Women of childbearing age are at a disproportionately high risk for depressive syndromes. Both depressive disorders and subclinical symptomatology, moreover, are associated with impaired parenting as well as with heightened vulnerability to psychopathology in their offspring. Despite the availability of efficacious treatments, most depressed persons do not receive treatment. Amongst the many barriers to treatment, several of the most substantial, including lack of mental health coverage, difficulties arranging childcare, and the absence of transportation differentially effect women of low socioeconomic status. For rural women, these difficulties may be compounded by the scarcity of providers within reasonable proximity. In the current application we propose to adapt an empirically-supported CBT intervention for depression to an Internet Computer Hard Drive/DVD hybrid delivery system. Adaptations to the CBT program will include the addition of content of particular relevance to mothers of young children, and the incorporation of instructional design principles to promote self-learning. The intervention will take advantage of the unique properties of the Internet, including multimedia presentation and interactive, components including professional and moderated peer social support. The adaptation and development will be characterized by a formative evaluation process designed to maximize its acceptability to and effectiveness for the targeted population. Subsequent to the adaptation, we will conduct a controlled pilot evaluation. Participants will be 70 mothers of children in Head Start classrooms. Inclusion in the sample will require elevated levels of depressive symptoms. Participants will be randomly assigned to either an immediate- or delayed- intervention condition. The evaluation of the intervention will focus on maternal depressive symptoms, parenting behavior, and child adjustment. A follow up assessment will enable us to examine maintenance of effects. The pilot will begin to build the evidentiary base necessary for a subsequent, large scale efficacy evaluation. Relevance. Depression is very common in women with young children, and most women, especially those living in poverty, do not receive treatment. We propose to develop and test a treatment program that depressed mothers can access through the Internet. An internet-based program is a cost-effective way to provide much needed services to depressed mothers. ? ? ?
| Sheeber, Lisa B; Seeley, John R; Feil, Edward G et al. (2012) Development and pilot evaluation of an Internet-facilitated cognitive-behavioral intervention for maternal depression. J Consult Clin Psychol 80:739-749 |
