Optional Web-Based Videoconferencing Added to Office-Based Care for Women Receiving Psychotherapy During the Postpartum Period: Pilot Randomized Controlled Trial

Background: Depression and anxiety during the postpartum period are
common, with psychotherapy often being the preferred method of
treatment. However, psychological, physical, and social barriers
prevent women from receiving appropriate and timely psychotherapy.
The option of receiving psychotherapy through videoconferencing
(VC) during the postpartum period presents an opportunity for more
accessible and flexible care. Objective: The aim of this study was
to assess the feasibility, acceptability, and preliminary
effectiveness of optional VC added to usual office-based
psychotherapy, with a psychotherapist during the postpartum period.
Methods: We conducted a pilot randomized controlled trial with 1:1
randomization to office-based care (treatment as usual; TAU) or
office-based care with the option of VC (treatment as usual plus
videoconferencing; TAU-VC) for psychotherapy during the postpartum
period. We assessed the ability to recruit and retain postpartum
women into the study from an urban perinatal mental health program
offering postpartum psychotherapy, and we evaluated the uptake,
acceptability, and satisfaction with VC as an addition to in-person
psychotherapy. We also compared therapy attendance using therapist
logs and symptoms between treatment groups. Symptoms were assessed
at baseline and 3 months postrandomization with the Edinburgh
Postnatal Depression Scale, Generalized Anxiety Disorder 7-item,
and Parental Stress Scale. Furthermore, 3-month scores were
compared between groups with intention-to-treat linear
mixed-effects models controlling for baseline score. Results: We
enrolled 38 participants into the study, with 19 participants in
each treatment group. Attendance data were available for all
participants, with follow-up symptom measures available for 25 out
of 38 participants (66%). Among the 19 TAU-VC participants, 14
participants (74%) utilized VC at least once. Most participants
were highly satisfied with the VC option, and they reported average
savings of Can $26 and 2.5 hours in travel and childcare expenses
and time per appointment. There were no significant differences
between the 2 groups for psychotherapy attendance or symptoms.
Conclusions: The option of VC appears to be an acceptable method of
receiving psychotherapy for postpartum women, with benefits
described in costs and time savings. On the basis of this small
pilot sample, there were no significant differences in outcomes
between office-based care with or without the option of VC. This
study has demonstrated the feasibility of such a program in an
urban center, which suggests that a larger study would be
beneficial to provide evidence that is more conclusive.

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Optional Web-Based Videoconferencing Added to Office-Based Care for Women Receiving Psychotherapy During the Postpartum Period: Pilot Randomized Controlled Trial