Incorporating Interpersonal Psychotherapy for Postpartum Depression into Social Work Practice

Background and Purpose: Social workers intervene with various vulnerable populations in a variety of settings; however few social worker-led evidence-based interventions for postpartum depression (PPD) have been described in the literature. As screening initiatives are being implemented around the world growing numbers of women are referred for treatment to mental health professionals, including social workers. This pilot study investigated the feasibility and acceptability of training Israeli social workers to administer Interpersonal Therapy (IPT) to women with PPD, who were referred by public health nurses following a screening procedure.

Methods: Women 4-24 weeks postpartum, screening positive for PPD symptoms, ≥ 18 years participated in this two-group, non-randomized repeated-measures pilot. The intervention group (n= 13) received eight 50-minute IPT sessions and the comparison group (n= 14) received treatment as usual. Primary outcomes, measured at the end of treatment and 4 weeks post treatment, included level of depression (measured with the Edinburgh Postnatal Depression Scale [EPDS]), level of maternal household functioning and social functioning (measured with the Postpartum Adjustment Questionnaire [PPAQ]) and treatment satisfaction (measured with the Client Satisfaction Scale–8 [CSQ-8]). Data were analyzed using repeated measures mixed-effects models for continuous outcomes, (mixed procedure, SAS, version 9.3).

Results: There was significant reduction in both groups in EPDS scores at the end of treatment  (t = -4.68, 95% CI [-6.49, -2.57], d = 1.07) and 4 weeks post-treatment  (t = -5.09, 95% CI [-7.14, -3.08], p < 0.001, d = 1.21), significant reduction in PPAQ scores (represents higher functioning) at the end of treatment (t = -2.09, 95% CI [-0.29, 0.00], p < 0.05, d = 0.44), and high patient acceptability. No differences were found between the groups in terms of levels of depression and functioning.

Conclusions and Implications: While no significant differences were found between groups with respect to PPD symptoms and maternal functioning, findings indicate that both the IPT and comparison groups experienced significant improvements over time with a medium and large effect size in maternal functioning and depressive symptoms respectively. These findings suggest preliminary feasibility of incorporating IPT into social work practice in Israel since experienced social workers demonstrated high fidelity to the protocol during supervision sessions, mastered IPT techniques, and provided effective treatment for PPD within a fairly short period of time. In addition, the CSQ-8 and participant comments supported the acceptability of therapy in both groups. Future studies are needed with larger sample sizes and social workers experienced in IPT to determine true differences between this evidence-based psychotherapeutic modality and usual care.