Psychodynamic therapy for depression in women with infants and young children

Am J Psychother. 2012;66(2):181-99. doi: 10.1176/appi.psychotherapy.2012.66.2.181.

Abstract

Background: It has long been known that the rate of depression is high among women with infants and young children. In recent research a psychodynamic therapy group was found to be beneficial for a self-selected, postnatal subgroup of women who were of middle socio-economic status (SES), educated and who met DSM-IV criteria for clinical or subclinical depression. The current study sought to replicate these findings with individual psychodynamic therapy and to compare outcomes for three psychodynamic treatment conditions: individual, group, and combined individual and group.

Method: Patients began and left treatment from each of the three psychodynamic therapy conditions on a self-determined basis. Pre- and postintervention DSM-IV Global Assessment of Functioning (GAF) were obtained by reliable blind raters. A ten-variable, self-administered postintervention outcome questionnaire provided further data.

Results: Women (n = 58) in all three therapeutic conditions showed statistically significant improvement in their pre-to-post GAF and large treatment effects. On the questionnaire, they indicated that they were affected positively by all three conditions. Statistically significant differences among treatment conditions favored the individual treatment.

Conclusions: Psychodynamic therapy appears well suited for the population of women in this study, especially when administered on an individual basis. The model employed here emphasized receiving and developing empathic emotional attunement, insight into one's relationships and early experiences, and a process for expressing feelings and resolving problems. Compared to group and combination therapies, the individual treatment may afford the greatest opportunity for receiving and developing these features and, thus, the best outcomes.

MeSH terms

  • Adult
  • Child, Preschool
  • Combined Modality Therapy / methods
  • Depression, Postpartum / psychology
  • Depression, Postpartum / therapy
  • Depressive Disorder / psychology*
  • Depressive Disorder / therapy*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Middle Aged
  • Mothers / psychology*
  • Observer Variation
  • Psychotherapy / methods*
  • Psychotherapy, Group / methods*
  • Self Report
  • Surveys and Questionnaires
  • Treatment Outcome