Change Mechanisms in Brief Interpersonal Psychotherapy for Women With Perinatal Depression: Qualitative Study. 2021

Nancy K Grote, and Mary Jane Lohr, and Mary C Curran, and Meg Cristofalo
School of Social Work (Grote, Lohr, Curran), Department of Child, Family, and Population Health Nursing (Lohr), and Department of Rehabilitation Medicine (Curran), University of Washington, Seattle; Department of Social Work, Seattle University, Seattle (Cristofalo).

OBJECTIVE Brief interpersonal psychotherapy (IPT-B) has been shown to be effective in treating perinatal depression and in preventing depressive relapse among socioeconomically disadvantaged women. Yet, it is unclear how IPT-B alleviates depression. Previous research has suggested four possible change mechanisms derived from IPT's interpersonal model: decreasing interpersonal stress, facilitating emotional processing, improving interpersonal skills, and enhancing social support. This study explored how women who received IPT-B or enhanced maternity support services (MSS-Plus) evaluated their respective experiences. METHODS A qualitative study was conducted with 16 women who had been recruited from public health clinics to participate in a larger, randomized controlled trial of women with major depression or dysthymia and who had been assigned to receive IPT-B or MSS-Plus. The sample was 63% non-Hispanic White, had an average age of 31.6 years, and was balanced in intervention group assignment, posttraumatic stress disorder status, and depression improvement. Telephone interviews included semistructured, open-ended questions eliciting participants' experiences with depression treatment. Predetermined, conceptually derived codes were based on the four postulated IPT change mechanisms. RESULTS Thematic coded excerpts were collected and discussed. Excerpts lent support to the role of IPT-B in helping women decrease their interpersonal stress; identify, reflect on, and regulate their emotions; and improve their social skills. Evidence for increasing social support was mixed but highlighted the importance of the therapeutic relationship. CONCLUSIONS Including qualitative findings into training in public health and other clinical settings will help illuminate the role of the provider in facilitating the change mechanisms that may lead to improved mental health among clients.

UI MeSH Term Description Entries
D007398 Interpersonal Relations The reciprocal interaction of two or more persons. Social Relationships,Husband-Wife Communication,Partner Communication,Communication, Husband-Wife,Communication, Partner,Husband Wife Communication,Husband-Wife Communications,Interpersonal Relation,Partner Communications,Relation, Interpersonal,Relationship, Social,Social Relationship
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011613 Psychotherapy A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. Psychotherapies
D011614 Psychotherapy, Brief Any form of psychotherapy designed to produce therapeutic change within a minimal amount of time, generally not more than 20 sessions. Short-Term Psychotherapy,Brief Psychotherapy,Psychotherapy, Short-Term,Solution-Focused Brief Therapy,Brief Psychotherapies,Brief Therapies, Solution-Focused,Brief Therapy, Solution-Focused,Psychotherapies, Brief,Psychotherapies, Short-Term,Psychotherapy, Short Term,Short Term Psychotherapy,Short-Term Psychotherapies,Solution Focused Brief Therapy,Solution-Focused Brief Therapies,Therapies, Solution-Focused Brief,Therapy, Solution-Focused Brief
D003863 Depression Depressive states usually of moderate intensity in contrast with MAJOR DEPRESSIVE DISORDER present in neurotic and psychotic disorders. Depressive Symptoms,Emotional Depression,Depression, Emotional,Depressive Symptom,Symptom, Depressive
D003865 Depressive Disorder, Major Disorder in which five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Symptoms include: depressed mood most of the day, nearly every daily; markedly diminished interest or pleasure in activities most of the day, nearly every day; significant weight loss when not dieting or weight gain; Insomnia or hypersomnia nearly every day; psychomotor agitation or retardation nearly every day; fatigue or loss of energy nearly every day; feelings of worthlessness or excessive or inappropriate guilt; diminished ability to think or concentrate, or indecisiveness, nearly every day; or recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt. (DSM-5) Depression, Involutional,Major Depressive Disorder,Melancholia, Involutional,Paraphrenia, Involutional,Psychosis, Involutional,Depressive Disorders, Major,Involutional Depression,Involutional Melancholia,Involutional Paraphrenia,Involutional Paraphrenias,Involutional Psychoses,Involutional Psychosis,Major Depressive Disorders,Paraphrenias, Involutional,Psychoses, Involutional
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000079062 Interpersonal Psychotherapy Interpersonal modification of psychodynamic psychotherapy. Therapy is present-focused and seeks to resolve problems in interpersonal relations. Aspects of attachment theory are used to analyze how past relationships affect current relationships. Psychotherapy, Interpersonal
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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