Treatment of Depression in Mothers in Home Visitation
| Status: | Completed |
|---|---|
| Conditions: | Depression, Depression |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 16 - 45 |
| Updated: | 10/14/2017 |
| Start Date: | October 2006 |
| End Date: | February 2013 |
This study develops and contrasts In-Home Cognitive Behavioral Therapy (IH-CBT), an adapted
evidence-based treatment for depressed mothers participating in home visitation, with typical
home visitation in which treatment may be obtained in the community. Mothers will be
identified using a two step process consisting of administration of a screen and subsequent
diagnosis of Major Depressive Disorder. The will then be randomized into the treatment and
control conditions. A comprehensive assessment of depression and related areas of functioning
will be administered at pre-treatment, post-treatment, and 3 month follow-up. It is
hypothesized that IH-CBT will lead to broad and durable gains in mood and social support
relative to those in typical home visitation.
evidence-based treatment for depressed mothers participating in home visitation, with typical
home visitation in which treatment may be obtained in the community. Mothers will be
identified using a two step process consisting of administration of a screen and subsequent
diagnosis of Major Depressive Disorder. The will then be randomized into the treatment and
control conditions. A comprehensive assessment of depression and related areas of functioning
will be administered at pre-treatment, post-treatment, and 3 month follow-up. It is
hypothesized that IH-CBT will lead to broad and durable gains in mood and social support
relative to those in typical home visitation.
This study involves the development and preliminarily testing of In-Home Cognitive Behavioral
Therapy (IH-CBT), a psychological treatment grounded in the cognitive model but adapted for
administration in conjunction with home visitation. IH-CBT is designed to (1) use the
techniques and approaches of CBT which have received strong empirical support, (2) be
implemented in the home setting, (3) meet the needs of young postpartum mothers in their
first year of home visitation, and (4) be seamlessly integrated with home visitation to
maximize the likelihood of recovery from depression, prevent relapse, and increase of the
benefits of home visitation. IH-CBT will be delivered by trained therapist who will provide
15 treatment sessions followed by a 1 month booster session. A small-scale randomized
clinical trial will be conducted contrasting IH-CBT delivered in conjunction with home
visitation and home visitation alone ("typical home visitation"—THV). Mothers in the THV
condition will be able to obtain treatment in the community if they choose.
Mothers will be identified based on obtaining a score of ≥12 on the Edinburgh Perinatal
Depression Screen administered by home visitors at 3 months postpartum. Final eligibility
will be determined based on subsequently obtaining a diagnosis of Major Depressive Disorder
(MDD) using the SCID. A comprehensive assessment of depression, other psychiatric symptoms,
social support and network, and parenting and child adjustment will be administered at
pre-treatment, post-treatment, and 3 month follow-up. Ratings of MDD at post-treatment and
follow-up will be conducted by clinicians blind to condition.
The following hypotheses will be tested:
Hypothesis 1. Mothers in IH-CBT will report greater reductions in self-reported and
clinician-rated depression at post-treatment and follow up relative to THV.
Hypothesis 2. Mothers in IH-CBT will report improvements in overall functioning, social
support, social network, and general psychiatric symptomatology at post-treatment and follow
up relative to IH-CBT.
Hypothesis 3. Mothers who recover from depression at post-treatment will report improvements
in parenting and child adjustment relative to those who do not recover.
Therapy (IH-CBT), a psychological treatment grounded in the cognitive model but adapted for
administration in conjunction with home visitation. IH-CBT is designed to (1) use the
techniques and approaches of CBT which have received strong empirical support, (2) be
implemented in the home setting, (3) meet the needs of young postpartum mothers in their
first year of home visitation, and (4) be seamlessly integrated with home visitation to
maximize the likelihood of recovery from depression, prevent relapse, and increase of the
benefits of home visitation. IH-CBT will be delivered by trained therapist who will provide
15 treatment sessions followed by a 1 month booster session. A small-scale randomized
clinical trial will be conducted contrasting IH-CBT delivered in conjunction with home
visitation and home visitation alone ("typical home visitation"—THV). Mothers in the THV
condition will be able to obtain treatment in the community if they choose.
Mothers will be identified based on obtaining a score of ≥12 on the Edinburgh Perinatal
Depression Screen administered by home visitors at 3 months postpartum. Final eligibility
will be determined based on subsequently obtaining a diagnosis of Major Depressive Disorder
(MDD) using the SCID. A comprehensive assessment of depression, other psychiatric symptoms,
social support and network, and parenting and child adjustment will be administered at
pre-treatment, post-treatment, and 3 month follow-up. Ratings of MDD at post-treatment and
follow-up will be conducted by clinicians blind to condition.
The following hypotheses will be tested:
Hypothesis 1. Mothers in IH-CBT will report greater reductions in self-reported and
clinician-rated depression at post-treatment and follow up relative to THV.
Hypothesis 2. Mothers in IH-CBT will report improvements in overall functioning, social
support, social network, and general psychiatric symptomatology at post-treatment and follow
up relative to IH-CBT.
Hypothesis 3. Mothers who recover from depression at post-treatment will report improvements
in parenting and child adjustment relative to those who do not recover.
Inclusion Criteria:
- first-time mother participating in home visitation program
- enrolled in home visitation program for at least 2 months
- 16 years of age or older
- score of 12 or higher on Edinburgh Perinatal Depression Screen at 3 months postpartum
- diagnosis of Major Depressive Disorder using the Structured Clinical Interview for the
Diagnostic and Statistical Manual for Mental Disorders
- English speaking
Exclusion Criteria:
- lifetime history of bipolar disorder, schizophrenia, mental retardation, organic brain
syndrome, antisocial personality disorder
- history of psychosis
- current substance dependence
- current antidepressant use or other mood altering medications and/or current
involvement in psychotherapy
We found this trial at
1
site
3333 Burnet Avenue # Mlc3008
Cincinnati, Ohio 45229
Cincinnati, Ohio 45229
1-513-636-4200
Cincinnati Children's Hospital Medical Center Patients and families from across the region and around the...
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