JMIR Publications

ABSTRACT

Background:

Depression and anxiety during the postpartum period are common, with psychotherapy being the preferred method of treatment. However, psychological, physical, and social barriers prevent women from receiving appropriate and timely psychotherapy. The option of receiving psychotherapy through videoconferencing (VC) during the postpartum period presents an opportunity for women to have more accessible and flexible care.

Objective:

The objective of the pilot RCT was to assess the feasibility, acceptability, and preliminary effectiveness of the option of VC psychotherapy in addition to TAU during the postpartum period.

Methods:

We conducted a pilot randomized controlled trial with 1:1 randomization to treatment as usual (TAU) with office-based care or treatment as usual with the option of VC (TAU-VC) for psychotherapy during the postpartum period. We assessed the ability to recruit and retain postpartum women into the study from an urban mental health program offering postpartum psychotherapy, and evaluated the uptake, acceptability and satisfaction with VC as an addition to in person psychotherapy. We also compared therapy attendance and symptoms between groups. Symptoms were assessed at baseline and 3-months post randomization with the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7-Item (GAD-7), and Parental Stress Scale (PSS). 3-month scores were compared between groups with intention-to-treat linear mixed effects models controlling for baseline score.

Results:

We enrolled 38 participants into the study; 19 in each treatment group. Attendance data were available for all participants, with follow-up symptom measures available for 25 (65.8%). Among the 19 TAU-VC participants, 14 (74%) utilized VC at least once. The majority of participants were highly satisfied with the VC option, and reported an average savings of $26CAD and 2.5 hours in travel and childcare expenses and time. There were no significant differences between the two groups for psychotherapy attendance or symptoms.

Conclusions:

The option of VC appears to be an acceptable method of receiving psychotherapy for postpartum women with benefits described in costs and time savings. Based on this small pilot sample, there were no significant differences in outcomes between usual care and the option of VC. This study has demonstrated the feasibility of such a program in an urban centre, which suggests that a larger study would be beneficial to provide more conclusive evidence.