Share This
Since launching in 2018, the Allegheny Health Network (AHN) Women's Behavioral Health program has helped over 15,000 women struggling with mental health disorders after pregnancy. AHN is one of the few hospitals in the country to offer intensive mother-baby outpatient treatment for postpartum perinatal mood and anxiety disorders at West Penn Hospital.
Expanding upon the strong foundation established over the last five years, the Women's Behavioral Health team opened a new program focusing on integrated perinatal and infant mental health treatment in early 2023. The Maternal Infant Health program focuses on strengthening the relationship between parent and child, while also equipping parents and caregivers with the tools they need to understand and read their child's emotional needs.
Nour Abdelghani, PsyD, is one of the clinicians working with families through this unique, integrative approach, which focuses on addressing the needs of mother and child simultaneously.
Emily Beatty: What made you want to get into psychology and women's behavioral health as a career?
Dr. Nour Abdelghani: When I first started graduate school, my plan was to become a child psychologist. In all honestly, going in I didn't know much about infant mental health or maternal infant health. You hear the words, "infant mental health," and your first reaction is "therapy for babies? How would that even work?" I then started learning about attachment theory and the importance of the relationship between a parent and their child starting as early as conception and took a strong interest in early childhood. I completed my internship and postdoctoral fellowship in infant mental health focusing specifically on dyadic parent-child therapy.
When I started working with young children and their parents, typically the mothers, I grew to appreciate the importance of a mother/caregiver's mental and emotional well-being. Maternal mental health isn't just about interventions for present concerns, but it is also preventive care for the next generation. There's a famous quote by one of the fathers of attachment psychology, D.W. Winnicott, that goes, "There is no such thing as an infant, meaning, of course, that wherever one finds an infant one finds maternal care, and without maternal care there would be no infant." I think that really captures our mission in the Maternal Infant Health Program at AHN.
Emily Beatty: AHN has made great strides in the last few years with its Women's Behavioral Health program. Can you tell me more about what resources AHN has for women postpartum in the Pittsburgh region?
Dr. Nour Abdelghani: The Women's Behavioral Health program focuses on serving women with perinatal mood and anxiety disorders. We also serve women who are dealing with infertility or have experienced pregnancy or infant loss. Our services include individual psychotherapy, psychiatric care, and medication management, as well as offering themed therapy groups for different presenting concerns. We also house a unique intensive outpatient program for new and expectant mothers that promotes keeping mother and baby together whenever possible throughout the treatment journey and providing care that is specific to the mental health concerns that arise during this critical period. With COVID-19, our services were also made available virtually, which has increased access for many new moms in Allegheny and surrounding counties. The latest addition is the Maternal Infant Health program.
Emily Beatty: Tell me more about the Maternal Infant Health program. What is this program, and why did it begin?
Dr. Nour Abdelghani: The goal of this program is to help moms with children ages newborn to five work on any challenges that are parent-specific, such as attachment and bonding and parenting skills, or child-specific like managing behavioral challenges and developmental delays and concerns and early exposure to trauma. Maternal Infant Health is therapy for the mother and child that puts the mother-child relationship at the center and aims to strengthen bonding and connection and empower parents. This treatment can be offered as an extension of services to our perinatal patients.
Emily Beatty: As part of this program, the Women's Behavioral Health team recently opened a new therapy room. What is this new therapy room used for?
Dr. Nour Abdelghani: The playroom space was designed primarily to support our new Parent-Child Interaction Therapy program (PCIT-T). PCIT-Toddlers is a structured, evidence-based, dyadic therapy model in which the parent and child are present together in the room and the clinician is on the other side of an observation booth. The parent is given an earpiece and microphone, and the clinician's role is to provide live guidance and instruction around managing meltdowns and tantrums or simply providing praise and supporting the child's play and development. The playroom is also used for other models of dyadic play such as Child-Parent Psychotherapy, a trauma-based intervention, and family therapy. We were able to partner with the Children's Museum of Pittsburgh to design the space and select toys and materials that are suitable for young children.
Emily Beatty: How novel is this approach?
Dr. Nour Abdelghani: Parent-child therapy is gaining a lot of support and traction in the field as the importance of the parent-child relationship in the early years is becoming more widespread and has been adopted as a primary approach to treating young children with behavioral concerns. What makes our program unique is its connection to the Women's Behavioral Health program, as well as the background and training our clinicians have in perinatal mental health. Our program focuses on providing these evidence-based treatments to women who have likely struggled with perinatal mood and anxiety disorder themselves, so we tailor these interventions to meet the unique needs of each family.
Emily Beatty: What can families expect going into a session? What are the overall goals or ideal outcomes?
Dr. Nour Abdelghani: A starting point is typically providing information about the program and about maternal infant health and dyadic parent-child therapy. During the initial session, the clinician working with the family will gather information about both the parent and the child and invite the parent to share concerns while observing the parent-child interactions. A modality is chosen based on the concerns presented by the family, and a plan for treatment is created with the parent's involvement.
