Internet-based treatment after pregnancy loss: concept and case study

The loss of a child during pregnancy results in significant psychological stress for many women, and may lead to long-lasting grief and psychological illnesses. However, only a small percentage of those affected seek or receive traditional forms of psychological treatment, and therefore novel treatment approaches and methods are required. This article introduces an Internet-based psychotherapy programme for patients after pregnancy loss. The five-week intervention comprises two components: structured writing disclosure and cognitive-behavioural therapy. Communication between the therapist and patient is text-based and asynchronous. The writing protocol consists of three treatment phases: self-confrontation, cognitive reappraisal and social sharing. A case report is presented to illustrate the course of the treatment and clinical considerations associated with delivering Internet-based interventions to patients after pregnancy loss.

[1]  A. Kersting,et al.  Psychological impact on women after second and third trimester termination of pregnancy due to fetal anomalies versus women after preterm birth—a 14-month follow up study , 2009, Archives of Women's Mental Health.

[2]  S. Joseph.  Psychometric Evaluation of Horowitz's Impact of Event Scale: A Review , 2000, Journal of traumatic stress.

[3]  P. Emmelkamp,et al.  Interapy, treatment of posttraumatic stress through the Internet: a controlled trial. , 2001, Journal of behavior therapy and experimental psychiatry.

[4]  J. Pennebaker,et al.  Nonverbal and verbal emotional expression and health. , 1993, Psychotherapy and psychosomatics.

[5]  B. Klapp,et al.  Pregnancy after early pregnancy loss: A prospective study of anxiety, depressive symptomatology and coping , 2008, Journal of psychosomatic obstetrics and gynaecology.

[6]  A. Maercker,et al.  Erfassung von psychischen Belastungsfolgen: Die Impact of Event Skala-revidierte Version (IES-R). , 1998 .

[7]  C. Reynolds,et al.  Treatment of complicated grief: a randomized controlled trial. , 2005, JAMA.

[8]  R. Cohen,et al.  Health Information Technology Use Among Men and Women Aged 18-64: Early Release of Estimates From the National Health Interview Survey, January-June 2009 , 2010 .

[9]  Does disclosure of emotions facilitate recovery from bereavement? Evidence from two prospective studies. , 2002, Journal of consulting and clinical psychology.

[10]  G. Andersson,et al.  Therapist Factors in Internet-Delivered Cognitive Behavioural Therapy for Major Depressive Disorder , 2009, Cognitive behaviour therapy.

[11]  A Kersting,et al.  [Internet therapy. Opportunities and boundaries]. , 2009, Der Nervenarzt.

[12]  R. Bradley,et al.  A multidimensional meta-analysis of psychotherapy for PTSD. , 2005, The American journal of psychiatry.

[13]  P. Emmelkamp,et al.  Interapy: a controlled randomized trial of the standardized treatment of posttraumatic stress through the internet. , 2003, Journal of consulting and clinical psychology.

[14]  B. Wagner,et al.  Internetbasierte Psychotherapie “Interapy„ , 2008 .

[15]  A. Maercker,et al.  Internet-Based Treatment for Complicated Grief: Concepts and Case Study , 2005 .

[16]  G. Andersson,et al.  Please Scroll down for Article Cognitive Behaviour Therapy Therapist Factors in Internet-delivered Cognitive Behavioural Therapy for Major Depressive Disorder , 2022 .

[17]  Insa Klingberg,et al.  SCL-90-R, Symptom-Checkliste von L. R. Derogatis - Deutsche Version , 2003 .

[18]  A. Kersting,et al.  Trauma and grief 2–7 years after termination of pregnancy because of fetal anomalies – a pilot study , 2005, Journal of psychosomatic obstetrics and gynaecology.

[19]  K. Swanson,et al.  Resolution of depression and grief during the first year after miscarriage: a randomized controlled clinical trial of couples-focused interventions. , 2009, Journal of women's health.

[20]  J. Pennebaker,et al.  Confronting a traumatic event: toward an understanding of inhibition and disease. , 1986, Journal of abnormal psychology.

[21]  John Suler,et al.  The Online Disinhibition Effect , 2004, Cyberpsychology Behav. Soc. Netw..

[22]  J. Pennebaker.  The effects of traumatic disclosure on physical and mental health: the values of writing and talking about upsetting events. , 1999, International journal of emergency mental health.

[23]  David A Savitz,et al.  Epidemiologic measures of the course and outcome of pregnancy. , 2002, Epidemiologic reviews.

[24]  E. Foa,et al.  Cognitive-behavioral Theory and Treatment of Posttraumatic Stress Disorder , 1999 .

[25]  J. Markowitz,et al.  Preliminary open trial of interpersonal counseling for subsyndromal depression following miscarriage , 2007, Depression and anxiety.

[26]  A. Barak,et al.  A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions , 2008 .

[27]  Helena Motlagh,et al.  Impact of Event Scale-revised. , 2010, Journal of physiotherapy.

[28]  P. Boelen,et al.  Treatment of complicated grief: a comparison between cognitive-behavioral therapy and supportive counseling. , 2007, Journal of consulting and clinical psychology.

[29]  J. Pennebaker.  Writing About Emotional Experiences as a Therapeutic Process , 1997 .

[30]  T. Berger.  E-Mental-Health. Neue Medien in der psychosozialen Versorgung [E-Mental-Health. New Media in Psychosocial Services] , 2009 .

[31]  J. Mann,et al.  Predicting depressive symptoms and grief after pregnancy loss , 2008, Journal of psychosomatic obstetrics and gynaecology.

[32]  A. Maercker,et al.  Comparison of two diagnostic systems for Complicated Grief. , 2007, Journal of affective disorders.

[33]  C. Reynolds,et al.  Inventory of complicated grief: A scale to measure maladaptive symptoms of loss , 1995, Psychiatry Research.

[34]  W. Stroebe,et al.  The efficacy of a brief internet-based self-help intervention for the bereaved. , 2010, Behaviour research and therapy.

[35]  Christine Knaevelsrud,et al.  Internet-Based Cognitive-Behavioral Therapy for Complicated Grief: A Randomized Controlled Trial , 2006, Death studies.