Perinatal project resources

Please note that these resources are for your information only and should not be used or duplicated elsewhere. 

Day 1ADHD –assessment and treatment in the perinatal context and implications for parenting

Date: 7 September 2021

Speakers: Dr Sally Cubbin and Dr Amanda Elkin

Intended learning objectives:

  • Recognise how ADHD presents in adults, with a particular focus on women
  • Understand how untreated ADHD may affect women in the perinatal period
  • Consider medication treatment options for ADHD in the perinatal period
  • Feel confident in writing a CD prescription

Essential reading:

  • Cubbin, S., Leaver, L., & Parry, A. (2020). Attention deficit hyperactivity disorder in adults: common in primary care, misdiagnosed, and impairing, but highly responsive to treatment. The British journal of general practice: The journal of the Royal College of General Practitioners,70(698), 465–466
  • Choice and Medication leaflet:  A guide to help you choose between the medications to help with symptoms of ADHD in pregnancy and breast-feeding

Recommended reading:

  • Choice and Medication: medication-specific ‘handy factsheets’ on: Methylphenidate, lis-dexamphetamine, atomoxetine, melatonin
  • Cortese, S., Adamo, N., Del Giovane, C., et al. (2018). Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. The Lancet. Psychiatry,5(9), 727–738
  • Kooij, J., Bijlenga, D., Salerno, L., (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry: The Journal of the Association of European Psychiatrists,56, 14–34.
  • Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., et al. (2020) Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC psychiatry,20(1), 404

 

Day 2: Autistic Spectrum Disorders in women

Date: 20th September 2021

Speakers: Dr Judy Eaton

Intended learning objectives:

  • Identify how Autism can present in women
  • Demonstrate a clear understanding of common comorbidities with Autism and how these can be evaluated
  • Formulate the type of support that may benefit women who have Autism in the perinatal period

Essential reading:

  • Green, R. M., Travers, A. M., Howe, Y. & McDouglas, C. J., (2019).  Women and Autism Spectrum Disorder: Diagnosis and Implications.  Current Psychiatry Reports, 21:22,
  • Went, H. E., (2016).  I didn’t fit the stereotype of autism: A qualitative analysis of women’s experiences relating to diagnosis of an Autism Spectrum Condition and mental health.  Thesis submitted as part fulfilment for the degree of Doctor of Clinical Psychology.  University of Exeter
  • Gould, J., (2017).  Towards understanding the under-recognition of girls and women on the autism spectrum.  Autism, vol 21 (6) 703 –705.Recommended reading

Recommended reading:

  • Women and Girls with Autism Spectrum Disorder: Understanding Life Experiences from Early Childhood to Old Age, by Sarah Hendrick, published by Jessica Kingsley Publishers
  • A Guide to Mental Health Issues in Girls and Young Women on the Autism Spectrum: Diagnosis, Intervention and Family Support, by Judy Eaton, published by Jessica Kingsley Publishers


Day 3: Partners of women with lived experience of perinatal mental illness

Date: 28 September 2021

Speakers: Dr Sally Wilson and Dr Lucinda Green

Intended learning objectives:

  • Understand the effect of a woman’s perinatal mental illness on her partner
  • Describe approaches to assessment and care for partners who have mental health problems in the perinatal period

Essential reading:

  • Lever Taylor, B., Billings, J., Morant, N., Bick, D., & Johnson, S. (2019). Experiences of how services supporting women with perinatal mental health difficulties work with their families: a qualitative study in England. BMJ Open, 9(7):e030208

Recommended reading:

  • Hanley, J. & Williams, M. (2019) Fathers and perinatal mental health. A Guide for recognition, treatment and management. Routledge
  • Ruffell, B., Smith, D.M. & Wittkowski, AJ. (2019) The Experiences of Male Partners of Women with Postnatal Mental Health Problems: A Systematic Review and Thematic Synthesis. Child Fam Stud.;28:2772–2790


Day 4: Couple and family interventions in the perinatal period

Date: 15 October 2021

Speakers: Dr Phil Arthrington

Intended learning objectives:

  • Describe the contribution that couple and family interventions can make to perinatal mental health services.
  • Identify key challenges faced by families during the perinatal period and how key systemic concepts can aid in making sense of these difficulties.
  • Discuss some of the main barriers to working with families in the perinatal period and how these may be overcome in your service.

