A Brief Intervention for the Treatment of Anxiety in Pregnancy: A Pilot Randomized Controlled Trial (The TAP Study)

Anxiety during pregnancy affects 1 in 4 pregnancies and is often comorbid with other mental health disorders. Early intervention is crucial to avoid persistent mental health issues and adverse obstetrical, neonatal and child outcomes. Traditional mindfulness-based cognitive therapy is effective, but its uptake is limited by its high resource intensity for patients and healthcare services. This study investigated the feasibility, acceptability, and preliminary efficacy of a novel, brief psychotherapy, "mindful adaptive practice in pregnancy" (MAPP), delivered in a synchronous virtual group format.

This pilot randomized controlled trial (RCT) was conducted at two university-affiliated health centers. Pregnant persons with elevated anxiety symptoms were randomly assigned to MAPP plus treatment as usual (TAU) or TAU alone. MAPP was delivered in five, 2-h virtual group sessions, over 4 weeks. Feasibility was assessed by recruitment rates and participant eligibility, intervention acceptability through online questionnaires, and adherence by session attendance and follow-up completion. Efficacy was preliminarily evaluated by anxiety symptom change post-treatment.

Participants were recruited from November 2021 to May 2022, with 69 randomized to MAPP (36 participants) or TAU (33 participants). High acceptability and adherence were reported for MAPP with over 80% attending three or more sessions. Preliminary results suggest significant reduction in anxiety symptoms for participants receiving MAPP compared to TAU.

MAPP was feasible and well accepted. Preliminary data suggest that this brief, synchronous virtual therapy may effectively reduce anxiety symptoms. Further investigation into MAPP's efficacy in a larger-scale RCT can confirm its viability as an intervention for anxiety during pregnancy.