Table 2 Intervention characteristics of studies included in the systematic review
Study | Time point of intervention m | Type of CBT intervention m | Method of delivery m | No. of sessions/ modules | Health professional m | Social support m | Parenting componant m | Fidelity | Study specific training |
|---|---|---|---|---|---|---|---|---|---|
Alhusen et al. [87] | Pre | CBT | Group | 6 | Mixed (SW & nurse) | Topic: social support systems, communication styles, and getting needs met | Incorporates attachment theory. Topics: stressors affecting mother-baby relationship and intergenerational transmission of thought patterns | Checklists and notes to ensure all content was covered | Training provided |
Ammerman et al. [88] | Post | CBT | IHI | 15 plus booster | MHP | No | Skills-based strategies used to increase maternal sensitivity to child cues | Checklists to ensure all content was covered. Supervision (weekly, provided by doctoral level clinicians) | NI |
Burns et al. [89] | Pre | CBT | IHI | 12 | MHP | No | No | Sessions rated with CTS-R. Sessions recorded monitored for adherence (10%). Supervision (weekly) | Trained to deliver the intervention until judged to be competent by a PSY with specialist perinatal expertise |
Dimidjian et al. [90] | Pre | BA | IHI | 10 | HP | No | No | Sessions rated with the QBAS. Role-plays rated by two BA experts | Training provided by authors included 2 days of in-person workshops and self-paced reading followed by ongoing weekly group telephonic supervision (90 min) and individual supervision (30 min). |
Forsell et al. [91] | Pre | CBT | G/MC self-help | 10 plus optional modules | MHP | No | No | NI | E-therapists had basic CBT training but no prior experience nor any special education or training in order to treat this specific population |
Fuhr et al. [92] | Pre | BA | IHI | 6 to 14 | NSP | Collaboration with the family | No | Sessions rated with TQS. Group supervision (fortnightly, once a month with a supervisor present and once a month without a supervisor present) | 25–40 h of classroom-based training. Comprised discussion and roleplays. A clinical internship period of 2 months followed the training. At the end of their training period competence was judged using standardized roleplays. Only those who passed predefined competence assessments were selected |
Honey et al. [85] | Post | CBT | Group | 8 | HP | No | No | NI | NI |
Hughes et al. [32] | Post | CBT | IHI | 16 | MHP | No | No | Supervision (weekly) | NI |
Khamseh et al. [83] | Pre | PS | Group | 5 | Mixed (PSY nurse) | No | No | NI | NI |
Lund et al. [93] | Pre | PS & BA | IHI | 6 | NSP | No | No | Checklists to ensure all content was covered. Supervision (weekly, group based with clinical social worker) | 5 days of training by a clinical SW in basic counselling and delivery of the intervention |
McKee et al. [86]a | Pre | CBT | IHI | 8 CBT plus 4 parenting sessions | MHP | Social support building sessions. Unstructured opportunities for supportive companionship | Four child-development psychoeducational modules. Topics: sensitive and responsive mothering | NI | NI |
Meager & Milgrom, [84]a | Post | CBT | Group | 10 | MHP | Partner session (n = 1). Group environment of social and emotional support | No | NI | NI |
Milgrom et al. [94] | Post | CBT | Group | 12 (3 with partner) | MHP | Partner sessions (n = 3) | No | Checklists to ensure all content was covered | One-to-one instruction in use of the therapy manuals and regular, intensive supervision from the principal investigator |
Milgrom et al. [73] | Post | CBT | IHI | 6 | Mixed (PSY and nurse) | Partner session (n = 1) | No | NI | Half-day training workshop in the CBT intervention. The training was conducted by a senior PSY with several years experience in delivering CBT for postnatal depression |
Milgrom et al. [95] A | Pre | CBT | IHI | 8 | MHP | Partner session (n = 1) | No | Checklists and notes to ensure all content was covered | Training provided for pregnancy-specific CBT programme |
Milgrom et al. [96] B | Post | CBT | Group | 12 | MHP | Partner sessions (n = 3) | No | Checklists to ensure all content was covered | NI |
Milgrom et al., [97] | Post | CBT | G/MC self-help | 6 | MHP | Access to literature for partner | No | NI | Training included working through the program (as if they were a participant), reading the coach manual, observing other coaches’ complete calls, and a verbal explanation from a senior PSY about the role and the tasks involved |
Misri et al. [98] | Post | CBT | IHI | 12 | MHP | No | No | NI | NI |
Morrell et al. [99] | Post | CBT | IHI | 8 | HP | No | No | NI | Trained to deliver psychologically informed sessions based on cognitive behavioral principles |
Nasiri et al. [100] | Post | PS | IHI | 6 | Mixed (Midwife & PSY) | No | No | NI | A clinical psychologist supervised performance on the first 10 participants |
Ngai et al. [101]a | Post | CBT | IHI | 5 | HP | No | No | Supervision (bi-weekly and tape review (10%) by the research team) | 20 hours of CBT training |
O’Mahen et al. [101]A | Pre | CBT | IHI | 12 | MHP | No | No | Sessions rated with CTS-R. Supervision (weekly and tape review (10%) by clinical supervisor) | Training consisted of: reading the manual, review and training in key concepts with either the principal investigator or clinical supervisor and co-investigator, and completion of an initial participant under close supervision |
O’Mahen et al. [103]B | Post | BA | Unguided self help | 11 | n/a | Topic: addressing support with new mother. Netmums ‘meet a mum’ feature, to connect with other women in their local area | No | NI | n/a |
O’Mahen et al. [104] | Post | BA | G/MC self-help | 12 | MHP | Netmums ‘meet a mum’ feature, to connect with other women in their local area | No | Supervision (weekly and tape review (20%) with chief investigator) | 5 days of training in the ‘high-intensity’ (functional analysis-based) perinatal-specific BA approach. Training involved a mix of didactics and roleplay around conducting functional analysis in perinatal-specific domains with the chief investigator, a clinical PSY with specialty expertise in BA and perinatal depression, and an IAPT trainer |
Pugh et al. [105] | Post | CBT | G/MC self-help | 7 | MHP | No | No | NI | A training workshop |
Rojas et al. [106] | Post | CBT | Group | 8 | HP | No | No | Supervision (weekly) | 8 hours of training |
Sikander et al. [107] | Pre | BA | IHI | 14 | NSP | Collaboration with the family | No | Sessions rated with ENACT rating scale. Supervision (group) | Brief classroom training and regular group training. Field supervision by local trainers who were not mental health specialists, and these trainers were supervised by a specialist therapist, generating a cascade model of training and supervision |
Trevillion et al. [108] | Pre | CBT | G/MC self-help | 8 | MHP | No | No | Checklists to ensure all content was covered. Sessions rated with CTS-R. Randomly selected tape review (20%) by PSY | Trained to deliver the intervention |
Van Lieshout et al. [109] | Post | CBT | Group | 1 | MHP | Section on getting support from others | No | Practitioners observed delivering trial workshops prior to RCT | 1 day classroom training |
Wiklund et al. [110]a | Post | CBT | IHI | NI | HP | No | No | NI | NI |
Wozney et al. [111]a | Post | CBT | G/MC self-help | 12 plus booster | NSP | Partner/companion information brochure | No | Supervision (weekly) with an expert clinician | Training involved reading the handbook, observing others complete calls and verbal modelling and explanations from a senior clinician about the role and the tasks involved |