Treating postpartum depression in rural veterans using internet delivered CBT: program evaluation of MomMoodBooster

Solness, Cara L.; Kroska, Emily B.; Holdefer, Paul J; O’Hara, Michael W.

doi:10.1007/s10865-020-00188-5

Cited by 10 publications

(13 citation statements)

References 57 publications

(86 reference statements)

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“…The MMB library also includes articles on relaxation, problem solving, and getting support for parenting (for further details on the development of the program, see the study by Danaher et al [ 41 ]). As described in earlier publications [ 42 , 43 , 60 , 61 ], to encourage optimal engagement and resulting behavior change [ 57 ], although the intervention can be accessed and used on smartphones, MMB was designed and optimized for use on desktop computers, laptops, and tablets and designed to function on popular browsers for both Windows PCs and Mac computers.…”

Section: Methodsmentioning

confidence: 99%

Internet and Face-to-face Cognitive Behavioral Therapy for Postnatal Depression Compared With Treatment as Usual: Randomized Controlled Trial of MumMoodBooster

Milgrom¹,

Danaher²,

Seeley³

et al. 2021

J Med Internet Res

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Background Previous research has confirmed that symptoms of postnatal depression (PND) can be ameliorated through internet-delivered psychological interventions. Advantages of internet-delivered treatment include anonymity, convenience, and catering to women who are unable to access face-to-face (FTF) treatments. To date, no research has examined the efficacy of such interventions compared directly with FTF treatments in women clinically diagnosed with PND. Objective This study aims to compare the efficacy of one of the first web-based cognitive behavioral therapy (CBT) interventions (internet CBT+coach calls) for PND (MumMoodBooster [MMB]) with FTF-CBT in a randomized controlled trial (RCT). Methods In this study, 116 postnatal women with a Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition (DSM-IV) diagnosis of major or minor depression were randomized to MMB (39/116, 33.6%), FTF-CBT (39/116, 33.6%), or a treatment-as-usual (TAU) control condition (38/116, 32.8%). Diagnostic status was determined at baseline and at 21-week follow-up using the Structured Clinical Interview for the DSM-IV. Severity of anxiety and depressive symptoms was evaluated using the Depression Anxiety Stress Scales and the revised Beck Depression Inventory at baseline, 12-week follow-up (after treatment), and 21-week follow-up. Results Of the 116 participants, 107 (92.2%) had a diagnosis of major depression at baseline. Rates of remission from a major or minor depressive episode at 21 weeks in both the FTF-CBT and MMB groups were superior to that of the TAU group (56.6% and 47.7% less likely to be depressed, respectively) and they were not significantly different from each other. Although remission rates differed between TAU and FTF-CBT, growth models showed that, in terms of symptom reduction across time, the FTF-CBT treatment was not significantly better than TAU. By comparison, MMB was statistically superior to both TAU and FTF-CBT in reducing symptoms of depression, anxiety, and stress from baseline to the 21-week follow-up (large and moderate effect sizes). Thus, after 21 weeks, the average symptom scores for depression and anxiety of women receiving MMB were approximately half those of women in both the TAU and FTF-CBT groups. Conclusions In this RCT, MMB was at least as effective as FTF-CBT in achieving remission from a diagnosed PND episode. MMB was superior to TAU and FTF-CBT in encouraging and maintaining reduction of symptom severity over the 21-week follow-up for depressed postnatal women. These findings replicate results of prior studies on MMB that showed clinically significant improvements in depressive symptoms, and they provide direct empirical support that internet-delivered treatment for depressed postnatal women is a viable alternative to FTF treatment. The generalizability of the results needs to be examined in future research, as RCTs of internet-based versus FTF treatments necessarily involve a subset of people who are willing to undertake either modality of treatment. Trial Registration Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12613000881730; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364683&isReview=true

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Section: Methodsmentioning

confidence: 99%

Internet and Face-to-face Cognitive Behavioral Therapy for Postnatal Depression Compared With Treatment as Usual: Randomized Controlled Trial of MumMoodBooster

Milgrom¹,

Danaher²,

Seeley³

et al. 2021

J Med Internet Res

View full text Add to dashboard Cite

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“…As a result, it can be inferred that internet CBT helps mothers in the intervention group feel less depressed than mothers in the control group. 14 There is currently an innovative increase in internet-based interventions. According to a study related to internet-based treatment, they found that patients who can attend treatment responsibly can benefit more from Internet-based treatment.…”

