It's just different in the country: postnatal depression and group therapy in a rural setting

The treatment of postnatal depression (PND) via group therapy is an accepted practice in Sydney and other metropolitan areas throughout Australia. This article analyses the difficulties faced in the importation of this urban-developed treatment model into a rural setting. In 1995, this program was established in a major rural centre of New South Wales (NSW) and drew participants from the regional centre, surrounding rural properties, towns and villages. Participation in the program resulted in significant lowering or absences of depressive episodes following treatment. But beyond this significant aspect of a positive response to this treatment program is a fascinating aspect of differences between the rural and urban groups in this population. The differences occurred in group formation, group process and attitudes of the participants. We would suggest that group leaders in rural PND programs face more resistance to the idea of groups for therapeutic intervention, need to draw different lines between personal and professional boundaries from their urban counterparts and are confronted with participants who adhere more strongly to the prevailing mythology of motherhood. This mythology may increase the likelihood and intensity of postnatal depression and cause greater resistance to cognitive restructuring skills, which are essential for challenging thoughts that enhance depression.