RESUMEN
Women in the postnatal period are at a high risk of developing clinically significant symptoms of anxiety. Cognitive behavioural therapy is effective in the treatment of postnatal anxiety; however, there are many barriers to accessing this treatment. This study examined the feasibility and acceptability of transdiagnostic cognitive behavioural therapy delivered remotely via Internet videoconferencing. Three women (Mage = 28.33 years; SD = 4.04) with a postnatal anxiety-related disorder were treated using the videoconference-delivered cognitive behavioural therapy. The treatment was delivered once per week over a 5-week period. All participants met criteria for clinically significant change in anxiety symptoms at post-treatment, and one participant met criteria for clinically significant change in depressive symptoms, which was maintained at 3-month follow-up. The intervention was also found to be acceptable by participants. The results provide preliminary feasibility evidence of the clinical utility and acceptability of remotely delivered transdiagnostic cognitive behavioural therapy as an intervention for postnatal anxiety disorders.
Asunto(s)
Trastornos de Ansiedad , Terapia Cognitivo-Conductual , Humanos , Femenino , Adulto , Estudios de Factibilidad , Trastornos de Ansiedad/terapia , Trastornos de Ansiedad/psicología , Ansiedad/terapia , Terapia Cognitivo-Conductual/métodos , Resultado del Tratamiento , InternetRESUMEN
BACKGROUND: Anxiety is common during the perinatal period and despite effective treatments being available, many women with perinatal anxiety disorders experience barriers when accessing treatment. AIMS: The aims of the current study were to explore women's perceived barriers to treatment uptake; cognitive behavioural therapy (CBT) treatment delivery preferences; and the utility of the Health Belief Model (HBM) in predicting intention to seek psychological help for women with perinatal anxiety symptoms. METHOD: This study employed a cross-sectional design consisting of women with self-reported anxiety in the perinatal period. A total of 216 women (Mage=28.53 years; SD=4.97) participated in the study by completing a battery of online self-report measures. RESULTS: The results indicated that the most salient barriers to accessing care were: (1) the cost of treatment, (2) wanting to solve the problem on their own, and (3) thinking the problem would go away without treatment. Group-delivered CBT was the least acceptable treatment method, while face-to-face individual CBT was the most acceptable treatment method. The HBM variables predicted approximately 35% of the variance in help-seeking intention. DISCUSSION: This study has important implications for the delivery of psychological care in the perinatal period and may be used to improve treatment uptake.
Asunto(s)
Trastornos de Ansiedad , Ansiedad , Embarazo , Femenino , Humanos , Estudios Transversales , Ansiedad/terapia , Trastornos de Ansiedad/terapia , Resultado del TratamientoRESUMEN
Cognitive-behavior therapy (CBT) is considered the psychological treatment of choice for anxiety disorders in the general population. However the efficacy of CBT for anxiety that occurs during the perinatal period, defined as the period from conception to 12 months post birth, is less understood. Perinatal anxiety is a complex and multifaceted problem that can affect both the pregnant women and the unborn child, as well as the wider family unit. The aim of this study was to synthesize the current empirical status of CBT for perinatal anxiety using a meta-analytic approach. Relevant articles were identified through a search of electronic databases through to June 2018. The search terms used include 'anxiety' or 'phobia' AND 'perinatal' or 'pregnan* or 'postnatal' or 'postpartum' AND 'CBT' or 'cognitive behav* therapy'. Randomized and non-randomized studies were included within the meta-analysis. A total of 13 studies met the inclusion criteria and were included in the meta-analysis. The pooled between-group mean effect size was small at post treatment (k = 7; d = 0.49; 95% CI: 0.08-0.91) favoring the CBT treatments (Q1 = 30.13, p <.001). Heterogeneity was high (I2 = 80.09). The pooled within-group mean effect size was large across the treatment groups from pre-treatment to post-treatment when combining all of the studies (i.e., controlled and uncontrolled studies; k = 14; d = 0.90; 95% CI: 0.63-1.17). Heterogeneity was high (I2 = 88.55). Some preliminary and exploratory moderator analyses were also conducted to inform potential future research in this field.