Section: Discussmentioning

confidence: 99%

Internet Cognitive Behavior Therapy for Postpartum Depression

Rahmawati

2023

JPPBR

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Background: Postpartum depression (PPD) occurs in 25-50% of those affected with 10-15% of postpartum mothers each year having depressive symptoms that last more than 6 months. PPD is an important public health issue because of its chronic and long-term effects that have significant detrimental effects on mothers, their families, and their child's development. The primary treatments for PPD have included psychological interventions such as physical counseling, interpersonal psychotherapy (IPT), cognitive behavior training (CBT), and problem-focused counseling. However, there is no information about how efficient and suitable these approaches are for postpartum depression. Objective: This study aimed to examine the efficacy of internet cognitive behavior therapy for postpartum depression. Methods: A systematic review is a method of study. An extensive search was conducted in Google Scholar, ScienceDirect, Medline, and PubMed to locate detailed indexed articles. The search included articles published, in the last 5 years, from 2015 to 2020. Results: All 5 studies were Randomized Controlled Trials (RCT) studies, with a total of 481 participants. PPD measurements using self- evaluation scales for depression and structured clinical interviews. Three studies used application programs are MumMoodBooster and one study used Therapist and Be a Mom combined CBT program. Conclusion: The study looked at the impact of internet CBT on PPD reduction. When compared to the TAU (control group), the findings of this 5 study showed that internet CBT could lower the EPDS score of all mothers in the intervention group (iCBT). Keywords: cognitive behavior therapy, depression, postpartum.

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“…The program from which these data were collected consisted of 6 self-directed, postpartum-specific, web-based CBT–based modules and 6 weekly concurrent phone coaching calls. A previous study described quantitative metrics of engagement and outcomes and provided further information regarding the methods of the intervention study [ 35 ]. On average, veterans engaged in 3.35 coaching calls and spent an average of 49.19 minutes on the phone with their coach over the course of their engagement with the program.…”

Section: Introductionmentioning

confidence: 99%

“…On average, veterans engaged in 3.35 coaching calls and spent an average of 49.19 minutes on the phone with their coach over the course of their engagement with the program. Effect sizes for depressive symptoms, behavioral activation, and automatic thoughts were large [ 35 ]. Because alliance effects for IPIs have been attributed to participant relationships with the IPI programs in some studies [ 19 , 28 ], this analysis quantifies the frequency of responses related to each for comparison.…”

Section: Introductionmentioning

confidence: 99%

Relationship Factors in Internet-Delivered Psychological Interventions for Veterans Experiencing Postpartum Depression: Qualitative Analysis

et al. 2023

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Background Internet-delivered psychological interventions (IPIs) have been shown to be effective for a variety of psychological concerns, including postpartum depression. Human-supported programs produce better adherence and larger effect sizes than unsupported programs; however, what it is about support that affects outcomes is not well understood. Therapeutic alliance is one possibility that has been found to contribute to outcomes; however, the specific mechanism is not well understood. Participant perspectives and qualitative methodology are nearly absent from the IPI alliance research and may help provide new directions. Objective In this study, we aimed to provide participant perspectives on engagement with an IPI for postpartum depression to help inform alliance research, development of new IPIs, and inform resource allocation. Methods A qualitative methodology was used to explore participant perspectives of veteran women’s engagement with the MomMoodBooster program, a human-supported internet-delivered intervention for postpartum depression. Participants were asked 4 open-ended questions with the 3-month postintervention survey, “In what ways did you find the MomMoodBooster most helpful?” “How do you think the MomMoodBooster could have been improved?” “In what ways did you find the personal coach calls to be helpful?” and “How do you think the personal coach calls could have been improved?” Results Data were collected from 184 participants who responded to at least 1 of the open-ended questions. These were analyzed using thematic analysis and a process of reaching a consensus among coders. The results suggest that not only the engagement with the support person is perceived as a significant contributor to participant experiences while using the MomMoodBooster content but also the relationship factors are particularly meaningful. The results provide insights into the specific qualities of the support person that were perceived as most impactful, such as warmth, empathy and genuineness, and feeling normalized and supported. In addition, the results provide insight into the specific change processes that can be targeted through support interactions, such as encouraging self-reflection and self-care and challenging negative thinking. Conclusions These data emphasize the importance of relationship factors between support persons and an IPI program for postpartum depression. The findings suggest that focusing on specific aspects of the alliance and the therapeutic relationship could yield fruitful directions for the training of support personnel and for future alliance-based research of internet-delivered treatments.

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Treating postpartum depression in rural veterans using internet delivered CBT: program evaluation of MomMoodBooster

Abstract: We especially thank Danaher and Tyler for their work in adapting the program to fit the requirements of our VA trial and for providing support/training.

Cited by 10 publications

References 57 publications

Internet and Face-to-face Cognitive Behavioral Therapy for Postnatal Depression Compared With Treatment as Usual: Randomized Controlled Trial of MumMoodBooster

Internet and Face-to-face Cognitive Behavioral Therapy for Postnatal Depression Compared With Treatment as Usual: Randomized Controlled Trial of MumMoodBooster

Internet Cognitive Behavior Therapy for Postpartum Depression

Relationship Factors in Internet-Delivered Psychological Interventions for Veterans Experiencing Postpartum Depression: Qualitative Analysis

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