Advice for Counseling and Therapy Graduate Students: Strategies for Working with Clients Experiencing Prenatal or Post-Partum Stressors

by Tony Vasquez, June 2014


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Students enrolled in counseling and therapy graduate program are likely to learn counseling techniques that may help them learn how to help a wide variety of clients. This article discusses the ways in which a graduate of a counseling and therapy graduate program might work with new mothers experiencing post-partum depression while working in the mental health field.

Background

I am fortunate enough to work for a supportive home visiting program that focuses on a mission to help pregnant women and new mothers with prenatal education, parenting information, and support. The goal is to have a healthy pregnancy and healthy birth outcomes. Many times we engage a pregnant or new mother who has been experiencing post-partum stressors. A key component of our program is the availability of offering mental health counseling and psychoeducation to address this maternal mood disorder. I have found some helpful strategies to address some of these post-partum stressors as they occur.

Educating New Mothers about Post-Partum Depression

For those new mothers who come into therapy reporting feelings that they are unmotivated to care for their child, or are having mood swings or negative thoughts about themselves or their child, I have found it helpful to educate them about postpartum depression. Supply mothers with informational/educational handouts. Bring easy to read guides and pamphlets that help new mothers with tips to address their symptoms. I have even brought short videos that offer vital information and examples of how other mothers have experienced the baby blues or postpartum depression and have recovered. In my experience I find it more helpful to understand what postpartum depression is rather than trying to find out the cause symptoms, it can make a difference in their recovery.

Helping New Mothers Experiencing Post-Partun Depression as a Therapist

Initially it is important to assess where the client is in regards to her symptoms, thoughts and feelings about her pregnancy/child and get an idea of what her support system are. I can usually capture this information during the initial interview but sometimes it may take two sessions to complete this process. I discuss with the client any history of depression or other mental health issues, which will help me to begin to formulate appropriate interventions and identify specific areas of need. I talk about supports that can be available to them now and the importance of building appropriate coping strategies. Referrals are made so that the client can have immediate access to resources that can help them in a time when they need the most support. Referrals to support groups, spiritual supports, and building natural supports can be made based on a client’s needs and receptiveness to services.

Throughout my work with new or expectant mothers, I like to measure their thoughts and feelings about pregnancy. An assessment tool is a powerful method to help us gain insight into any potential post-partum stressors. There are different tools such as the Beck Depression Scale and Mood Disorder Scale but I feel that the Edinburgh Postnatal Depression Scale or the EPDS is the most effective. I always have the client complete an Edinburgh Post-Natal Depression scale during the 1st session. This can be done again in several weeks to measure any improvements or possible developing issues with client. It is a 10 question tool focusing on post-partum stressors and is helpful even if the client is being seen prenatally. This is a proactive tool that can have far reaching positive implications if treatment is sought early.

During subsequent sessions I like to help the client understand what she may be experiencing. We discuss some factors that may increase the chances of developing post-partum depression and also things she can do to decrease the risk for post-partum depression. We talk about how having a baby is a major life changing event which can trigger a wide range of emotions. When women experience negative thoughts associated with their pregnancy or baby, they often suffer in silence. Talking with them about these thoughts and emotions can normalize some of the shame they may feel for having these negative thoughts.

If women report that they are experiencing symptoms, we complete a safety plan focusing on some of the symptoms that she is experiencing. We document a plan and identify who the client can call for support and where she can go if symptoms become too severe. This plan is important because it gives a client a concrete plan of action. The plan should include phone numbers of helpful family members, case manager, OB/GYN, PCP, Doula and pediatrician. This plan gets posted somewhere that the client can access.

Throughout therapy I infuse psycho educational items in order to help client address self-care, relaxation, coping strategies, and parenting techniques. There are other complementary methods that have also helped depending on your client’s needs. This can include aroma therapy, nutrition, exercise, meditation, and other alternative treatments.

Support, support, and more support! Request a session with all of the clients support people (ask client if they want certain people there who know what is going on regarding postpartum stressors) so they can be informed about what things mom may be experiencing. Educate them on postpartum depression and how they can be more helpful during his time. It is also vital to engage with father of baby and discuss how he can help his significant other during this time. If client has minimal to no support system discuss support groups or new mommy support groups. These resources are so powerful and help the client realize that she does not have to suffer alone.

I have worked with soon to be mothers in many stages of their pregnancy and also those who have already given birth and have started to experience some post-partum stressors. I have found that these tips have been very helpful for my clients as they mitigate their symptoms in a period that should bring much joy and happiness of being new mothers.

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