• This poster proposes using existing staff at amaternal wellness clinic with an integrative caremodel to provide doulas w...
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Doulas to fill the gap: a proposed model of doula delivery of cognitive-behavioral therapy principles for maternal internalizing disorders _ Rinad Beidas 4_30_13

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Doulas to fill the gap: a proposed model of doula delivery of cognitive-behavioral therapy principles for maternal internalizing disorders _ Rinad Beidas 4_30_13

  1. 1. • This poster proposes using existing staff at amaternal wellness clinic with an integrative caremodel to provide doulas with training andconsultation in CBT principles.Objectives• New care models for maternal health clinics suchas the proposed offer an opportunity toincorporate doulas into standard practice whileoffering doulas the opportunity to access andadequately support a broad base of clients.• CBT has been successfully incorporated intotask-shifting models for maternal mental healthinternationally (Patel & Kirkwood 2008; Rahmanet al., 2008). The current model considers a task-shifting approach for the American reproductiveand mental health care systems.• Successful implementation of this model couldoffer insight into training for other types ofdoulas (e.g., abortion, postpartum, bereavement)in CBT principles.• Limitations of this model include theimplementation challenges of any novelintervention, such as feasibility and sustainability(e.g., protected psychologist and/or social workertime for consultation), funding, monitoring, andstandardization of workshop training. Themodel also assumes a co-located care model witha CBT expert therapist on staff. Additionally, themodel assumes a well-managed doula collectivethat adheres to practice guidelines outlined byprofessional accrediting organizations.Discussion• Doulas are persons trained and experienced inchildbirth who provide continuousphysical, emotional, and informational support tomother and family before, during and just afterbirth.• Benefits of doulas are well-documented, includingdecreased cesarean section and epiduralrates, decreased instrumental and pharmacologicalinterventions, increased initiation ofbreastfeeding, maternal-infant bonding, and patientsatisfaction (Hodnett et al., 2012). There areemerging calls for doulas to be integrated intostandard maternal health care (Kozhimannil etal., 2013).• Despite these benefits and the growing presenceof doulas in clinical settings, there remains aperceived tension between the medical model andthe doula care model (Hunter, 2012).• Empirical research suggests pregnancy and thepostpartum period account for the highestprevalence of mental health problems (e.g., anxietyand depression) in a womans life (Botega &Dias, 2006). Cognitive-behavioral therapy (CBT) isan evidence-based practice (EBP) for thesedisorders but a research-to-practice gap remains(Beidas et al., 2012). Suggestions for addressingthis gap include utilizing paraprofessionals(Rotheram-Borus et al., 2012). Doulas are apotential paraprofessional cohort to increase theimplementation of EBPs in maternal health.BackgroundDoulas to fill the gap: a proposed model of doula delivery ofcognitive-behavioral therapy principles for maternalinternalizing disordersMargaret Mary Downey, BA; and Rinad Beidas, PhDUniversity of Pennsylvania Perelman School of Medicine, Center for Mental Health Policy and Services ResearchDoulaCollectiveHospitalsMaternalWellnessClinicsBirthCentersHomeBirthsMaternal HealthClinicOngoingConsultation• Co-located caremodel• Expert therapistPatientsOutreachThanks to Rinad Beidas, PhD; and to Delane Casiano; PhD; Jabina Coleman, MSW, CLC; Sara Kornfield, PhD;and all staff at the Helen O. Dickens Center for Women’s Health at the University of PennsylvaniaHires aProvides CBT informed care

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