Essential reading:

  • Hunt, C. (2006). When baby brings the blues: Family therapy and postnatal depression. Australian and New Zealand Journal of Family Therapy, 27(4), 214-220

Recommended reading:

  • Arthington, P. (in press). Mighty oaks from little acorns grow: Why beginnings matter. Context, 172, pp.xxxxx. Warrington: AFT
  • Barker, S. (2019). Perinatal mental health and working with families. In N. Evans (Ed),Family Work in Mental Health: A Skills Approach. Keswick: M&K Publishing. pp. 67-82
  • Cluxton-Keller, F., & Bruce, M.L. (2018). Clinical effectiveness of family therapeutic interventions in the prevention and treatment of perinatal depression: A systematic review and meta-analysis. PLoS ONE, 13(6): e0198730

 

Day 5: Compassionate Leadership

Date: 5 November 2021

Speakers: Dr Lucinda Green and Dr Nic Horley

Intended learning objectives:

  • Understand the advantages of compassionate leadership approaches for leaders and teams
  • Understand the theoretical underpinnings of compassion focussed ideas
  • Recognise the importance of self-compassion
  • Be familiar with compassion focussed activities that can be used with their teams

Essential reading:

  • West, M., Eckert, R., Collins, B., &Chowla, R. (2017) Caring to Change. How compassionate leadership can stimulate innovation in health care. The King’s Fund 

Recommended reading:

  • Conversano, C., Ciacchini, R., Orrù, G., Di Giuseppe, M., Gemignani, A., & Poli, A. (2020). Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review. Frontiers in psychology,11, 1683.
  • de Zulueta P. C. (2015). Developing compassionate leadership in health care: an integrative review. Journal of healthcare leadership,8, 1–10.
  • Gilbert, P.l & Basran, J. (2018). Imagining One’s Compassionate Self and Coping with Life Difficulties. EC Psychology and Psychiatry,7, 971-978
  • Heaversedge, J. & Halliwell, E.(2012) The Mindful Manifesto. Hay House UK Ltd
  • Neff, KD,Knox, MC,Long, P,Gregory, K.(2020) Caring for others without losing yourself: An adaptation of the Mindful Self‐Compassion Program for Healthcare Communities. J Clin Psychol. 76,1543–1562
  • NHS England (2014) Building and Strengthening Leadership: Leading with Compassion.

 

Day 6: Infertility, fertility treatment and psychological implications

Date: 17 November 2021

Speakers: Suzanne Dark and Dr Lucinda Green

Intended learning objectives:

  • Describe and recognise the psychological consequences of infertility and fertility treatment
  • Understand the role of the counsellor in the infertility clinic and the other care and support available for women having fertility treatment
  • Discuss the risk of mental health problems associated with infertility and fertility treatment

Essential reading:

  • Bhat, A., & Byatt, N. (2016). Infertility and perinatal loss: when the bough breaks.  Current psychiatry reports, 18(3), 31.

Recommended reading:

  • Bronya Hi-Kwan Luk & Alice Yuen Loke(2015)The Impact of Infertility on the Psychological Well-Being, Marital Relationships, Sexual Relationships, and Quality of Life of Couples: A Systematic Review, Journal of Sex & Marital Therapy,41:6,610-625,
  • Doyle, M., & Carballedo, A. (2014). Infertility and mental health. Advances in Psychiatric Treatment,20(5), 297-303.
  • Golombok, S. (2015) Modern families: Parenting and children in new family forms. Cambridge University Press.
  • McCluskey G & Gilbert P. Implications counselling for people considering donor-assisted treatment. Fully updated version. British Infertility Counselling Association: 2015.
  • De Berardis, D., Mazza, M., Marini, S., Del Nibletto, L., Serroni, N., Pino, M. C., Valchera, A., Ortolani, C., Ciarrocchi, F., Martinotti, G., & Di Giannantonio, M. (2014). Psychopathology, emotional aspects and psychological counselling in infertility: a review. La Clinica terapeutica, 165(3), 163–169
  • Ebdrup,N. H., Assens, M., Hougaard, C. O., Pinborg, A., Hageman, I., & Schmidt, L. (2014). Assisted reproductive technology (ART) treatment in women with schizophrenia or related psychotic disorder: a national cohort study. European journal of obstetrics, gynaecology, and reproductive biology, 177, 115–120
  • Pasch, L. A., Holley, S. R., Bleil, M. E., Shehab, D., Katz, P. P., & Adler, N. E. (2016). Addressing the needs of fertility treatment patients and their partners: are they informed of and do they receive mental health services?. Fertility and sterility, 106(1), 209–215.e2
  • Patel, A., Sharma, P., & Kumar, P. (2018). Role of Mental Health Practitioner in Infertility Clinics: A Review on Past, Present and Future Directions. Journal of Human Reproductive sciences, 11(3), 219–228
  • Szkodziak, F., Krzyżanowski, J., & Szkodziak, P. (2020). Psychological aspects of infertility. A systematic review. The Journal of international medical research, 48(6), 300060520932403
  • Vikström, J., Josefsson, A., Bladh, M., & Sydsjö, G. (2015). Mental health in women 20-23years after IVF treatment: a Swedish cross-sectional study. BMJ open, 5(10), e009426.

