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The Tavistock First-Time Parent Study: a pilot randomised controlled feasibility trial of a brief couple-focused perinatal intervention to reduce inter-parental discord

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Abstract

Numerous studies report that some first-time parents experience a decline in relationship quality and an increase in conflict after the birth of a first baby. Inter-parental discord that is frequent, intense, and poorly resolved increases the likelihood of relationship breakdown and adversely impacts child development. We investigated the feasibility of a brief preventative couple-focused psychotherapeutic intervention in the perinatal period in a general population sample. Sixty couples expecting their first baby were recruited from the Royal Free Hospital, London. Thirty were randomly assigned to treatment (TMT, a newly developed five-session couple-focused intervention), and 30 to usual care (TAU). Outcomes were collected at 28 weeks into pregnancy, 6–8 weeks after birth, and when the baby was 6 months old. The intervention was feasible and acceptable, evidenced by 100% attendance. However, no change in relationship quality or inter-parental discord was detected in either TMT or TAU groups across the transition to parenthood. The intervention did not improve outcomes vs. TAU. Depression assessed by the Hospital Anxiety and Depression Scale increased across the cohort and mood symptoms assessed by the Edinburgh Postnatal Depression Scale decreased in mothers but not fathers. The absence of a decline in relationship quality could reflect sample attributes: couples were older than average UK first-time parents, had high levels of educational qualifications, and low discord. Even in this low-risk sample, only 20 out of 30 TAU couples completed all three assessments, vs. 29 out of 30 TMT couples. Larger-scale RCTs of perinatal couple-focused psychosocial interventions may be hampered by selection effects and attrition. They may benefit from co-design with stakeholders and active control conditions.

Trial registration: ISRCTN12258825; 1st May 2020 (retrospectively registered).

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Acknowledgements

We are very grateful to the families who took part and to the midwives and obstetricians who helped with recruitment, without whom the study would not have been possible. We are also extremely grateful to Lynne Cudmore, Joanna Lee, and Chris Clulow, who delivered the therapeutic intervention, and to Jude Bayley and Donna Oxley who helped with recruitment.

Funding

This study was supported by a grant from the UK Mental Health Foundation.

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Authors and Affiliations

  1. Research and Development Unit, The Tavistock and Portman NHS Foundation Trust, 120 Belsize Lane, London, NW3 5BA, UK

    Eilis Kennedy, Elizabeth O’Nions, Sam Bursnall & Rob Senior

  2. Research Department of Clinical, Educational and Health Psychology, University College London, London, UK

    Eilis Kennedy & Elizabeth O’Nions

  3. Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK

    Briony D. Pulford

  4. University College London, Great Ormond Street Institute of Child Health, London, UK

    Judit Germuska

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  1. Eilis Kennedy
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Correspondence to Eilis Kennedy.

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The authors report no conflict of interest.

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Ethical approval was obtained from the Camden and Islington Community Local Research Ethics Committee (07/Q0511/3).

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Written informed consent was obtained from all participants.

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Kennedy, E., O’Nions, E., Pulford, B.D. et al. The Tavistock First-Time Parent Study: a pilot randomised controlled feasibility trial of a brief couple-focused perinatal intervention to reduce inter-parental discord. Eur Child Adolesc Psychiatry 32, 451–462 (2023). https://doi.org/10.1007/s00787-021-01862-y

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