Ammerman Lab
Treatment of Maternal Depression in Home Visiting

Treatment of Maternal Depression in Home Visiting

A number of studies have documented the mental health needs of at-risk mothers in home visitation. In particular, maternal depression leads to numerous negative outcomes in both mothers and children. Research shows that up to 60% of mothers in home visiting experience clinically significant depression during the first three years of the child’s life, that for many mothers major depressive disorder has a persistent and chronic course, and that up to 74% of mothers have been victimized by violence and trauma. In response, we developed In-Home Cognitive Behavioral Therapy, an evidence-based treatment that has been adapted for use in depressed mothers in home visitation.

Moving Beyond Depression™: Bringing Effective Treatment to Home Visiting Programs

Moving Beyond Depression™ (MBD), a program of Every Child Succeeds, was developed to scale up the availability of IH-CBT and effective identification strategies for home visiting programs around the country. MBD provides state and regional home visiting programs with training and support in screening for and identifying depression in mothers, mastering and implementing IH-CBT with fidelity and effectiveness, and evaluation tools and procedures to measure impact.

Treatment of Maternal Depression in Home Visitation: Mother and Child Impacts

R01 funded by the National Institute of Mental Health: In this study, 220 mothers enrolled in home visitation will be recruited through initial screening and subsequent diagnosis of MDD. Subjects will be randomly assigned to IH-CBT (in-home cognitive behavioral therapy) + home visitation or PCT (present-centered therapy) + home visitation. We will evaluate subjects’ levels of depression, psychiatric comorbidity, adaptive functioning, social support, parenting, and child functioning at pretreatment, post-treatment, and at six-, 12- and 18-month follow-ups. We hypothesize that IH-CBT will be superior to PCT in (1) recovery from depression, (2) risk of relapse and recurrence, and (3) increasing social support and reducing overall psychiatric symptomatology. Co-Investigators on this study include Jennie G. Noll, PhD (Cincinnati Children's), Mekibib Altaye, PhD (Cincinnati Children's), Frank W. Putnam, MD (Cincinnati Children's and University of North Caroline School of Medicine), and Edward Tronick, PhD (University of Massachusetts Boston).

Treatment of Depression in Mothers in Home Visitation

R34 funded by the National Institute of Mental Health: In this study, we further developed and refined In-Home Cognitive Behavioral Therapy (IH-CBT). We randomly assigned 93 mothers with MDD to IH-CBT or “typical” home visitation (THV). We evaluated subjects’ levels of depression, psychiatric comorbidity, adaptive functioning, social support, trauma, and child functioning pretreatment, post-treatment and three-month follow-up.

We hypothesized that IH-CBT would be superior to THV in (1) reducing depressive symptoms, (2) facilitating recovery from depression, (3) and increasing social support and social networks. Although the study is currently in the data analytic stage, our preliminary findings suggest that IH-CBT substantially reduced depressive symptoms, led to remission of MDD, and had broad positive impacts on maternal functioning. Moreover, data suggest that recovery from depression was associated with improvements in parenting, reduction in parenting stress and improved child social and emotional functioning.

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