 

Day 7: Premenstrual Syndrome and menopause

Date: 3 December 2021

Speakers: Dr Michael Craig

Intended learning objectives:

  • Discuss the management of Premenstrual Syndrome with women who have co-existing mental health problems.
  • Describe the impact of the menopause on women’s mental health
  • Understand the management of menopause related mood symptoms

Essential reading:

  • Green LJ, O’Brien PMS, Panay N, Craig M on behalf of the Royal College of Obstetricians and Gynaecologists. Management of premenstrual syndrome(2016) BJOG ; DOI: 10.1111/1471-0528.14260

Recommended reading:

  • Craig, M. C., Sadler, C., & Panay, N. (2019). Diagnosis and management of premenstrual syndrome. Practitioner, 263(1824), 15-19
  • Clow A & Smyth N (2020).Stress and Brain Health: Across the Life Course. International Review of Neurobiology Volume 150,2-246

 

Day 8: Infertility, fertility treatment and psychological implications

Date: 10 December 2021

Speakers: Dr Giles Berrisford

Intended learning objectives:

  • Define potential criteria for women who will be eligible for perinatal mental health services once the NHS Long Term Plan is fully implemented
  • Describe approaches to implementing the NHS Long Term plan in perinatal mental health services

 

Day 1: The National Picture: where are we now? what is your role?

Date: 10 January 2022

Speakers: Dr Giles Berrisford

Intended learning objectives:

  • Demonstrate an understanding of how the case for perinatal mental health service expansion was made
  • Apply this understanding to the development of services in wave 1 and wave 2 of the Five Year Forward View
  • Evaluate the proposed changes to perinatal mental health services outlined in the NHS Long Term Plan and consider how these service developments can be implemented.
  • Describe the range of factors that can affect a woman’s mental health in the perinatal period and her experience of pregnancy and parenting.
  • Summarise, formulate and communicate assessments to enable women, families and professionals to understand the factors which have contributed to her mental health problems, associated risks and/or her risk of developing a perinatal mental illness

 

Day 2: What does the literature tell us about women’s experience of care and treatment in the perinatal period?

Date: 28 January 2022

Speakers: Dr Clare Dolman, Dr Henry Fay, Kathryn Grant, Rachael Buabong, Rosie Lowman

Intended learning objectives:

  • Demonstrate an awareness of the barriers to care for women in the perinatal period
  • Understand the factors influencing women’s decision-making around pregnancy and childbirth
  • Recognise how healthcare professionals can improve the experience of women and families receiving perinatal mental healthcare
  • Understand the benefits of involving women and partners in co-producing perinatal mental health services.
  • Recognise the effect of a woman’s perinatal mental illness on her partner

 


Day 3: Assessment of the mother-infant relationship in clinical practice

Date: 7 February 2022

Speakers: Dr Maddalena Miele, Dr Jane Barlow, and Dr Amanda Jones

Intended learning objectives:

  • Understand the key ways in which perinatal mental health problems can affect the ability of women to interact with their infant
  • Demonstrate a basic knowledge of the current clinical approaches to assessing parent-infant relationships
  • Describe the basic principles of attachment theory and the neurobiology of parenting
  • Outline the determinants of a sensitive parent-infant interaction
  • Understand the key ways in which parent-infant interaction during the postnatal period influences the later capacity of the infant for emotion regulation
  • Examine some of the key evidence-based methods of working dyadically, with mothers experiencing perinatal mental health problems, to support the interaction with the baby

 

Day 4What have we learned from women who have died from psychiatric causes in the perinatal period?


