Millett Lottie, Taylor Billie Lever, Howard Louise M, Bick Debra, Stanley Nicky, Johnson Sonia
Division of Psychiatry,University College London,UK.
Section of Women's Mental Health,Institute of Psychiatry,Psychology and Neuroscience,King's College London,UK.
Behav Cogn Psychother. 2018 Jul;46(4):421-436. doi: 10.1017/S1352465817000650. Epub 2017 Oct 30.
Perinatal mental health difficulties are highly prevalent. In England, the Improving Access to Psychological Therapy (IAPT) programme provides evidence-based psychological treatment, predominantly in the form of brief manualized cognitive behavioural therapy (CBT), to people with mild to moderate depression or anxiety. Yet little is known about the experiences of women referred to IAPT with perinatal mental health difficulties.
The aim of this qualitative study was to investigate how women view IAPT support for perinatal mental health. We also gained the perspective of IAPT therapists.
Semi-structured interviews were conducted with twelve women who had been referred to and/or received therapy from IAPT during the perinatal period. Additionally, fourteen IAPT therapists participated in two focus groups. Thematic analysis was used.
Key themes centred on barriers to access and the need to tailor support to (expectant) mothers. Women and therapists suggested that experiences could be improved by supporting healthcare professionals to provide women with more help with referrals, better tailoring support to the perinatal context, improving perinatal-specific training, supervision and resources, and offering a more individualized treatment environment.
Overall, women reported positive experiences of support offered by IAPT for perinatal mental health difficulties. However, services should seek to facilitate access to support and to enable therapists to better tailor treatment.
围产期心理健康问题极为普遍。在英国，改善心理治疗可及性（IAPT）项目为患有轻至中度抑郁或焦虑的人群提供循证心理治疗，主要形式为简短的手册化认知行为疗法（CBT）。然而，对于被转介至IAPT处理围产期心理健康问题的女性的经历，我们知之甚少。
这项定性研究的目的是调查女性如何看待IAPT对围产期心理健康的支持。我们还获取了IAPT治疗师的观点。
对12名在围产期被转介至IAPT并/或接受其治疗的女性进行了半结构式访谈。此外，14名IAPT治疗师参加了两个焦点小组。采用了主题分析法。
关键主题集中在获得治疗的障碍以及为（准）母亲量身定制支持的必要性。女性和治疗师表示，通过支持医疗保健专业人员为女性提供更多转介帮助、更好地根据围产期情况量身定制支持、改善围产期特定培训、监督和资源以及提供更个性化的治疗环境，可以改善体验。
总体而言，女性报告了IAPT为围产期心理健康问题提供支持的积极体验。然而，服务机构应努力促进获得支持，并使治疗师能够更好地量身定制治疗。