An ideal outcome is for a parent to feel a sense of mastery in their skills as a parent, manage challenging behaviors and feel the bond between them and their child strengthen over the course of treatment. Our goal first and foremost is to empower moms to engage with their children while feeling supported by our team. At the start of the treatment, a clinician will usually talk a lot in each session and engage in hands-on play and model/demonstrate strategies or provide direction to the parent. As the journey comes to an end, the clinician takes a backseat, and the parent takes the lead.
Emily Beatty: Postpartum depression and overall mental health often have a stigma associated. How can providers help break the stigma? What about individuals?
Dr. Nour Abdelghani: Approximately 1 out of 7 women in the U.S. will experience perinatal mood or anxiety disorder in their lifetime, yet stigma is a major barrier to women from sharing their struggles or seeking support. When mental health is treated as an integral part of a pregnancy or parenting journey, the way we think about it as a society starts to change. Simply speaking, some women experience morning sickness or acid reflux during pregnancy, and some women experience depression, anxiety, or perinatal obsessive-compulsive disorder (OCD). An anxious or depressed mother is not a bad or unfit mother. Educating women, their partners, and their families about what to expect and how to go about seeking help is really the game changer.
One of the strengths of a hospital-based program is the collaboration with other departments. Building relationships and spreading awareness among OB/GYNs, primary care physicians, and nursing staff who are a patient’s first point of contact when they are struggling increases the likelihood of patients being referred for services when needed. In addition, we see a lot of women who say they were referred by friends or coworkers who spoke to their own experiences with postpartum depression or anxiety and the support they received in our program. When women talk to other women and share their experiences, they chip away at the stigma.
Emily Beatty: What are some warning signs of postpartum depression that moms and their loved ones can look out for?
Nour Abdelghani: The key symptoms to look out for are symptoms associated with clinical depression: Loss of interest in activities (including difficulty engaging with the baby, bathing, feeding, and dressing the baby), excessive guilt and feelings of failure and inadequacy, frequent persistent crying, changes in affect or emotional responsiveness, changes in appetite, difficulty sleeping that is not just linked to waking up with the baby, feeling like they are not worthy as a parent or that their kids, partner or family would be better off without them, and in severe cases thoughts or urges for self-harm or suicidal thoughts or intent.
We also educate new moms and their families on the difference between "Baby Blues" and postpartum depression or anxiety. "Baby Blues" refers to a strong emotional response experienced by most new moms and is brought on by hormonal changes and exacerbated by fatigue in the first month post-partum. It tends to last 10 days to two weeks. The symptoms of "Baby Blues" are mild, such as crying, maybe slight changes in appetite or sleep, reluctance to leave the house or get dressed, a spike in anxiety perhaps around the baby's safety, and self-doubt. An important difference is the absence of suicidal ideation or self-harm. I tell patients that a good rule of thumb is if symptoms last longer than two weeks or are impairing the individual's functioning or posing a safety risk, it's time to speak with a provider.
Emily Beatty: What's in store for the future? What does a successful program look like five years from now?
Nour Abdelghani: Right now, most of our referrals come from the Women's Behavioral Health program and include moms who are receiving treatment for perinatal mood and anxiety disorders or have recently transitioned out of treatment. In the future, we hope to expand to different AHN locations such as Wexford, Forbes, and Erie to offer these services where they are needed. In addition, the growth of this program will allow for external referrals from local pediatricians and early intervention specialists, and early childhood programs. In five years, our hope is that Maternal Infant Health services will become more widely available to members of the Pittsburgh community across various geographic locations. Because it's a newer program, getting the word out and spreading awareness about this unique offering is one of our current priorities.
Dr. Nour Abdelghani is a clinical psychologist with Allegheny Health Network's Women’s Behavioral Health. Dr. Abdelghani specializes in perinatal mood and anxiety disorders as well as attachment disorders and trauma. She is also part of the Maternal Infant Health Program.
Dr. Abdelghani completed her internship and post-doctorate in Miami, Florida in infant mental health. She is trained in dyadic parent-child psychotherapy models such as PCIT-Toddlers and Child Parent Psychotherapy (CPP) and DIR Floortime. Dr. Abdelghani provides outpatient individual and dyadic therapy and co-facilitates the Circle of Security an attachment based parent training model delivered in a group setting.
Highmark Health and its subsidiaries and affiliates comprise a national blended health organization that employs more than 42,000 people and serves millions of Americans across the country.
Entire contents © Highmark Health. All Rights Reserved.
Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.
Need to find info about providers, prescriptions, coverage, claims, ID cards, or health spending or savings accounts? If so, your Highmark member site is the place to go. (It’s separate from this blog.)