Delivery of CBT to treat postnatal depression: health visitors' perceptions

The most extensively researched form of psychotherapy over the last 10 years, cognitive behavioural therapy (CBT), has recently been promoted in health visiting practice. Health visitors, frontline practitioners for the majority of women with postnatal depression (PND), stand between the use of antidepressants for PND on the one hand where compliance is not good and the potential to offer a practical alternative using cognitive behavioural techniques on the other. The aim of this study was to examine how health visitors understand the concept of CBT and envisage its implementation in practice with regard to the treatment and management of PND. A qualitative research methodology using a phenomenological approach was adopted to analyse transcripts from two semi-structured focus group interviews with nine health visitors about their work with PND and CBT. The findings demonstrated that health visitors do not want to be known as 'frontline' professionals in the delivery of CBT to treat PND as this would imply 'counsellor'--a diversion from their professional identity and unique role. However, they wanted to be equipped with more than just introductory basic assessment and treatment techniques in CBT to deliver a pragmatic, psycho-educational approach to PND in four to eight home sessions.