Individual-based Psychotherapy for Perinatal Women

As some of you may have noticed, I’ve been writing tweets about the need to individualize treatment for women with antepartum and postpartum depression. Perhaps you’re wondering, why is that? what is this is all about? I thought perhaps I’d elaborate on this topic this week, and take a break from writing about empty nest syndrome and the process of change.

Well my motivation to write about individualizing treatment began when I started reading and preparing for the upcoming class that I’m teaching at Argosy University (formerly known as The Illinois School of Professional Psychology). As I was delving into the perinatal literature, I noticed many recommendations that suggest using cognitive-behavioral or interpersonal evidence-based approaches with all women with the above conditions. It is a time when it has become politically correct and the new jargon of evidence-based treatments is endorsed for any mental condition, including perinatal mood and anxiety disorders. Of course, we all want to use treatments that work to help our patients. So what’s the problem?

There are a few problems inherent in this logic. First there is an assumption that treatments that haven’t been researched in a randomized controlled trial (only one form of research) aren’t legitimate. There is a subtle idea that other treatments that aren’t in this group of treatment approaches, don’t work. In additon, the methods that are suggested are often manualized, which is a handy way to control variables in research, but isn’t the best way to conduct actual psychotherapy with real people.

I admit that I am no fan of manual type therapy as it’s a cookbook approach, that treats everyone alike and lacks the art of finding what works best for the individual’s unique needs. In practicing in the specialization of perinatal disorders for almost nineteen years, I’ve discovered that each woman despite similar symptoms may respond to a different treatment approach and a particular style of doing therapy. I suppose the obvious message here is.. we are not all alike; if we only use a specific way of treating all our patients, we will find that some respond but many don’t respond to our interventions. The practice of clinical psychology is both an art and a science, and the new focus on using a few forms of manualized evidence-based treatment, may address aspects of the science of psychology, but it leaves behind the art of being a good clinician and in so doing this .. likely leaves behind many patients that don’t fit into our treatment model.

Education promotes each child as unique with individual needs. Yet why think all perinatal women respond alike or need the same treatment approach? I propose instead that we utilize an individual-based treatment in psychotherapy for pregnant and postpartum women.


~ by ppdsus on September 2, 2011.

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