The effectiveness of psychological interventions for anxiety in the perinatal period: A systematic review and meta-analysis

Background: Anxiety disorders are a relatively common occurring mental health issue during pregnancy and the perinatal period. There is evidence that untreated perinatal anxiety is a risk factor for adverse outcomes for mother and infant. Despite their potential acceptability to users, psychological interventions research for this population is still in its infancy. This systematic review and meta-analysis aimed to comprehensively evaluate the evidence of the effectiveness of psychological interventions for reducing perinatal anxiety. Method: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched included EMBASE, MEDLINE, PsychINFO, MIDIRS, CINAHL and the Cochrane Library. Search terms included: Psychological Therapy, Perinatal Period, Antenatal, Postnatal, Anxiety, Obsessive Compulsive Disorder and Phobia. Results: The search strategy identified 2025 studies. A total of 21 studies published between 2004 and 2021 fulfilled inclusion criteria. Of those, 17 were included in the meta-analysis. Overall results indicated that psychological interventions were more effective than control conditions in reducing symptoms of perinatal anxiety with a medium post treatment effect size. Significant effect sizes were also identified for online, face-to-face, group and guided self-help treatment modalities. Limitations: A small sample of studies are represented and limited to articles published in English. The review was unable to draw specific conclusions about what works (i.e. therapeutic modality/delivery) for whom (i.e. specific diagnoses) due to purposefully broad inclusion criteria. The longer-term effects of psychological interventions for perinatal anxiety and infant outcomes could not be established. Conclusions: This review demonstrates that psychological interventions are effective in reducing symptoms of both anxiety and comorbid anxiety and depression in the antenatal and postnatal periods. The results also demonstrate the efficacy of delivering such interventions in multiple settings, including online, and in group format. Further research is required to optimise treatment delivery to individual needs.

Remote Psychological Interventions for Fear of Cancer Recurrence: Scoping Review

Background Patients with cancer and survivors may experience the fear of cancer recurrence (FCR), a preoccupation with the progression or recurrence of cancer. During the spread of COVID-19 in 2019, patients and survivors experienced increased levels of FCR. Hence, there is a greater need to identify effective evidence-based treatments to help people cope with FCR. Remotely delivered interventions might provide a valuable means to address FCR in patients with cancer. Objective The aim of this study is to first discuss the available psychological interventions for FCR based on traditional cognitive behavioral therapies (CBTs) or contemporary CBTs, in particular, mindfulness and acceptance and commitment therapy, and then propose a possible approach based on the retrieved literature. Methods We searched key electronic databases to identify studies that evaluated the effect of psychological interventions such as CBT on FCR among patients with cancer and survivors. Results Current evidence suggests that face-to-face psychological interventions for FCR are feasible, acceptable, and efficacious for managing FCR. However, there are no specific data on the interventions that are most effective when delivered remotely. Conclusions CBT interventions can be efficacious in managing FCR, especially at posttreatment, regardless of whether it is delivered face to face, on the web, or using a blended approach. To date, no study has simultaneously compared the effectiveness of face-to-face, web-based, and blended interventions. On the basis of the retrieved evidence, we propose the hypothetical program of an intervention for FCR based on both traditional CBT and contemporary CBT, named Change Of Recurrence, which aims to improve the management of FCR in patients with cancer and survivors.

Meditation, Mindfulness, and Mental Health

In the last six decades, the concept of mindfulness has been widely studied, researched, and practiced in mainstream psychology, mental health, and health disciplines. Over a period of time, clinical practitioners have integrated meditation and mindfulness practices or techniques in the mainstream psychological interventions for emotional and behavioral disorders such as anxiety, depression, chronic pain, borderline personality disorder, and eating disorder. This chapter highlights the application of Mindfulness-Based Interventions in various clinical and non-clinical samples. It also covers the importance of mindfulness practices for the crisis due to the COVID-19 pandemic, discusses integrating technology into mindfulness training, and presents various issues and challenges related to mindfulness practices.

Digitising Creative Psychological Therapy

In response to the COVID-19 pandemic, there has been a need to adapt and develop psychological interventions that address the mental health of those in need. As a result, Arts for the Blues (A4B), an evidence-based creative group psychotherapy model, originally developed for in-person delivery to address the needs of clients with depression, was transformed into a remote therapy option. This chapter presents an overview of plans and steps so far and offers activities used online during a public workshop with 24 participants and training sessions with 70 psychotherapists (qualified and trainee). Concerns around safety, group sizes, time, and guidance/support are discussed, while the value of online work for clients with depression (adults and children) are explored. It is concluded that even when in-person delivery is possible, online versions will be useful since they encourage a wider reach and make interventions more accessible.