Category: Adult Anxiety
Anxiety symptoms are common during pregnancy and the postpartum period but it is only in recent years that there has been much focus in the literature on the issue of anxiety disorders in the perinatal period. However, there is little guidance in how to best treat perinatal anxiety, and only one published study on adapting group cognitive-behavioural therapy (CBT) for anxiety to the perinatal population (Green, Haber, Frey, & McCabe, 2015). The current investigation aimed to develop and evaluate a group perinatal CBT intervention suitable for delivery in a tertiary care anxiety clinic. Session content includes psychoeducation regarding anxiety during the perinatal period, self-care and pregnancy/postpartum, goal-setting, exposure strategies, nurturing the relationship with baby, challenging negative thoughts, and relapse prevention. A workbook has been developed which provides information and homework exercises in each of these areas. Female patients with varied primary symptom presentations, including generalized anxiety, social anxiety, panic, health anxiety and obsessive-compulsive disorder, either pregnant or within 12 months postpartum, were invited to participate. This group consisted of 6 weekly 1.5-hour sessions. Three groups have been run to date (n = 13), with a projected total N of 25. Participants completed the Perinatal Anxiety Stress Scale (PASS) and the Edinburgh Postnatal Depression Scale (EPDS) at the first and last group sessions. A preliminary analysis was conducted using a repeated measures ANOVA with time as the within-subjects independent variable and total PASS scores as the dependent variable. Results revealed a significant main effect of time, such that anxiety scores decreased from pre- to post-group, F(1,12) = 19.54, p =.001, partial eta squared = .62, with mean scores decreasing from the severe range, to the mild-moderate range, for anxiety symptoms. A similar analysis conducted on the EPDS revealed the same pattern of results, F(1,12) = 8.35, p =.01, partial eta squared = .41. Treatment acceptability was measured using the Treatment Acceptability/Adherence Scale (TAAS) and administered to a subset of participants. Results revealed that the treatment was highly acceptable. Descriptive feedback on the group experience was also solicited via post-group anonymous feedback questionnaires. Participants expressed that they most appreciated the perinatal focus, and that meeting with other mothers normalized their anxious feelings. Thus, there is good preliminary evidence that patients with mixed-anxiety presentations can have good success in a group setting, and moreover, that this treatment is highly acceptable to patients. Results will be discussed within the context of CBT models of and treatments for perinatal anxiety.