SS-11-01

Interaction focussed psychotherapy for postpartum disorders C. Hornstein. Center f. Psychiatry Nordbaden, Wiesloch, Germany

Postpartum illness of the mother affects the interaction with the baby and may cause cognitive and emotional deficits in the baby, especially in case of severely and chronically ill mothers. Therefore postpartum disorders require specific psychotherapy focussing on maternal disorder and mother-infant-interaction. An integrated therapy program for women with psychotic disorders or severe depression in early motherhood was developed at the mother-baby- unit in the Psychiatric Hospital Nordbaden, Wiesloch. The standardized six-week treatment program combines a cognitive group therapy, an individual video microanalytic therapy as well as a daily support program and a psychoeducational group for fathers. The evaluation of the treatment in an naturalistic design shows significant effects on several parameters. Treatment outcome will be demonstrated in 44 mother-baby-dyades with regard to psychopathological parameters, maternal self-confidence, mother- to-child-bonding and mother-infant-interaction (microanalytic interaction scales of Laucht & Esser). The different treatment outcomes of diagnostic subgroups be discussed.

SS-11-02

Outcome of brief mother-infant psychotherapies as a function of maternal depression

C. Robert-Tissot. Switzerland

A research program of the Geneva Group (C. Robert-Tissot) provide data on maternal depression at pre-treatment assessment on 132 mothers consulting for a functional (sleep, feeding) or behaviour problem (excessive crying, opposition) of a child (2 to 30 months of age). The effects of maternal depression on infants behaviour and development, on mother-infant interactions and on maternal representations were examined before and after treatment, and at preadolescence, for a sub-group having participated to the different assessments and follow-up. Mother-infant brief psychotherapy (mean of 6 sessions) prove to be affective to reduce infant symptoms as well as to modify maternal feelings and self-esteem. Results are discussed in the framework of a transactional and developmental model.“

SS-11-03

Psychotherapy of parents after the birth of a dead child

A. Kersting. Münster, Germany

Despite improved medical possibilities the number of stillborn children has not change in the past 10 years. The psychological consequences of a stillbirth for women and their families have comprehensively been examined in the past 25 years, in particular after it was revealed that normal mourning reactions after a stillbirth differed only insignificantly from those of other mourning situations. The loss of a child late in a pregnancy, while or briefly after birth can lead to over months and years of continuing psychological symptoms and can affect family relations in different ways even as far as the bonding to the following child. During the treatment of women, who have experienced the perinatal death of a child, the physicians, midwives and nurses are frequently confronted with their own helplessness. Even if the psychological consequences of stillbirths have often been described in the literature, to date there has been no standardized psychotherapeutic intervention program whose effectiveness has been empirically proven. In this context the characteristics of the psychotherapeutic treatment of parents after the birth of a dead child will be summarized and an intervention program for parents after the birth of a dead child will be presented.