Partnering with partners: a quality improvement project in perinatal intensive outpatient programming

Perinatal Mood and Anxiety Disorders (PMADs) are among the most common complications of childbirth. Intensive Outpatient Programming (IOP) treats the most acute/severe PMADs while fostering birthing patient-infant relationships. As perinatal psychiatric treatments expand, non-birthing partners are critical to include and serve, both for their own PMADs risk and to support birthing patients.

This quality improvement study describes the development and early implementation of a 1-3 session program, termed Partner Project, serving patients in a perinatal IOP and their partners. Treatment goals were to: improve partner understanding of PMADs/treatment, promote partner well-being and contact with services, cultivate partner skills for patient support, and foster intimate relationship functioning. Couples (n = 17) participated, with measures of anxiety, depression, bonding, and program feedback.

The final protocol involves two sessions with both partners beginning during early/middle IOP treatment and ending around graduation. Patient anxiety, depression, and bonding symptoms began in clinical ranges and significantly decreased after treatment. On average, no partner questionnaires (baseline only) were in clinical ranges, though prompted important discussions about thoughts of self-harm, coping, and partner mental health. Referrals were requested/provided to individual, couples, and fathering group therapies. Feedback forms were not required (patient n = 6, partner n = 4), though indicated high levels of satisfaction and provided qualitative information on treatment experiences.

Partner Project sessions adapted evidence-based couple-based interventions to the perinatal IOP context, and demonstrated treatment interest and satisfaction. Patients, partners, and infants stand to benefit from including and addressing partner PMADs and relational functioning within perinatal mental health treatment.