PMH-C Psychological Interventions & Treatment Strategies 5 — Questions and Answers
Question 1: When a postpartum patient with depression and significant sleep deprivation presents for therapy, the clinician should prioritize:
- Beginning intensive daily trauma processing sessions
- Addressing sleep as a treatment target alongside depressive symptoms (Correct answer)
- Deferring all therapy until normal sleep is restored
- Focusing exclusively on medication management for sleep
Correct answer: Addressing sleep as a treatment target alongside depressive symptoms
Sleep deprivation can worsen and maintain postpartum depression, so addressing sleep alongside depressive symptoms is a critical therapeutic priority.
Question 2: A perinatal clinician using Acceptance and Commitment Therapy (ACT) would help a patient with postpartum anxiety primarily by:
- Challenging the accuracy of anxious thoughts through Socratic questioning
- Increasing psychological flexibility and helping her act according to her values despite anxiety (Correct answer)
- Eliminating anxious thoughts through thought stopping techniques
- Restructuring core schemas about danger and safety
Correct answer: Increasing psychological flexibility and helping her act according to her values despite anxiety
ACT focuses on increasing psychological flexibility—accepting difficult thoughts and feelings without struggle while committing to valued actions.
Question 3: Which of the following is the most evidence-based group therapy format for postpartum depression?
- Unstructured support groups without a facilitator
- CBT or IPT-based structured group therapy (Correct answer)
- Psychodrama groups
- Grief-focused bereavement groups
Correct answer: CBT or IPT-based structured group therapy
Structured group formats based on CBT or IPT have the strongest evidence base for treating postpartum depression in group settings.
Question 4: A clinician is using Circle of Security (COS) with a postpartum mother who has anxious attachment. The primary goal of this intervention is to:
- Teach the mother behavioral sleep training techniques
- Help the mother understand and respond to her infant's attachment needs (Correct answer)
- Process the mother's childhood trauma directly
- Improve the couple's communication and intimacy
Correct answer: Help the mother understand and respond to her infant's attachment needs
Circle of Security helps caregivers understand their infant's attachment cues and signals, improving their ability to serve as a secure base and safe haven.
Question 5: When treating perinatal insomnia using Cognitive Behavioral Therapy for Insomnia (CBT-I), which component directly addresses dysfunctional beliefs about sleep?
- Sleep restriction therapy
- Stimulus control
- Cognitive restructuring of sleep-related beliefs (Correct answer)
- Relaxation training
Correct answer: Cognitive restructuring of sleep-related beliefs
Cognitive restructuring in CBT-I specifically targets unhelpful beliefs and attitudes about sleep (e.g., 'I must get 8 hours or I cannot function') that perpetuate insomnia.
Question 6: A perinatal clinician working with a patient who has limited insight into her depression and resists therapy should use which approach to build therapeutic alliance?
- Immediately confront the patient's denial and resistance
- Use empathic validation, psychoeducation, and motivational enhancement strategies (Correct answer)
- Terminate treatment until the patient is ready to engage
- Increase session frequency to overcome resistance
Correct answer: Use empathic validation, psychoeducation, and motivational enhancement strategies
Building therapeutic alliance with resistant patients requires empathic validation, normalization, and motivational techniques to increase readiness for engagement.
Question 7: Which principle of trauma-informed care is most critical when conducting psychological treatment with a survivor of intimate partner violence during the perinatal period?
- Focusing immediately on trauma narrative processing
- Prioritizing safety, choice, and empowerment throughout treatment (Correct answer)
- Maintaining strict therapeutic neutrality about relationship decisions
- Encouraging rapid disclosure of all trauma details
Correct answer: Prioritizing safety, choice, and empowerment throughout treatment
Trauma-informed care for IPV survivors must prioritize safety planning, restore a sense of choice and control, and use an empowerment-based approach throughout treatment.
PMH-C Psychological Interventions & Treatment Strategies 5
When a postpartum patient with depression and significant sleep deprivation presents for therapy, the clinician should prioritize: