TABLE 2.

Treatment Program.

Step 1: Behavioral interventions
Session 1	Understanding and dealing with depression. The sessions involve the individual or group development of the themes of the treatment program. The first session begins with participant and the therapist introducing themselves, sharing experiences to encourage a sense of belonging within the group. This psychoeducational session invites women describe their expectations of motherhood and the therapist provides information on prenatal and postnatal depression.
Session 2	Pleasurable activities: where do I find the time? The therapist encourages the women to think about their daily routine and to talk about their difficulties, thoughts, emotions and joys. Possible pleasurable activities (to enjoy alone, with their child and with their partner) are suggested for reducing the stress and fatigue of everyday commitments.
Session 3	Quick relaxation strategies. The therapist proposes some relaxation techniques (for example, Jacobson’s progressive muscle relaxation). Together with participants, the therapist examines possible simple “stress-eliminating” techniques.
Session 4	Assertiveness and self-esteem: telling others what I think and how I feel. The therapist proposes role-playing and communication techniques intended to encourage the women to express their needs in an assertive manner.
Step 2: Cognitive interventions
Session 5	Unrealistic expectations on childcare: how the past can influence the present. This session reflects on the image of motherhood and the mother. Childcare methods learned from the family of the mother-to-be are compared with those adopted in the partner’s family.
Session 6	My inner voice: the missing link. The therapist helps participants to understand the impact that thoughts, emotions and behaviors can have on mothers’ everyday life and proposes new ways to deal with negative thoughts, cognitive distortions and/or reasoning errors, by replacing them with more functional thoughts for their well-being.
Session 7	Developing a more effective way of thinking. In this and in subsequent sessions, the therapist helps participants to focus on techniques to encourage positive thoughts.
Session 8	Query/challenge your inner critic. Questioning irrational beliefs and negative/critical thoughts.
Step 3: Prevention of relapse
Session 9	Putting it all together: “moving forward”. Mothers are encouraged to build and use new social networks so that they can refer to them for social support when treatment is concluded.
Session 10	Consolidating what I have learned. Session to reinforce treatment education and experiences. Mothers can bring their babies.
Additional clinical forms with fathers
Session 1	Involving fathers: fathers and post-natal depression. In subsequent sessions, fathers are also involved. The therapist provides fathers with information on perinatal depression. This particular session encourages couples to express their feelings about being parents and how they have felt in the past few weeks.
Session 2	Couple relationship. This session addresses the changes that have occurred in the couple’s relationship since the baby’s birth. Couples are encouraged to communicate and spend quality time together.
Session 3	Do it on your own. Summarizing the treatment experience and looking at how each couple is dealing with issues related to planning family life with the child.
Additional clinical forms with the presence of children: baby H.U.G.S
Session 1	Let’s play! Games and physical contact. The therapist introduces neonatal massage technique and talks about the feelings generated by of physical contact. Parents are presented with games for different ages and emphasis is given to the pleasure of proper mother–child interaction and the importance of non-verbal communication.
Session 2	Let’s learn something about our child. Observing and understanding his/her signals. Activities involving non-verbal interactive behavior are recommended, including stress responses. Parents are encouraged to observe and interpret the child’s non-verbal communication in a playful and fun context. The therapist introduces stimulation activities to identify differences in temperament.
Session 3	Let’s analyze our feelings. Parental responses to the signals of their newborn. Couples are encouraged to observe the differences between their needs and those of their newborn baby.