{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:14:07Z","timestamp":1791396847635,"version":"4.3.3"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Engagement in psychotherapy is essential for achieving effective mental health outcomes, yet maintaining participation can be challenging\u2014especially during significant disruptions such as the COVID-19 pandemic. The SUMMIT Trial evaluated a brief behavioral activation treatment for perinatal depression and anxiety, comparing telemedicine with in-person psychotherapy. Due to pandemic-related disruptions, in-person randomization was suspended twice, dividing participants into peak and non-peak COVID-19 timeframes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This secondary mixed-methods analysis examined enrollment, retention, satisfaction, and depressive and anxiety symptoms between peak (March 2020-July 2021 &amp;amp; Jan-April 2022) and non-peak COVID-19 periods (Jan-March 2020, Jul 2021-Jan 2022, April 2022-Sep 2023). During peak-COVID-19, participants received telemedicine-only; otherwise, they were randomized to telemedicine or in-person treatment. T-tests compared symptom scores and enrollment rates; chi-square and logistic regression analyzed retention and satisfaction. Qualitative data underwent thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1230 participants, 597 (48.5%) enrolled during peak-COVID and were randomized to telemedicine, while 693 (56.3%) were randomized to telemedicine or in-person treatment. Enrollment (25.4 vs. 21.8 participants\/month,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.250), retention (98.12% vs. 98.42%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.689) and satisfaction (CSQ-8: 3.45 vs. 3.39,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.174) did not differ significantly. No differences were observed in depressive or anxiety symptoms at baseline (EPDS: 15.85 vs. 15.72,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.546; GAD-7: 11.70 vs. 11.96,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.3670) or at 3 months (EPDS: 9.09 vs. 9.09,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.980; GAD-7: 6.42 vs. 6.38,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.907).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Engagement, efficacy, and experience were comparable across pandemic phases, highlighting the feasibility of telemedicine-based adaptations in the midst of public health crises.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2025.1686719","type":"journal-article","created":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T16:06:36Z","timestamp":1769097996000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Engagement, efficacy, and experiences of psychotherapy for perinatal populations with depression and anxiety during the COVID-19 pandemic"],"prefix":"10.3389","volume":"16","author":[{"given":"Holly A.","family":"Krohn","sequence":"first","affiliation":[{"name":"Department of Psychiatry, School of Medicine, University of North Carolina","place":["Chapel Hill, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Shelly","sequence":"additional","affiliation":[{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie E.","family":"Gibori","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Endeavor Health","place":["Evanston, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Andrejek","sequence":"additional","affiliation":[{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"La Porte","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Endeavor Health","place":["Evanston, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea S.","family":"Lawson","sequence":"additional","affiliation":[{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Anand","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara S.","family":"Berenbaum","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy-Lee","family":"Dennis","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health","place":["Toronto, ON, Canada"]},{"name":"Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto","place":["Toronto, ON, Canada"]},{"name":"Lawrence S. Bloomberg Faculty of Nursing, University of Toronto","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Griffen","sequence":"additional","affiliation":[{"name":"Maternal Mental Health Leadership Alliance","place":["Arlington, VA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Lea","sequence":"additional","affiliation":[{"name":"Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health","place":["Toronto, ON, Canada"]},{"name":"Department of Sociology, Faculty of Social Sciences, McMaster University","place":["Hamilton, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert G.","family":"Maunder","sequence":"additional","affiliation":[{"name":"Lunenfeld-Tanenbaum Research Institute, Sinai Health","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Meltzer-Brody","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, University of North Carolina","place":["Chapel Hill, NC, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone N.","family":"Vigod","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto","place":["Toronto, ON, Canada"]},{"name":"Department of Psychiatry, Women\u2019s College Hospital","place":["Toronto, ON, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard K.","family":"Silver","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Endeavor Health","place":["Evanston, IL, United States"]},{"name":"Department of Obstetrics & Gynecology, Pritzker School of Medicine, University of Chicago","place":["Chicago, IL, United 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