PMH-C Psychological Interventions & Treatment Strategies 4 — Questions and Answers
Question 1: When using problem-solving therapy (PST) with a postpartum patient overwhelmed by new parenthood demands, the clinician focuses on:
- Exploring unconscious conflicts about motherhood
- Teaching a structured process to identify problems, generate solutions, and evaluate outcomes (Correct answer)
- Prescribing antidepressants to reduce distress before problem-solving
- Encouraging the patient to accept problems without trying to solve them
Correct answer: Teaching a structured process to identify problems, generate solutions, and evaluate outcomes
PST teaches a structured, step-by-step approach to defining problems, brainstorming solutions, and evaluating the effectiveness of chosen strategies.
Question 2: A perinatal clinician is working with a patient who experienced sexual trauma and now has significant anxiety about labor and delivery. Which approach addresses both the trauma history and birth-specific fears?
- Childbirth education classes alone
- Trauma-informed birth preparation integrating EMDR or trauma-focused CBT (Correct answer)
- Scheduling an elective C-section without addressing psychological needs
- Avoidance of discussing the birth plan to reduce anxiety
Correct answer: Trauma-informed birth preparation integrating EMDR or trauma-focused CBT
Trauma-informed birth preparation that integrates EMDR or trauma-focused CBT addresses both the underlying trauma and birth-specific anxieties.
Question 3: Which of the following best describes the primary goal of Dyadic Developmental Psychotherapy (DDP) in the perinatal context?
- Treating the mother's depression through individual CBT sessions
- Improving the quality of parent-child attachment through joint therapeutic work (Correct answer)
- Teaching behavioral management techniques for infant sleep
- Providing couples counseling to improve partner relationships
Correct answer: Improving the quality of parent-child attachment through joint therapeutic work
DDP focuses on healing disrupted attachment by working therapeutically with both the parent and child together to improve their relational quality.
Question 4: A mother with postpartum psychosis has been stabilized on medication. Which psychological intervention is most appropriate as she transitions to outpatient care?
- Intensive trauma processing therapy immediately
- Psychoeducation, relapse prevention planning, and family support (Correct answer)
- High-intensity group therapy three times per week
- Discontinuing all therapy since medication has stabilized symptoms
Correct answer: Psychoeducation, relapse prevention planning, and family support
After stabilization, psychoeducation about the illness, relapse prevention planning, and involving family supports are appropriate psychological interventions.
Question 5: Behavioral activation, a key component of CBT for perinatal depression, primarily works by:
- Reducing negative automatic thoughts through journaling
- Increasing engagement in meaningful activities to improve mood (Correct answer)
- Teaching diaphragmatic breathing to reduce arousal
- Challenging the validity of depressive cognitions
Correct answer: Increasing engagement in meaningful activities to improve mood
Behavioral activation combats the withdrawal and inactivity of depression by systematically scheduling and increasing engagement in rewarding activities.
Question 6: Which format of psychotherapy delivery has shown effectiveness for postpartum depression and can improve access for mothers with young infants?
- In-person individual therapy only, as other formats lack evidence
- Telephone-delivered or internet-based CBT (Correct answer)
- Only group formats with a minimum of 10 participants
- Therapy exclusively within the first 48 hours postpartum
Correct answer: Telephone-delivered or internet-based CBT
Telephone-delivered and internet-based CBT have demonstrated effectiveness for postpartum depression and significantly improve access for mothers who face barriers to in-person care.
Question 7: In treating a pregnant woman with generalized anxiety disorder, the perinatal clinician would modify standard CBT by:
- Avoiding any discussion of worry content to prevent distress
- Adapting worry themes to pregnancy-specific concerns and adjusting pacing for fatigue (Correct answer)
- Using medication as the only intervention during the first trimester
- Deferring all treatment until after delivery
Correct answer: Adapting worry themes to pregnancy-specific concerns and adjusting pacing for fatigue
Standard CBT is adapted for pregnant patients by addressing pregnancy-specific worry themes and adjusting session pacing to accommodate physical symptoms like fatigue.
PMH-C Psychological Interventions & Treatment Strategies 4
When using problem-solving therapy (PST) with a postpartum patient overwhelmed by new parenthood demands, the clinician focuses on: