The Mood Disorders Centre at the University of Exeter, in collaboration with Netmums and Shake Creative, has developed and refined an online Cognitive Behavioural Therapy (CBT) and Behavioural Activation intervention for postnatal depression (PND).
About one in ten mothers in the UK experience postnatal depression. It usually develops four to six weeks after childbirth, but, in some cases, can take several months. There are many symptoms, including difficulty sleeping, low mood and feeling unable to cope. A number of studies have demonstrated that PND can impact on sensitivity to the baby’s needs, meaning their wellbeing can be affected too. However, only 15-30% of women seek help for the condition.
Cognitive Behavioural Therapy and Behavioural Activation involve strategies that help people suffering from depression to reengage with meaningful and healthy behaviours. Due to long waiting lists and the need for child care, some CBT treatment is heavily delayed. Pilot work has been conducted to study the impact of internet based CBT, which can be carried out at the patient’s convenience and in the privacy of their own home. Mothers in the pilot trial also have access to Supporters who provide assistance with material via telephone and email.
In Devon and Cornwall, it is estimated that approximately 1,281 women will suffer from PND every year.
Dr Heather O'Mahen at the Mood Disorders Centre compared the impact of an online intervention of Behavioural Activation supported by mental health workers via telephone to treat symptoms of PND. The treatment was compared to "real world" treatment as usual, which normally includes a GP visit and depression screening and two further health visitor check-ups. The project monitored the impact of the intervention on the symptoms of PND and the wellbeing of the women.
Women were recruited from Netmums for treatment. The online intervention was developed with service users. In order to see if the treatment had a lasting impact on the women who participated in the trial, information about women's mood and wellbeing 6 and 12 months after the trial was also collected. Women in the trial also participated in interviews in order to feedback on their experiences of the treatment and the research trial.
The initial project is now complete with results showing that women receiving the online treatment for PND liked the treatment. Importantly, women who received the treatment saw, and were able to sustain, an improvement in their symptoms during the 16-month follow-up period.
Adapted versions of the programme are now being used in Torbay and Devon. Netmums is also making the treatment available to its 1,000,000 members. Furthermore, the study will be included in the new revision of NICE's Antenatal and Postnatal Depression Guidelines.