlled trial (RCT), participants were randomized between intervention and a wait-list. Outcomes were the Parenting Stress Index (PSI; R.R. Abidin, 1995), Parenting Sense of Competency Scale (Self-Efficacy subscale; J. Gibaud-Wallston & L.P. Wandersman, 1978), and the Depression, Anxiety, Stress Scales (P.F. Lovibond & S.H. Lovibond, 1995). In the feasibility study (n = 74), PSI scores dropped on all subscales, all ps < .01. Depression, p < .001, anxiety, p = .01, stress, p = .01, and self-efficacy, p < .001, all showed improvements, as did observer-rated mother-infant interactions, p < .001. In the RCT, depression, p < .001, anxiety, p = .005, and stress, p < .001, symptoms were significantly reduced for intervention participants (n = 16), as compared to wait-list participants (n = 15). The CHUGS program had high participant satisfaction and produced improvements in self-efficacy, depression, anxiety, stress, and mother-infant interactions that supported the program's acceptability and the utility of further rollout.

Effects of parenting interventions for mothers with depressive symptoms and an infant: systematic review and meta-analysis

“…59,60 Three studies were excluded because of insufficient numeric data [62][63][64] and one study was excluded because of unacceptably high risk of bias. 65 Table 2 presents participant characteristics. No studies started during pregnancy.…”

“…60 One study was excluded from the review because of an unacceptably high risk of bias caused by lack of assessor masking and high risk of bias in relation to ‘incomplete outcome data addressed’. 65…”

“…60 One study was excluded from the review because of an unacceptably high risk of bias caused by lack of assessor masking and high risk of bias in relation to 'incomplete outcome data addressed'. 65 The outcomes included in the meta-analysis on the parentchild relationship were characterised by low-to-medium and unclear risk of bias domain. In three of these studies, 52,56,59 the risk of bias domains of the outcomes were assessed as relatively low (1-2) or unclear risk of bias.…”

A review and analysis of the components of potentially effective perinatal mental health interventions for infant development and mother-infant relationship outcomes

“…Figure 2 presents an overview of the quality of included studies. Twelve of the sixteen included studies reported the use of a randomised controlled trial (RCT) design (Challacombe et al, 2017;Ericksen et al, 2018;Fonagy et al, 2016;Goodman et al, 2015; PERINATAL MENTAL HEALTHCARE: REV INFANT OUTCOMES. 10 Letourneau et al, 2011;Murray et al, 2003;Onozawa et al, 2001;Puckering et al, 2010;Onozawa et al, 2001;Puckering et al, 2010;Stein et al, 2006;Tambelli et al, 2015;Tsivos et al, 2015;van Doesum et al, 2008), although four of these studies did not include adequate concealment of the allocation process in their design (Letourneau et al, 2011;Murray et al, 2003;Onozawa et al, 2001;Tambelli et al, 2015).…”

Children Are Born to Dance! Pediatric Medical Dance/Movement Therapy: The View from Integrative Pediatric Oncology

“…Elizabeth Loughlin, a dance movement therapist in Australia, has worked extensively with the pediatric population in several contexts. Loughlin offers therapeutic playgroups and individual DMT for depressed and anxious mothers and their infants in the hospital outpatient and psychiatric inpatient settings [64]. She also worked in medical DMT within her social work role in a pediatric hospital setting for over 20 years providing DMT programs for children and adolescents with medical conditions [57,65,66].…”