Addressing the mother–baby relationship in interpersonal psychotherapy for depression: an overview and case study

Objective: This article describes the development of an interpersonal psychotherapy group which has been adapted to address the mother–child relationship in the context of postnatal depression (PND). Background: When PND develops, the child of the sufferer is also at risk for deleterious outcomes. It is thought that this is because the mother–baby bonding process is interrupted, affected, or reduced in quality by the existence of depression in addition to genetics and biological effects of exposure to illness in utero. Past approaches to mitigating this risk have focused on treating the depression as the primary issue and the mother–baby relationship as secondary. This article makes the argument that interpersonal psychotherapy has neglected this relationship despite the evidence that this is a key precipitating/perpetuating factor in PND, and that targeting this relationship has benefits for both mother and baby. Method: An interpersonal psychotherapy protocol was developed, modified to incorporate psychoeducation and practice of maternally sensitive interactions. A case study from a version of this group intervention is provided. Results: The case study outcomes on self-report scales of depression suggest the modified protocol is as effective in treating PND as the original protocol. Self-report of maternal attachment and videotape measures of maternal sensitivity also improved, suggesting that the modified protocol can address the mother–baby relationship. Conclusion: The suitability of adapting interpersonal psychotherapy to address the mother–baby relationship appears promising. Further rigorous trials using this therapy are warranted to determine its effectiveness.