An Open Trial of Web-Based Mindfulness-Based Cognitive Therapy for Perinatal Women at Risk for Depressive Relapse

https://doi.org/10.1016/j.cbpra.2016.02.002Get rights and content

Highlights

  • Prevention of depressive relapse among at-risk pregnant women is important.

  • Web-based Mindful Mood Balance program acceptable among at-risk pregnant women.

  • Multiple benefits, opportunities for Mindful Mood Balance program enhancement reported in exit interviews.

  • Minimal to mild depression symptom severity sustained during participation.

Abstract

Depression occurring during pregnancy and postpartum (i.e., the perinatal period) is common and associated with adverse outcomes for women and their offspring. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce risk for depressive relapse among at-risk individuals generally, and recent adaptations document the efficacy of MBCT among perinatal women specifically. In addition, MBCT, when delivered using a web-based format (Mindful Mood Balance [MMB] program), has demonstrated acceptability and feasibility for at-risk individuals generally. The aim of the present open trial study was to examine the feasibility, acceptability, and preliminary outcomes of MMB for use with pregnant women at risk for depressive relapse (N = 37). We predicted that MMB would be feasible and acceptable as assessed by session completion and participation in phone coaching calls, home practice completion, and self-reported satisfaction via questionnaire and interview. We also predicted that women would not demonstrate significant worsening of depression symptom severity during MMB, consistent with our focus on prevention. A brief case example based on a composite of participants is presented to illustrate the MMB structure and content and the phone coaching protocol. Participants demonstrated engagement with the program, reported perceiving benefits in the intended depression prevention targets of MMB, and sustained minimal to mild depressive symptom severity over the course of the program. Given these promising results and the potential benefits of averting depression for women and their families, further development and rigorous testing of MMB among at-risk pregnant women is warranted.

Section snippets

Participants and Procedures

The study protocol was approved by the Institutional Review Boards at University of Colorado Boulder, Kaiser Permanente Colorado, and HealthPartners Institute for Education and Research in Minnesota. All participants provided written informed consent. Participants were recruited from the Boulder community from April 2013 to December 2013 via online resources (e.g., local listservs, Craigslist), and flyers posted at local medical settings or retail stores catering to pregnant women. Participants

Participant Enrollment and Flow

Rates of enrollment and participant flow are presented in a CONSORT diagram in Figure 1. Detailed here are specific reasons that women declined participation or were ineligible. Of the 123 women who completed a phone screen, reasons for ineligibility were no history of major depression (n = 28), currently depressed (n = 10), technical barriers (n = 2), serious mental illness (n = 1), and miscarriage before intake (n = 1). Reasons for decline at phone screen included the time commitment (n = 8), dealing

Discussion

The current study examined the feasibility and preliminary outcomes of MMB among pregnant women at risk for depressive relapse. Results provide support for MMB as a feasible and acceptable option for perinatal women, which may be associated with the prevention of depressive relapse. Women at risk for depressive relapse sustained minimal to mild depressive symptom severity over the course of the intervention.

The majority of participants (57.76%) in the current study completed the MMB program,

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  • Cited by (0)

    Jennifer N. Felder is now at University of California, San Francisco. We acknowledge funding by a University of Colorado Boulder Beverly Sears Graduate Student Grant (PI: Felder). We would also like to acknowledge the important work of study team members including Brittany Weeks, Kaitlyn Haak, Alison Conner, Chelsea Neely-Holt, Ellen Arkfeld, Marcia Hayes, Dani Rein, and Elisabeth Seburg. This article is based on Jennifer N. Felder’s doctoral dissertation at University of Colorado Boulder.

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