Improving wellness for women and their families

September 11, 2013

Program supports women in their ever-changing roles

Mother Resting Head on Infant's Chest

 

Throughout their lives, women undergo many significant transitions. Pregnancy, childbearing, infertility, trauma, loss, and hormone changes – women may experience some or all of these during their lifetimes, all while constantly growing and evolving in their roles as mothers, daughters, partners, and individuals.

When it comes to mental health, women also have unique needs and experiences, some of them related to these life events, and some not. The Women and Infants Mental Health (WIMH) Program was created to address the distinct mental wellness needs of women, which are shaped by the complexities of their lives and entwined with their personal relationships.

Although depression and anxiety are highly prevalent among women, “most do not get effective treatment,” notes Kate Rosenblum, Ph.D., the WIMH Program’s interim director. “Our challenge is always to make sure we’re doing our best to identify women who need help, reach them effectively, and provide support that they can connect to.”

The WIMH Program incorporates research and clinical service delivery focused on the experiences of women across the lifespan.  The WIMH Clinic provides consultation and continuing care for women of all ages experiencing depression, anxiety, or trauma-related difficulties. Another program specialty is helping parents enhance attachment with their children, particularly women who may be concerned that their own mental health issues may prevent them from developing strong bonds with their infants. Services are provided both in the clinic and in community settings.

Maternal depression, stress, and a history of trauma can all have a lasting negative impact on child development and bonding between mothers and babies. Combined with other factors like social isolation, young age, and poverty, “this can cumulate into a big risk for parenting success,”  says Maria Muzik, M.D., an attending psychiatrist with the WIMH Program.

“Mom Power” is a 10-week educational group intervention co-developed by Muzik and Rosenblum that supports high-risk mothers and their children. The program provides a positive, encouraging therapeutic environment for moms to learn new strategies to care for their own needs and help foster the developmental growth of their children.

The educational curriculum, provided in various community settings, helps mothers safely cope with current stressful life circumstances and mental health symptoms while building parenting skills and connections with other families.

“There’s a feedback loop – as parents’ mental health symptoms are addressed, they feel more confident as parents, and when they feel more confident as parents, it also helps to address their symptoms. But they really need support for both,” Muzik says.

“We realized in delivering the program that we had to pair support for parenting with support for addressing mental health concerns and social isolation,” Rosenblum explains. “Everyone wants to be the best parent they can possibly be, and is doing the best that they can. When depression or trauma or social isolation get in the way, it is really important that we address those concerns. And we see that the impact of this program is to both improve parenting and also reduce or ameliorate those mental health symptoms.”

Mom Power is one example of an intervention based on research findings from U-M and elsewhere that have been translated in a way to optimally benefit the particular needs of individuals and their families in various settings.

Based on some of the group’s research findings related to the transmission of mental health issues between generations and the impact of mental health on parenting, Mom Power blends core components of evidence-based practices, including Child Parent Psychotherapy (CPP), motivational interviewing, Cognitive Behavioral Therapy (CBT), Interpersonal psychotherapy (IPT), and Dialectical behavior therapy (DBT). Pilot testing data and input from past participants help to continually refine the program.

“For women with limited resources, it can be really hard to access services, so we appreciated a real need to offer something in the community that would engage parents, support parenting, and connect them with other families,” Rosenblum says. Mom Power also helps identify women who could benefit from additional care and more targeted interventions; on average, two thirds of graduates of Mom Power are referred to care within the community following the program.

Now, community partners have expanded the program into different settings across several Michigan counties. “We are focused on how we can effectively reach as many women as possible, and how we can make this program sustainable and delivered in an ongoing way through community providers across the state,” Rosenblum says.

Although the WIMH Program serves women of all ages, the concerns specific to pregnancy and the postpartum period mean that many come to them around the time of childbirth, a period the program views as a unique opportunity for positive change.

“We respect that when a woman and her partner either transition into parenthood or see their families grow, that it’s really a special and magical time,” Rosenblum explains. “This is a time when parents may experience high levels of vulnerability, but there are also real opportunities, high levels of motivation to engage in treatment, and to make meaningful changes, both for themselves and for their infant and their family,” Muzik adds.

“One of the things we find is that parents often put their own needs and their own health last,” says Kate Bullard, M.S.W., M.P.H., WIMH clinical services and research coordinator. “During pregnancy and the post-partum period, women are sometimes willing to take better care of themselves when they understand the context of how it impacts their child and how it can help them as a parent.  And since pregnancy is, for some women, the only time they come in contact with health care providers, we have found this is a key opportunity for support and mental health treatment,” she says.

The WIMH Program, part of the Department of Psychiatry of the U-M Medical School, benefits from well-established partnerships with other departments, including pediatrics and OB/GYN, and the program receives many referrals for care from U-M OB providers.

As part of an academic medical center with a dynamic research enterprise, the WIMH Program’s services benefit from faculty and staff steeped in the field’s latest knowledge and engaged in their own research to evaluate, improve, and refine the care they provide.  Research priorities for WIMH Program faculty include the effects of mental health issues (particularly trauma, PTSD, and depression) on the parent-child relationship and effective ways to intervene and provide support during the critical period around childbirth; biological factors that predict treatment efficacy; animal models examining factors involved in the intergenerational transmission of risk from parent to offspring; sleep and depression in pregnancy and the postpartum period; and brain imaging studies examining the neuroanatomy of the “parental brain.” Most faculty and staff are members of the Depression Center, and share its emphasis on detecting and treating depression and related illnesses as early as possible.

The WIMH Program is passionate in its belief that all women and their families deserve support as they navigate the many transitions that occur throughout the life cycle.  For more information about their clinical, research, and educational activities, visit their webpages.