Preliminary Effectiveness of Family Therapy for Perinatal Depressive Symptoms: Results From a Pilot Randomized Trial

ABSTRACT A significant portion of mothers (pregnant and postpartum) enrolled in U.S. home visiting programs report clinically significant depressive symptoms. Non‐violent family conflict precipitates and exacerbates their depressive symptoms. This pilot randomized trial tested the preliminary effectiveness of a family therapy intervention, Resilience Enhancement Skills Training (REST), compared to the standard of care in home‐visited mothers with moderate to severe depressive symptoms and moderate to high conflict with family members. A total of 83 mothers and their family members ( N = 166) were randomized to receive REST or the standard of care. Both interventions were delivered by clinicians using HIPAA‐compliant video conferencing technology. Outcomes were assessed by research assistants, blinded to study group assignment, at post‐intervention, 3, and 6 months later. Linear mixed‐effects models were used to analyze changes in continuous outcomes in mothers and family members, separately. Mixed‐effects logistic regression was used to analyze changes in maternal job attainment/school enrollment. Participants in both study groups showed improvements in outcomes. When compared to standard‐of‐care participants, REST participants had significantly greater reductions in family conflict (mothers ES = −1.19, family members ES = −0.77), maternal depressive symptoms (ES = −0.96) and co‐occurring anxiety symptoms (ES = −0.59), and greater increases in family cohesion (mothers ES = 0.99, family members ES = 0.94) and maternal job attainment/school enrollment (ES = 0.70). The results highlight the value of family therapy for the treatment of moderate to severe depressive symptoms in home‐visited mothers, including those with co‐occurring moderate to severe anxiety symptoms. Trial Registration: Registered in ClinicalTrials.gov on 02/04/2021. NCT04741776 https://clinicaltrials.gov/ct2/show/NCT04741776