In the postpartum period, approximately 10 to 16 percent of women will become clinically depressed. The impact of major depression in the postpartum period is profound with considerable emotional pain for the new mother as well as disturbances in infant development. Unfortunately, few preventive interventions have been developed or systematically tested to reduce the risk of postpartum depression. An area of even greater neglect is the development of such an intervention for financially disadvantaged women who are at high risk for postpartum depression and for the disturbances associated with postpartum depression. This treatment development application proposes to develop a psychosocial intervention for financially disadvantaged, pregnant women at risk for postpartum depression. and to collect preliminary data on the efficacy of this intervention in reducing the likelihood of postpartum depression. The intervention, """"""""Life at Home with a New Baby,"""""""" is an interpersonal-oriented intervention that targets those factors that may play a significant role in the development of postpartum depression (i.e., poor social support, role transitions, and life stressors). More specifically, the aims of this project are to: (i) develop the manual for the intervention, """"""""Life at Home with a New Baby"""""""" (ii) develop, implement, and evaluate a therapist training program, (iii) develop and test the reliability and validity of competence and adherence rating scales that evaluate the training therapists' ability to perform the intervention and assess the reliable delivery of the intervention, and (iv) conduct a randomized controlled pilot study to evaluate the initial efficacy of the proposed intervention compared to a care as usual condition in a sample of financially disadvantaged, pregnant women at risk for postpartum depression. and to provide an estimate of effect size in comparison to the care as usual condition. This pilot study will lay the groundwork for a larger clinical trial evaluating the efficacy of this new group intervention.
