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An Open Trial of In-Home CBT for Depressed Mothers in Home Visitation

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Abstract

Research has demonstrated that low income mothers participating in home visitation programs have high rates of depression. This study used an open trial design to evaluate In-Home Cognitive Behavioral Therapy (IH-CBT), an evidence-based treatment for depression that is delivered in the home setting and has been adapted to address the needs of low income mothers participating in home visitation. 64 depressed mothers recruited from a home visitation program and who had completed IH-CBT were compared to 241 mothers from the same setting who met identical screening criteria at enrollment but did not receive the treatment. In addition, pre- and post-treatment measures of depression and related clinical features were contrasted in the 64 mothers receiving IH-CBT. There was a significantly greater reduction in depressive symptoms in the IH-CBT group relative to their counterparts who did not receive the treatment. Results from pre-post comparisons showed that treated mothers had decreased diagnosis of major depression, lower reported stress, increased coping and social support, and increased positive views of motherhood at post-treatment. Findings suggest that IH-CBT is a promising approach to addressing maternal depression in the context of home visitation and warrants further study. Public health implications for home visiting programs are discussed.

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References

  1. National Research Council and Institute of Medicine. (2009). Depression in parents, parenting, and children: Opportunities to improve identification, treatment, and prevention. Committee on Depression, Parenting Practices, and the Healthy Development of Children, Board on Children, Youth, and Families, Division on Behavioral and Social Sciences and Education. Washington, DC: The National Academies Press.

  2. Lennon, M., Blome, J., & English, K. (2001). Depression and low-income women: Challenges for TANF and welfare-to-work policies and programs. New York: National Center for Children in Poverty, Mailman School of Public Health, Columbia University.

    Google Scholar 

  3. Guterman, N. (2001). Stopping child maltreatment before it starts: Emerging horizons in early home visitation services. Thousand Oaks, CA: Sage.

    Google Scholar 

  4. Kendrick, D., Hewitt, M., Dewey, M., Elkan, R., Blair, M., Robinson, J., et al. (2000). The effect of home visiting programmes on uptake of childhood immunization: A systematic review and meta-analysis. Journal of Public Health Medicine, 22, 90–98.

    Article  PubMed  CAS  Google Scholar 

  5. Sweet, M. A., & Appelbaum, M. I. (2004). Is home visiting an effective strategy? A meta-analytic review of home visiting programs for families with young children. Child Development, 75, 1435–1456.

    Article  PubMed  Google Scholar 

  6. Astuto, J., & Allen, L. (2009). Home visitation and young children: An approach worth investing in? Society for Research in Child Development, Social Policy Report, 23, 3–22.

    Google Scholar 

  7. Ammerman, R. T., Putnam, F. W., Bosse, N. R., Teeters, A. R., & Van Ginkel, J. B. (2010). Maternal depression in home visitation: A systematic review. Aggression and Violent Behavior, 15, 191–200.

    Article  PubMed  Google Scholar 

  8. Ammerman, R. T., Putnam, F. W., Altaye, M., Chen, L., Holleb, L. J., Stevens, J., et al. (2009). Changes in depressive symptoms in first time mothers in home visitation. Child Abuse & Neglect, 33, 127–138.

    Article  Google Scholar 

  9. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). BDI-II manual. San Antonio: The Psychological Corporation.

    Google Scholar 

  10. Administration for Children and Families. (2006). Depression in the lives of early head start families. [Brochure]. Washington, DC: Administration for Children and Families.

    Google Scholar 

  11. Duggan, A., Fuddy, L., Burrell, L., Higman, S. M., McFarlane, E., Windham, A., et al. (2004). Randomized trial of a statewide home visiting program to prevent child abuse: Impact in reducing parental risk factors. Child Abuse & Neglect, 28, 623–643.

    Google Scholar 

  12. DuMont, K., Mitchell-Herzfeld, S., Greene, R., Lee, E., Lowenfels, A., Rodriguez, M., et al. (2008). Healthy familes New York (HFNY) randomized trial: Effects on early child abuse and neglect. Child Abuse & Neglect, 32, 295–315.

    Article  Google Scholar 

  13. Ammerman, R. T., Putnam, F. W., Stevens, J., Holleb, L. J., Novak, A. L., & Van Ginkel, J. B. (2005). In-home cognitive behavior therapy for depression: An adapted treatment for first-time mothers in home visitation. Best Practices in Mental Health, 1, 1–14.

    Google Scholar 

  14. Beck, J. S. (1995). Cognitive therapy: Basics and beyond. New York: Guilford Press.

    Google Scholar 

  15. Ammerman, R. T., Bodley, A. L., Putnam, F. W., Lopez, W. L., Holleb, L. J., Stevens, J., et al. (2007). In-home cognitive behavior therapy for a depressed mother in a home visitation program. Clinical Case Studies, 6, 161–180.

    Article  Google Scholar 

  16. Lau, A. S. (2006). Making the case for selective and directed cultural adaptations of evidence-based treatments: Examples from parent training. Clinical Psychology: Science and Practice, 13, 295–310.

    Article  Google Scholar 

  17. Olds, D. L. (2002). Prenatal and infancy home visiting by nurses: From randomized trials to community replication. Prevention Science, 3, 153–172.

    Article  PubMed  Google Scholar 

  18. Daro, D. A., & Harding, K. A. (1999). Healthy families America: Using research to enhance practice. Future Child, 9, 152–178.

    Article  PubMed  CAS  Google Scholar 

  19. Steer, R., Brown, G., Beck, A., & Sanderson, W. (2001). Mean BDI-II total scores by severity of major depressive episode. Psychological Reports, 88, 1075–1076.

    PubMed  CAS  Google Scholar 

  20. Spitzer, R. L., Williams, J. B., Kroenke, K., Linzer, M., deGruy, F. V., I. I. I., Hahn, S. R., et al. (1994). Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA, 272, 1749–1756.

    Article  PubMed  CAS  Google Scholar 

  21. Beck, A. T., Rush, A. J., Shaw, F. B., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  22. Blagys, M. D., & Hilsenroth, M. J. (2002). Distinctive activities of cognitive-behavioral therapy: A review of the comparative psychotherapy process literature. Clinical Psychologist, 22, 671–706.

    Google Scholar 

  23. Keller, M. B. (2003). Past, present, and future directions for defining optimal treatment outcome in depression: Remission and beyond. JAMA, 289, 3152–3160.

    Article  PubMed  Google Scholar 

  24. Spitzer, R. L., Kroenke, K., & Williams, J. B. (2000). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. JAMA, 282, 1737–1744.

    Article  Google Scholar 

  25. Warner, R., Appleby, L., Whitton, A., & Faragher, B. (1997). Attitudes toward motherhood in postnatal depression: Development of the Maternal Attitudes Questionnaire. Journal of Psychosomatic Research, 43, 351–358.

    Article  PubMed  CAS  Google Scholar 

  26. Church, N. F., Brechman-Toussaint, M. L., & Hine, D. W. (2005). Do dysfunctional cognitions mediate the relationship between risk factors and postnatal depression symptomatology? Journal of Affective Disorders, 87, 65–72.

    Article  PubMed  Google Scholar 

  27. Mayberry, L. J., Horowitz, J. A., & Declercq, E. (2007). Depression symptom prevalence and demographic risk factors among U.S. women during the first 2 years postpartum. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 36, 542–549.

    Article  PubMed  Google Scholar 

  28. Gunlicks, M. L., & Weissman, M. M. (2008). Change in child psychopathology with improvement in parental depression: A systematic review. Journal of American Academy of Child Adolescent Psychiatry, 47, 379–389.

    Article  Google Scholar 

  29. Administration on Children Youth and Families. (2002). Making a difference in the lives of children and families: The impacts of Early Head Start Programs on infants and toddlers and their families. Washington, DC: U.S. Department of Health and Human Services.

    Google Scholar 

  30. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., et al. (2003). The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). JAMA, 289, 3095–3105.

    Article  PubMed  Google Scholar 

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Acknowledgments

Supported in part by Grant R34MH073867 from the National Institute of Mental Health. The authors acknowledge the participation and support of the United Way of Greater Cincinnati, Kentucky H. A. N. D. S., Ohio Help Me Grow, and www.OhioCanDo4Kids.org. We also thank Angelique R. Teeters for her helpful comments on the manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 3015, Cincinnati, OH, 45229, USA

    Robert T. Ammerman, Nicole R. Bosse & Amy L. Bodley

  2. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 3008, Cincinnati, OH, 45229, USA

    Frank W. Putnam

  3. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, ML 3005, Cincinnati, OH, 45229, USA

    Jodie A. Short & Judith B. Van Ginkel

  4. Department of Pediatrics, Nationwide Children’s Hospital, The Ohio State University School of Medicine, Columbus, OH, USA

    Jack Stevens

Authors
  1. Robert T. Ammerman
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  2. Frank W. Putnam
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  3. Jack Stevens
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  4. Nicole R. Bosse
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  5. Jodie A. Short
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  6. Amy L. Bodley
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  7. Judith B. Van Ginkel
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Correspondence to Robert T. Ammerman.

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Ammerman, R.T., Putnam, F.W., Stevens, J. et al. An Open Trial of In-Home CBT for Depressed Mothers in Home Visitation. Matern Child Health J 15, 1333–1341 (2011). https://doi.org/10.1007/s10995-010-0691-7

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  • DOI: https://doi.org/10.1007/s10995-010-0691-7

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