Created and co-ordinated by doctoral student Nicky Pugh as part of her dissertation research project in clinical psychology, the Maternal Depression Online program allows women who suffer from depression after giving birth to treat themselves online with the aid of a trained therapist.
The Online Therapy Unit for Service, Education and Research is currently conducting clinical trials for the program.
“I’ve been involved in online therapy since 2011 under the direction of Dr. Heather Hadjistavropoulos,” Pugh said. “We’ve been offering different online therapy programs for a variety of different clinical disorders, and I’ve always had an interest in maternal mental health.
“I understand that it’s a very undertreated disorder. The disorder reaches as many as 10 per cent of Saskatchewan women, and less than 20 per cent of those women actually receive services for their condition.”
The effects of postpartum depression are not limited to mothers.
Studies have linked the condition to relationship problems, risky behaviour and adverse effects on maternal and infant health. A depressed postpartum mother may not be able to provide the level of care her baby requires, interfering with the growing attachment between mother and child.
Maternal Depression Online offers structured -- and largely self-directed -- psychological therapy using seven online modules that feature text, graphics, animation, audio, video and online activities.
Patients work with assigned therapists through a secure email connection, submitting check-in questions and mood ratings at the beginning of each session and performing homework assignments in-between.
In terms of content, the modules focus on both thoughts and behaviour.
“It’s a cognitive behavioural focus, so that means that we focus on unhelpful and negative thinking patterns that generally women with post-partum depression report … like if the baby doesn’t stop crying, (a woman might think) ‘I’m a bad mother’ and then that makes them feel depressed,” Pugh said.
“We look at those thoughts and we challenge them to help them think more realistically … We also have modules that focus on their behaviours …We know that when women are depressed, they’re more likely to stay home and be isolated, which further exacerbates their depression. So we focus on getting them more active, getting them out more, re-engaging them with their friends.”
The disorder reaches as many as 10 per cent of Saskatchewan women, and less than 20 per cent of those women actually receive services for their condition. - Nicky Pugh
By engaging in such “psycho-education,” the program attempts to help sufferers of postpartum depression break down their symptoms and understand the aggravating factors in the proper context.
One of the demographics Pugh hopes will benefit most from the adoption of online therapy are women in rural communities, who often lack the means to obtain proper care for postpartum depression.
“We know that rural women struggling with postpartum depression have very limited access to mental health treatment,” Pugh said.
“Often there might not be a counsellor or a psychologist in their community, so they have to travel to a larger city centre to seek out treatment, and we also know that women in rural cities or rural towns feel more stigmatized with respect to postpartum depression because of the tight-knit nature of their community, so it’s even more challenging.”
By allowing rural women to access treatment from their homes, Pugh hopes to bypass such obstacles entirely.
Since clinical trials began in July 2012, the Online Therapy Unit has witnessed a large reduction in symptoms from patients who have tried the online treatment. They plan to continue offering the service until late summer, when they will evaluate results and patient feedback to determine the overall effectiveness of the program and how it might be improved.
The long-term future of Maternal Depression Online is an open question, but Pugh has some ideas how the program might be applied on a larger scale.
“It all depends on funding, of course, but ideally, it should be incorporated into the mental health care system as kind of a first step for those women who are struggling with either mild to moderate symptoms of postpartum depression,” she said.
“If we can identify those women and treat them with online therapy, perhaps we could take the burden off of mental health facilities in the city.”