Treating Depression Among Adolescent Perinatal Women With a Dialectical Behavior Therapy–Informed Skills Group

https://doi.org/10.1016/j.cbpra.2016.12.002Get rights and content

Highlights

  • This study examines a DBT informed skills group for depressed adolescent perinatal women.

  • Findings suggest the intervention is credible, acceptable, and associated with change in depression.

  • Findings indicate challenges with feasibility, particularly enrollment and retention of depressed adolescent perinatal women.

  • A case study demonstrates one participant’s experience in the DBT informed skills group.

Abstract

Depression is a prevalent and impairing problem affecting both women and offspring during the perinatal (pregnancy and the postpartum) period. Despite this, few studies have examined treatments for perinatal adolescents with depressive symptoms. The present study examined the feasibility and preliminary outcomes of a dialectical behavioral therapy (DBT) informed skills group among depressed adolescent perinatal women (N = 25) recruited from both a public health parent education program and an adolescent obstetric clinic. A brief composite case example is included to illustrate how DBT skills were taught, practiced, and applied. Findings suggest the intervention was credible, acceptable, and associated with improvement in depression. Challenges with feasibility of enrolling and retaining adolescent perinatal women were evident, as approximately half of the enrolled participants did not complete the study. This study provides preliminary evidence that a DBT-informed skills group may be a promising intervention for depressed adolescent perinatal women and points to important directions for clinical practice and research, including treatment engagement and retention.

Section snippets

Participants

The University of Colorado Institutional Review Board and the Colorado Multiple Institutional Review Board reviewed and approved the study, and all participants provided informed consent. Participants were recruited through two area organizations: a suburban public health program that provides parenting support for adolescent perinatal women, as well as help in connecting with services, including health and mental health care, shelter, and food (n = 21), and an urban hospital-based comprehensive,

Baseline Characteristics of the Sample

On average, participants were approximately 19 years old, and postpartum with a child of approximately 3.5 months of age. The majority of participants were White (76%) and approximately half were of Latina ethnicity (52%). The greatest proportion of participants reported an annual gross household income of less than $10,000, and being never married (48%). Demographics and clinical characteristics of the sample are presented in Table 2.

Treatment Credibility

On average, participants found the group to be credible and

Discussion

Given the prevalence of depression among adolescent perinatal women and the potential impact on maternal and child well-being, there is a pressing need to develop and make available treatments that are credible, feasible, acceptable, and effective. The present study represents an initial step to modify and evaluate a DBT-informed skills group that is matched to the developmental needs of this population and grounded in an evidence base for DBT skills groups for adolescents and treatment

Conclusions

In summary, a DBT-informed skills group appears to be a credible and acceptable intervention for depressed adolescent perinatal women. Furthermore, participants evidenced improvement in depression. It will be important for future work to examine methods to promote engagement and retention and to test efficacy in randomized controlled trials with a longer follow-up period. This research is the first step in a line of research to examine DBT-informed skills training as a promising intervention

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    This research was supported by grants from the University of Colorado Boulder's Beverly Sears Grant and Dorothy Martin Award, as well as the University of Colorado School of Medicine Developmental Psychobiology Research Group Grant. The authors would like to thank our DBT group co-leaders Jessica Lunsford Avery and Mikaela Kinnear Elson, as well as research assistants Tina Gupta, Alexa Levinson, Erika Heilman, Gianna Rea, Navodita KC, Shagun Pawar, Dianna Torgerson, Jacob Kincaid, Ruth McClure, Anna McIntosh, Sarah Hopkins, and Morgan Spellman. This article is based on Blair V. Kleiber's doctoral dissertation at University of Colorado Boulder.

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    Jennifer N. Felder is now at University of California, San Francisco.

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