Counselling by health visitors in the treatment of postnatal depression
Holden, Jenifer M.
A randomised controlled trial of counselling by health visitors was conducted in health centres in Edinburgh and Livingston. Standardised measures of psychiatric morbidity were used to identify sixty women who were suffering from depression at about thirteen weeks postnatal. Fifty-five women gave their informed consent to participation in the trial, and were allocated using random numbers to the treatment group or a control group. Seventeen health visitors were given a brief training in methods of non-directive counselling, and were asked to pay eight consecutive weekly visits to women in the treatment group. Fifty women completed the trial.After a mean time interval of thirteen weeks, the women were re-interviewed, using the same measures of depression. The interviewer did not know to which group the mother had been assigned. The percentages of wanen who had recovered in the counselled and control groups were 69.2% and 37.5% respectively. The difference, 31. 7%, had a 95% confidence interval of 5% to 58%. The Chi squared statistic was 5.06, with an associated P value of 0.03.Although confidence in the robustness of these firxlings must be tempered by the small numbers in the trial, the superior rate of recovery of women in the treatment group is encouraging. Implications for the training of health visitors, in particular for the development of listening skills are discussed.