The treatment of postnatal depression by health visitors: Impact of brief training on skills and clinical practice

Louis Appleby, Emma Hirst, Sarah Marshall, Felicity Keeling, Janet Brind, Tony Butterworth, Joan Lole

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background: Postnatal depression can be effectively treated by cognitive behavioural counselling (CBC), a simple intervention designed to be delivered by non-specialists in mental health. Methods: Health visitors were trained in CBC and post-training changes in counselling skills, clinical practice and costs were assessed. Results: Following training health visitors showed improved counselling skills, and they carried out more mental health assessments, recorded mental symptoms more often and treated more women themselves. However, their mean number of contacts with depressed women did not change; and the number of urgent contacts diminished. Referrals to general practitioners did not increase but there was an increase in referrals to mental health services. Costs to health visitor practice did not increase. Limitations: Assessment of clinical practice was based on health visitor records. The study uses a 'before and after' design rather than randomisation of subjects. Conclusions: Training health visitors in CBC leads to improved counselling skills and corresponding changes in clinical practice, without increasing the costs of health visitor practice. © 2002 Elsevier B.V. All rights reserved.
    Original languageEnglish
    Pages (from-to)261-266
    Number of pages5
    JournalJournal of Affective Disorders
    Volume77
    Issue number3
    DOIs
    Publication statusPublished - Dec 2003

    Keywords

    • Cognitive therapy
    • Community health nursing
    • Counselling
    • Depression
    • Postpartum

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