Frontiers in Perinatal Mental Health: Assessing and Intervening on Psychological Distress During a Critical Vulnerability Window
4 - (Sym 87) Perinatal PTSD Treatment During the COVID-19 Pandemic: Feasibility and Acceptability of Narrative Exposure Therapy (NET) via Telehealth
Saturday, November 19, 2022
3:30 PM – 5:00 PM EST
Location: SoHo/Herald, 7th Floor
Keywords: Perinatal, Assessment, Treatment Recommended Readings: Judd, F., Newman, L. K., & Komiti, A. A. (2018). Time for a new zeitgeist in perinatal mental health. Australian & New Zealand Journal of Psychiatry, 52(2), 112-116. Osborne, L. M., Kimmel, M. C., & Surkan, P. J. (2021). The crisis of perinatal mental health in the age of Covid-19. Maternal and child health journal, 25(3), 349-352. Spadaro, B., Martin-Key, N. A., Funnell, E., & Bahn, S. (2022). mHealth Solutions for Perinatal Mental Health: Scoping Review and Appraisal Following the mHealth Index and Navigation Database Framework. JMIR mHealth and uHealth, 10(1), e30724.
Assistant Professor Rush University Medical Center Chicago, Illinois
Posttraumatic stress disorder (PTSD) is a significant (undetected/undertreated) complication of pregnancy linked to adverse perinatal outcomes for mother and infant. Unfortunately, perinatal PTSD treatment studies are few. Moreover, mental health treatment during pregnancy has always posed unique challenges before the COVID-19 pandemic, particularly in low-resource urban settings where risk of violence exposure is high. Perhaps an unintended positive consequence of the pandemic is the mental healthcare system’s response to accelerate adaptation of efficacious methodologies for high-needs populations due to compounded effects of pandemic stress and pre-existing trauma. In 2019, we began our feasibility and acceptability study of Narrative Exposure Therapy (NET) for pregnant individuals with PTSD, aiming to test whether partial telehealth delivery of a short-term therapy for traumatic stress could enhance engagement, retention, and satisfaction. As the open-label trial (N=28) nears completion in 2021, most participants will have completed the study entirely via telehealth due to the pandemic. Rather than pause the trial when the pandemic started in 2020, we adapted, successfully engaging and retaining 79% (n=22) of participants in NET. Pregnant participants (47% Hispanic/Latina, 35% Black/African American, median age = 28, median gestational week in pregnancy = 21.5) received 4-6 sessions of exposure therapy following intake and psychoeducation sessions. Over 90% (n=19) of participants reported a clinically meaningful reduction of PTSD symptoms post-treatment. Analysis of qualitative data from exit interviews of >90% (n=18) of treatment completers reveals critical information regarding the needs and experiences of pregnant trauma survivors, and the particular importance of processing their traumas while being pregnant at a time of high stress, such as the pandemic. Results of the feasibility and acceptability trial suggest that more adaptation and acceleration of service delivery, not less, is needed so that perinatal mental health clinical science can “catch up” to the needs and desires of a neglected population.