PMH-C Psychological Interventions & Treatment Strategies 2 — Questions and Answers
Question 1: Which type of therapy is considered a first-line psychological treatment for postpartum depression due to its strong evidence base and focus on relationship disruptions common in new mothers?
- Dialectical Behavior Therapy (DBT)
- Interpersonal Therapy (IPT) (Correct answer)
- Acceptance and Commitment Therapy (ACT)
- Psychodynamic Therapy
Correct answer: Interpersonal Therapy (IPT)
IPT is a first-line treatment for postpartum depression because it directly targets interpersonal role transitions, conflicts, and grief that frequently accompany new parenthood.
Question 2: A mother with perinatal OCD experiences intrusive thoughts about harming her infant. The most appropriate therapeutic approach for these ego-dystonic thoughts is:
- Encouraging her to avoid all situations that trigger the thoughts
- Exposure and Response Prevention (ERP) (Correct answer)
- Prescribing antipsychotic medication as the first intervention
- Hospitalizing the patient immediately
Correct answer: Exposure and Response Prevention (ERP)
ERP, a form of CBT, is the gold-standard treatment for OCD, including perinatal OCD with ego-dystonic intrusive thoughts about infant harm.
Question 3: During motivational interviewing with a pregnant patient who is ambivalent about stopping alcohol use, the clinician should primarily:
- Provide direct advice and list consequences of alcohol use
- Explore and reinforce the patient's own reasons for change (Correct answer)
- Set a firm quit date and monitor compliance
- Refer immediately to an inpatient detox program
Correct answer: Explore and reinforce the patient's own reasons for change
Motivational interviewing focuses on eliciting and reinforcing the patient's intrinsic motivation by exploring their own values and reasons for change.
Question 4: Which component of Cognitive Behavioral Therapy is most targeted when a clinician helps a postpartum patient identify that the thought 'I am a terrible mother' is a cognitive distortion?
- Behavioral activation
- Cognitive restructuring (Correct answer)
- Relaxation training
- Mindfulness-based exposure
Correct answer: Cognitive restructuring
Cognitive restructuring involves identifying, challenging, and reframing maladaptive automatic thoughts and cognitive distortions.
Question 5: A lactating mother with moderate postpartum depression declines medication. Which psychotherapy modality has the strongest evidence for treating moderate PPD without pharmacotherapy?
- Psychoeducation alone
- CBT or IPT (Correct answer)
- Supportive therapy only
- Art therapy
Correct answer: CBT or IPT
CBT and IPT both have robust evidence bases for treating moderate postpartum depression as standalone treatments without pharmacotherapy.
Question 6: In treating perinatal PTSD related to a traumatic birth experience, which trauma-focused therapy has the most evidence and is considered safe in the perinatal period?
- Eye Movement Desensitization and Reprocessing (EMDR) (Correct answer)
- Hypnotherapy
- Free association psychoanalysis
- Sensorimotor psychotherapy exclusively
Correct answer: Eye Movement Desensitization and Reprocessing (EMDR)
EMDR has substantial evidence for perinatal PTSD and is considered safe to use during pregnancy and postpartum.
Question 7: A clinician using Mindfulness-Based Cognitive Therapy (MBCT) with a postpartum patient would focus primarily on:
- Changing the content of depressive thoughts directly
- Developing a different relationship with thoughts to prevent relapse (Correct answer)
- Teaching assertiveness and social skills
- Analyzing the developmental roots of depression
Correct answer: Developing a different relationship with thoughts to prevent relapse
MBCT teaches patients to observe thoughts without judgment and change their relationship with depressive thinking, reducing relapse risk.
PMH-C Psychological Interventions & Treatment Strategies 2
Which type of therapy is considered a first-line psychological treatment for postpartum depression due to its strong evidence base and focus on relationship disruptions common in new mothers?