A Comparative Analysis of the Acceptability of the MATER Positive Psychology Intervention Versus Cognitive Behavioural Therapy in Women With Postpartum Depression

Postpartum depression (PPD) is a prevalent condition with important consequences for both mothers and infants. Although Cognitive Behavioural Therapy (CBT) is considered the first-line psychological treatment, Positive Psychology Interventions (PPIs) have recently emerged as promising approaches by promoting well-being alongside symptom reduction. This randomized clinical trial compared the acceptability of an online Positive Psychology programme (Maternal insights for Awareness, Thriving, Emotions and Resilience MATER) with a CBT programme for women with PPD. A total of 136 women were randomly assigned to one of the two conditions, both consisting of 10 weekly online group sessions. Acceptability was assessed through indicators of satisfaction and adherence. Results showed no significant differences between groups in overall satisfaction, perceived skill acquisition, perceived therapists' empathy and understanding, quality of treatment or willingness to recommend the programme. However, a significant interaction between intervention type and symptom severity emerged for perceived therapist competence: Among participants with more severe depressive symptoms, therapists in the PPI condition were rated as more competent than those in the CBT condition. Dropout rates were similar across groups, and session attendance declined over time in both interventions. Employment predicted greater retention, whereas having two or more children increased the likelihood of dropout. These findings support the feasibility and acceptability of both interventions and suggest that Positive Psychology-based programmes may be particularly well perceived by women experiencing more severe postpartum depressive symptoms. Trial Registration: ClinicalTrials.gov: Identifier: NCT05676918.