Most people living with postpartum depression (PPD) will not receive effective treatment in Canada. 

While PPD affects 20 per cent of the birthing population, only 10 per cent of them receive evidence-based treatment.

A study by Psychiatrist and Canada Research Chair in the Perinatal Programming of Mental Disorders Dr. Ryan J. Van Lieshout found that online group cognitive behavioural therapy (CBT) for PPD delivered by mothers who have recovered from PPD is 11 times more effective than no intervention.

The Health Insider talked to Dr. Lieshout to better understand the results and what it could mean for Canadian perinatal healthcare. 

The Research

183 mothers were randomly sorted into two groups. Group one received treatment right away while group two was waitlisted for six weeks before starting treatment.

Researchers assessed levels of depression, anxiety, social support, mother-infant bonding, and infant temperament at the start of treatment and again after nine weeks.

Participants in group one were assessed again three months after finishing therapy to test how stable the effects are over time.

Licensed therapists then review footage of the sessions and work with the mother delivering the therapy on any mistakes they may have made and next steps.

When therapy is delivered by peers, it “hopefully mitigates the impact of there not being enough professionals,” Lieshout said.

The study was published in Acta Psychiatrica Scandinavica journal in August 2023.

Integrating Postpartum Depression Treatment into Canadian Healthcare 

“Moms are suffering and we need more innovative treatments,” Patricia Tomasi said.

Tomasi is the Co-Founder and Co-Executive Director of the Canadian Perinatal Mental Health Collaborative.

The study “caused a lot of ripple effects in the perinatal mental health world. Really valuable, great, insightful, good ripple effects,” she said.

The research proved for the first time that peers can deliver effective group online therapy for postpartum depression treatment.

Tomasi has experienced PPD and said what she wanted most during her care was support from someone who understood how she felt. The results of the study are “common sense yet revolutionary,” she said.

She suggested it could become the first line of treatment for PPD and it should be part of the stepped care pathway utilized in Canada.

A Grain of Salt

Lieshout faced a challenge in designing the study. By waitlisting group two instead of not treating them, it’s possible the results are slightly inflated.

But Lieshout said he didn’t feel right about not treating someone who’s suffering and asking for help, especially since the study started during the height of the COVID-19 pandemic with mental health deteriorating across the country.

And he continued that even with the possibility of a slightly inflated end result, the difference in effectiveness is high enough that the results still represent a significant improvement. 

Lieshout is planning a follow-up study on training mothers to effectively deliver online group CBT therapy sessions.

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