Treatment Access, Engagement and Cognitive Behavioural Therapy for Perinatal Anxiety

Abstract

<p>Perinatal anxiety disorders are common and are associated with significant burden on women and their families, and with increased health care costs. Cognitive behaviour therapy (CBT) is considered the psychological treatment of choice for anxiety disorders in the general population" however, the efficacy of CBT for perinatal anxiety is less understood. The overarching aim of this program of research was to evaluate the acceptability and efficacy of CBT for perinatal anxiety. This was achieved across four separate studies. Study 1 synthesised the current empirical status of CBT for perinatal anxiety using a meta-analytic approach. The meta-analysis included 13 studies and found that CBT is an effective treatment for perinatal anxiety. Study 2 used a qualitative approach to explore women's experiences of perinatal anxiety, as well as facilitators and barriers to accessing treatment during the perinatal period. The study included 20 women (<i>M_age</i> = 34.65 years, <i>SD</i> = 8.68) who participated in semi-structured interviews. The findings indicated two overarching themes, facilitators and barriers to accessing treatment in the perinatal period" and common experiences of perinatal anxiety and what treatment would ideally provide - with each overarching theme encompassing numerous global and organising themes. Study 3 used a quantitative approach to further explore the perceived barriers to help-seeking intention for perinatal anxiety and women's treatment preferences, and to examine the utility of the Health Belief Model (HBM) in predicting future help-seeking intention specific to perinatal anxiety. A total of 216 women (<i>M_age</i> = 28.53 years" <i>SD</i> = 4.97) with perinatal anxiety symptoms participated in the study by completing a battery of online self-report measures. The study found the most common barriers to accessing treatment were the cost of treatment" wanting to solve the problem on their own" and thinking the problem would go away, and found that face-to-face individual CBT was women's preferred treatment approach. The study also found that the HBM variables together predicted approximately 35% of the variance in help Study 4 used a case series design to investigate the efficacy and acceptability of remotely delivered transdiagnostic CBT for postnatal anxiety. Three women (<i>M_age</i> = 28.33 years" <i>SD</i> = 4.04) were treated using transdiagnostic CBT delivered remotely via internet videoconferencing. The study found significant reductions from pre-treatment to posttreatment on both anxiety and depression measures. Taken together, the findings of this program of research can be used to enhance treatment uptake and improve treatment access during the perinatal period.</p>