The Survivor Moms' Companion Trauma-Specific Perinatal Psychoeducation Intervention in a Community Outreach Program:...

Posttraumatic stress disorder (PTSD) confers significant risk during the childbearing year, including for maternal substance use, inadequate prenatal care, preterm birth, and impaired maternal-infant bonding. Although several treatments are available for PTSD, few are specific to the perinatal period. The purpose of this pilot study was to evaluate outcomes of a PTSD- and pregnancy-specific psychoeducational intervention, the Survivor Moms' Companion (SMC).

The SMC includes psychoeducation with tutor support to address maternal posttraumatic stress, affect regulation, and interpersonal sensitivity. This open pilot was conducted in a large city in a mid-Atlantic state within an organization that provides perinatal services via community health workers (CHWs). The majority of participants were aged 20 to 25 years and African American and had low levels of income and educational attainment. The SMC learning modules were supplied to participants by specially trained CHWs who provided weekly face-to-face support during 30-to-60-minute tutoring sessions. Pretest-to-posttest analyses using multiple imputation methodology and paired-samples t tests examined PTSD symptom counts and scores related to theorized mechanisms of affect dysregulation and interpersonal sensitivity. Nonparametric statistical tests examined clinically meaningful changes.

Of 56 women who completed pretests, 38 (67.9%) completed the core dose of a minimum of 4 of 10 learning modules. Examination of intention-to-treat (n = 56) pretest-to-posttest scores revealed statistically significant improvements in PTSD symptoms (P < .001), affect regulation (depression [P < .001] and anger expression [P < .05]), and interpersonal sensitivity (P < .001). Per-protocol analyses (n = 38) revealed significant changes from clinical to nonclinical range scores for PTSD (P < .01) and depression (P < .05).

These findings suggest that a psychoeducational intervention with tutor support can be influential in fostering positive mental health changes in a high-risk perinatal population. CHWs with intervention-specific training can be effective at implementing a trauma-specific intervention.