Date: 28 February 2022

Speakers: Dr Roch Cantwell, Dr Hind Khalifeh, and Dr Lucinda Green


Intended learning objectives:

  • Describe the epidemiology of self-harm and suicide in the perinatal period.
  • Describe the distinctive clinical features of maternal suicide.
  • Recognise risk in relation to maternal suicide and apply this to clinical assessment.
  • Understand the evidence base regarding the extent and impact of domestic violence / abuse in the perinatal period
  • Understand the evidence base regarding interventions for domestic violence/ abuse including for domestic violence/abuse in the perinatal period
  • Demonstrate skills in enquiring about and responding to domestic violence/abuse disclosures by women under the care of perinatal mental health services
  • Describe the factors highlighted in child serious case reviews which can affect children’s safety and wellbeing and increase the risk of abuse and neglect
  • Recognise how perinatal mental health services, working effectively in partnership with a range of professionals, can ensure child safeguarding concerns are identified early and that effective care, treatment and support for women and families can reduce the risk of harm to infants and children



Day 5: Prescribing anti-depressant medication in the perinatal period: how do we translate evidence into practice?

Date: 4 March 2022

Speakers: Prof Ian Jones and Dr Angelika Wieck

Intended learning objectives:
  • Understand the kinds of methodological problems that hamper research into the reproductive safety of psychotropic drugs and be able to take these into account when interpreting peer-reviewed publications
  • Be familiar with currently available evidence on the reproductive safety of the main psychotropic drugs, resources that provide high quality evidence updates and current influential prescribing guidance
  • Be able to apply current evidence and general principles for the pharmacological management of pregnant and breastfeeding women to clinical scenarios

 

Day 6: Personality Disorder and its implications for Maternal Mental Health and Parenting

Date: 18 March 2022

Speakers: Dr Gwen Adshead and Dr Nic Horley

Intended learning objectives:

  • Demonstrate an understanding of personality function and dysfunction
  • Understand how personality function may become disordered in pregnancy and postnatally
  • Appreciate the importance of assessment and treatment of personality disorder by perinatal mental health services
  • Understand the different psychological therapies for women with personality disorder and their use during the perinatal period
  • Outline the psychological interventions which can support the parent-infant relationship for women with personality disorder and their infants

 

Day 7: Joint working between forensic and perinatal psychiatry

Date: 25 April 2022

Speakers: Dr Gwen Adshead, Dr Olivia Protti, Dr Livia Martucci, Dr Lucy Stephenson, and Mr Alex Ruck Keene, Barrister

Intended learning objectives:

  • Recognise the relevant legal frameworks and to formulate a legally informed advance decision making document with women in the perinatal period
  • Describe upcoming reforms to the Mental Health Act and the impact on advance decision making in the perinatal period
  • Distinguish between ethical/moral issues and legal frameworks and how to approach them separately

 

Day 8: Pre-pregnancy Counselling

Date: 6 May 2022

Speakers: Dr Maddalena Miele, Dr Lucinda Green, and Dr Emily Finch

Intended learning objectives:
  • Understand the range of factors which should be discussed during the preconception consultation and the rationale for these
  • Have a framework to share the outcome of the consultation in a meaningful and sensitive way to women and their partners, highlighting risks, protective factors and the risks and benefits of treatments
  • Understand how to organise and chair a perinatal mental health pre-birth planning meeting to ensure that the woman, her partner and other family members and the relevant professionals have a shared understanding of any concerns, needs and risks as well as the woman and family’s strengths
  • Develop effective perinatal mental health care plans collaboratively with women, partners, other carers and professionals
  • Understand the issues encountered in measuring how common substance misuse in pregnancy is
  • Explore ways to identify substance misuse in pregnancy
  • Understand what interventions are available to reduce the harm from substance misuse in pregnancy


Day 9: Eating Disorders: presentation, assessment, care and treatment in the perinatal period

Date: 16 May 2022

Speakers: Dr Catia Acosta, Dr Lucinda Green, and Dr Sarah Finnis

Intended learning objectives:
  • Screen for and identify women who have a diagnosis of an eating disorder in the perinatal period
  • Assess women who have eating disorders in the perinatal period, including assessment of the risk to the woman, the foetus and the infant and requesting physical investigations and discussing risk concerns with women
  • Devise a perinatal mental health care plan for a woman who has an eating disorder in the perinatal period, in partnership with the woman, the eating disorder service and other relevant professionals
  • Understand the factors which contribute to birth trauma (PTSD)
  • Understand how pregnancy-related trauma and loss can affect women and partners
  • Demonstrate knowledge and understanding of the challenges and complexities for women and partners associated with assisted conception

 

Day 10: Compassionate Leadership


Date: 7 June 2022

Speakers: Dr Lucinda Green & Dr Nic Horley

Intended learning objectives:

  • Understand the advantages of compassionate leadership approaches for leaders and teams
  • Understand the theoretical underpinnings of compassion focussed ideas
  • Recognise the importance of self-compassion
  • Be familiar with compassion focussed activities that can be used with their teams

 

Details of resources for this programme will be posted in due course. 

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