Randomized controlled trial of telephone-based cognitive-behavioral therapy on parenting self-efficacy and satisfaction

Developing a sense of parenting self-efficacy and satisfaction is essential for positive parenting and healthy development of the child. The present study evaluated the efficacy of a telephone-based cognitive-behavioral therapy (T-CBT) on parenting self-efficacy and satisfaction at 6 weeks and 6 months postpartum. A multi-site randomized controlled trial was conducted between July 2012 and March 2014. A total of 397 Chinese mothers at risk of postnatal depression were recruited through the postnatal units at three regional public hospitals in Hong Kong and were randomized to receive T-CBT (n = 197) or standard care (n = 200). The T-CBT consisted of five weekly 30-min sessions focusing on changing dysfunctional cognitions and developing problem-solving skills. Parenting self-efficacy and satisfaction were measured by the efficacy and satisfaction subscales of the Parenting Sense of Competence Scale (PSOC-E/S), respectively, at baseline, 6 weeks, and 6 months postpartum. When compared with standard care, T-CBT was associated with a significant improvement in parenting self-efficacy and satisfaction at 6 weeks postpartum (mean difference in PSOC-E: 2.85 [95% CI: 1.72-3.98], p <.001; mean difference in PSOC-S score: 1.61 [95% CI: 0.52-2.71], p =.004), and 6 months (mean difference in PSOC-E score: 3.37 [95% CI: 1.89-4.85], p <.001; mean difference in PSOC-S score: 2.39 [95% CI: 0.96-3.82], p =.001). T-CBT produced significantly greater improvement in parenting self-efficacy and satisfaction than standard care. The results highlight the potential of T-CBT as a promising treatment modality to facilitate maternal adaptation and promote a sense of parenting self-efficacy and satisfaction during the transition to new motherhood.