Blended CBT Intervention vs. a Guided Web-Based Intervention for Postpartum Depression: Results From a Pilot Randomized Controlled Trial

Abstract

Objectives: This pilot randomized controlled trial evaluated the acceptability and preliminary effectiveness of a blended cognitive behavioural intervention—combination of a web-based program and sessions with a psychologist (intervention group)—compared to a guided web-based intervention (active control group) for the treatment of postpartum depression. Methods: Adult Portuguese women in the postpartum period (up to 12 months) presenting clinically relevant depressive symptoms were considered eligible. Participants were randomly assigned to the intervention group (n = 17) or the control group (n = 17) and completed self-report questionnaires at baseline, post-intervention and at 3-month follow-up. Results: In both arms, dropout rates were low, and participants considered the treatment acceptable and useful. Mixed ANOVAs revealed a significant reduction in depressive symptoms and improvements in secondary outcomes (anxiety, negative thoughts, emotion regulation, self-compassion and psychological flexibility) from baseline to post-intervention in both groups. No time × group interactions were found. A significant clinical change in depressive symptoms was observed in more than 80% of the participants in both groups. Significant associations were observed among therapeutic alliance and depressive symptoms. Conclusions: The results of our study support the acceptability, usability and preliminary effects on postpartum depression of both interventions and highlight the important role of therapist support in blended and guided web-based interventions. Trial Registration: ClinicalTrials.gov identifier: NCT04441879.