Men's peripartum mental health: Issues and interventions
By Daniel B. Singley, PhD
Most psychologists do not receive training about the transition to fatherhood, so this article provides a brief overview of critical aspects of men’s peripartum mental health. Each section below covers one key mental health factor along with some brief recommendations to consider when working with new fathers.
Mental Health History
The strongest predictor of men developing peripartum psychopathology is his partner’s own experience of peripartum mental health problems (Paulson & Basemore, 2010), and men who develop peripartum depression tend to experience symptoms such as irritability, self-isolation, overworking, substance use and hopelessness rather than crying or intense sadness (Kim & Swain, 2007).
- Take a thorough mental health history of both parents.
- Educate parents regarding how their mental health status impacts the family system as-a-whole.
Men are socialized to be strong, adventurous and successful (David & Brannon, 1976) rather than nurturing caregivers. Both the father and his partner may simultaneously feel the need to have him more involved with his infant while also putting up barriers to him doing so due to deeply-ingrained gender roles (Pleck, 2010).
- Have men read chapters 1 and 8 of "The Masculine Self" (2007) and discuss with the parents how they express difficult emotions.
- Discuss parents’ expectations about new fathers.
The Parental Alliance
Research shows that maternal and paternal postpartum depression are indirectly linked through pathways of impaired spousal support and reduced relationship satisfaction (Don & Mickelson, 2012), suggesting that new fathers need to give and to receive support from their partners.
- Assess the satisfaction and supportiveness of the parents’ relationship using a valid instrument.
- Brief couples counseling regarding assertive communication, productive conflict resolution and effective co-parenting.
Both parents need to nurture their sources of support to buffer the stresses of new parenthood (Crnic et al., 1983). However, new fathers are often largely focused on the mother and baby even to the exclusion of activities with others which they typically find energizing.
- Explain the need to actively have a “diversified social support portfolio” during times of stress.
- Encourage new fathers and mothers to seek social support from friends and family.
Parenting self-efficacy is defined as “beliefs or judgments a parent holds of their capabilities to organize and execute a set of tasks related to parenting a child.” (Montigny & Lacharite, 2005 – p. 387).
Confidence in the ability to perform infant care tasks is directly related to a parent’s satisfaction with a parenting role, so fathers with low self-efficacy are less likely to undertake these tasks (Elek et al., 2003). A mother’s “other-efficacy” regarding the father’s parenting ability can result in “gatekeeping” behavior which deprives fathers of newborns with the much-needed practice and connection they need to feel more confident and bond with the baby.
- Assess the extent to which both parents feel confident in caring for their baby along with their sense of each others' competence in doing so.
- Encourage expectant fathers to practice caregiving activities such as bathing, diapering, swaddling, soothing and feeding an infant prior to the birth.
- Give the father the opportunity to be alone with and caring for the baby as soon as possible. In the words of one midwife: “Moms should do the nursing, and dads should do everything else.”
Children whose fathers are highly involved with them — even from birth — have been shown to be more emotionally secure, confident in exploring their environment and to have better social —relationships with peers during childhood (Parke, 1996; Yeung, Duncan, & Hill, 2000).
- Clarify to both parents that fathers are able to handle every aspect of caring for their infant except nursing.
- Encourage the father to talk with other new dads about caring for an infant.
- Give both parents a clear understanding of how the father’s direct involvement with his baby impacts the child’s subsequent social, emotional, intellectual and academic functioning.
The information presented here regarding psychological considerations in men’s transition to fatherhood is by no means comprehensive, but rather is intended to give mental health practitioners a clear list of social cognitive factors which research and theory have shown to be important when working with men and couples in the peripartum period.
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