CBT for Young Mothers
Condition: Anxiety; Depression; Emotion Regulation
MeSH terms: Depression
Study type: Interventional

Summary: 
      Approximately 1 in 4 adolescent mothers will develop depression after delivering a child,
      though some studies suggest that as many as 53% will develop postpartum depression. A
      frequent accompanying symptom is emotion dysregulation which not only adversely affects their
      mental well-being, but jeopardizes their parenting and their child's health. Unfortunately
      significant barriers exist for young mothers, preventing access to treatment. This study will
      pilot the feasibility of having public health nurses deliver this 9-session program within a
      curriculum for teen mothers.
    

Detailed description: 
      Up to 50% of women who become parents during the teenage years suffer from mental disorders
      after the birth of their children. While they most commonly develop depression, anxiety
      problems and substance use disorders are also common, and in many cases they are comorbid. A
      significant proportion of these young women will also manifest impairing but sub-syndromal
      levels of symptoms. A frequent accompanying symptom is emotion dysregulation which not only
      adversely affects their mental well-being, but jeopardizes their parenting and their child's
      health, as well as longer-term labour market outcomes.

      Perinatal mental disorders are associated with significant suffering and high health care
      costs. Indeed, a single case of postpartum depression is estimated to cost $150,000, a figure
      that may be even higher in young mothers. Compounding these adverse effects is the fact that
      just 15% of women with young children and mental disorders receive evidence-based care,
      numbers that are almost certainly lower in young mothers given their well-known difficulties
      engaging in health care.

      Getting these young women to engage in treatment can be a significant challenge, but given
      the substantial risks and costs associated with mental disorders in this group, as well as
      the effectiveness of preventive and treatment interventions (particularly the
      psychotherapies), it is important that innovative ways to engage and support adolescent
      mothers be developed. Since many will attend school either in a traditional or adapted
      setting, the educational system provides an ideal place to deliver interventions aimed at
      optimizing the mental health of teenage mothers.

      The purpose of this pilot study is to develop and establish the feasibility of having public
      health nurses deliver a 9-session group cognitive behavioural therapy-based resilience
      curriculum within a school program for teenage mothers at the District School Board of
      Niagara. In addition to establishing the feasibility and acceptability of the curriculum,
      estimates of intervention effect and its variance will be generated to support a later
      large-scale study aimed at assessing its effectiveness.

      CBT-based curriculum has been developed to help build resilience and optimize mood, anxiety,
      and emotion regulation in 15-24 year old women attending a supported school program in
      Niagara Region. Sixty women will be recruited and changes in depression, anxiety, emotion
      regulation, parenting, and behavioural problems in their children will be measured pre-group,
      immediately post-group, and 6 months later.
    

Intervention name(s): Cognitive Behavioural Therapy
Intervention type(s): Behavioral
Intervention description(s): The transdiagnostic CBT-based curriculum is based on the extensive clinical experience of the research team with young women and those struggling with perinatal mental disorders. The team also has significant expertise delivering CBT for depression and anxiety (including perinatal variants) in groups. The manual was developed by the research team and is based on the state-of-the-art in resilience and CBT interventions in adolescents and young adults (e.g., the Penn Resiliency Program (60), Treatment for Adolescent Depression Study (61)). After it was developed, it was subjected to further scrutiny by public health nurses and STRIVE staff, who have extensive experience working with young mothers.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Young mother; Depression; Anxiety; Resilience; Emotion regulation; Parenting; CBT