Cognitive Behavioral Therapy for Perinatal Distress
Purchase: Amazon, Barnes & Noble, or Routledge
Cognitive Behavioral Therapy for Perinatal Distress is a clinician-focused guide by Amy Wenzel, PhD, ABPP, with Karen Kleiman, MSW, LCSW, on applying CBT with pregnant and postpartum clients experiencing depression, anxiety, and related emotional distress.
The book demonstrates how CBT structure and strategy can be integrated into a warm, supportive therapeutic approach tailored specifically to the perinatal period.
Designed for practitioners and students in perinatal mental health, the text addresses CBT case conceptualization, cognitive and behavioral interventions, problem-solving, communication skills, and relapse prevention. Its clinical examples make the material especially accessible for professionals working with women during pregnancy and the postpartum period.
About the Book
Perinatal mood and anxiety disorders are among the most common complications of pregnancy and the postpartum period. According to the World Health Organization, approximately 10% of pregnant women and 13% of those who have recently given birth develop a clinically significant mental health disorder.
In the United States, maternal mental health disorders affect roughly 600,000 U.S. mothers annually, with research from the George Washington University Policy Center for Maternal Mental Health estimating that up to 75% of affected women never receive the treatment they need.
Cognitive Behavioral Therapy for Perinatal Distress was written to help close that gap. Rather than treating CBT as a rigid, manualized protocol, Wenzel and Kleiman present a flexible clinical framework. They integrate CBT structure with a therapeutic stance that recognizes the unique vulnerabilities, strengths, and circumstances of perinatal women.
The result is a resource that is both evidence-based and clinically nuanced, which is precisely what treating this population requires.
The book begins by grounding the reader in perinatal distress, then moves through CBT conceptualization, specific interventions for depression and anxiety, and the relational dimensions of treatment. Its tone reflects the warmth and clinical specificity that postpartum-specialized practitioners will recognize from direct patient work.
Who This Book Is For
The primary audience is licensed and trained mental health professionals who work with pregnant and postpartum clients. Specific readers include:
Clinical psychologists and licensed counselors
Licensed clinical social workers
Psychiatrists and psychiatric nurses
Therapists specializing in women's mental health
Graduate students and postdoctoral trainees in clinical psychology
Perinatal mental health professionals and postpartum specialists
The book is structured as a professional clinical resource. While the subject matter is directly relevant to the women these practitioners serve, the text is organized for clinicians learning to apply CBT in a perinatal context. It is not a general-reader self-help guide.
Topics Covered in the Book
The book is organized into twelve chapters, moving from foundational concepts through specific interventions to specialized clinical considerations.
CBT Conceptualization of Perinatal Distress
The opening chapters establish a clear framework for understanding why perinatal women experience emotional distress and how CBT conceptualizes these presentations.
Chapter 2 walks through the cognitive behavioral model applied to this population, identifying the cognitive patterns, behavioral avoidance, and situational stressors common in pregnancy and postpartum adjustment.
Chapter 3 reviews the research on CBT efficacy for perinatal distress, giving clinicians the evidence base they need to feel confident recommending this approach to clients and referring providers.
Chapter 4 takes a step that many CBT texts skip entirely: it focuses on the therapeutic relationship. Wenzel and Kleiman make the case that effective CBT with perinatal women depends on the quality of the clinical alliance. This chapter distinguishes the book from more purely technical treatment manuals and reflects both authors' extensive clinical experience.
Behavioral Interventions for Perinatal Depression and Anxiety
Chapters 7 and 8 provide the core behavioral intervention content, addressing perinatal depression and anxiety as distinct but related presentations. The chapter on depression covers behavioral activation, scheduling pleasurable activity, reducing avoidance, and building capacity for self-care within the specific constraints new and expectant parents face.
The chapter on anxiety addresses exposure-based strategies, worry management, and behavioral experiments suited to the realities of the perinatal period.
Chapter 6 covers cognitive interventions: evaluating unhelpful cognitions, identifying automatic thoughts, and developing balanced responses. Each technique is adapted for the context in which perinatal women actually live, including sleep disruption, physical recovery, shifting identity, and relationship adjustment.
Problem Solving, Communication Skills, and Relapse Prevention
Chapters 9 and 10 address two areas that clinical experience consistently shows to be pressing for perinatal clients: interpersonal communication and practical problem solving. Hormonal change, role transition, and sleep deprivation all place strain on communication between partners, family members, and support networks. These chapters give clinicians concrete strategies for helping clients navigate those stressors.
Chapter 11 covers relapse prevention and the conclusion of treatment, a phase that is often abbreviated with perinatal clients who may stop therapy when acute symptoms remit but before durable coping skills are in place. Chapter 12 addresses special considerations and future directions, rounding out the clinical picture with guidance on more complex presentations.
Why CBT Matters in Perinatal Mental Health
The research on CBT for perinatal mood and anxiety disorders is substantial. A meta-analysis published in Clinical Psychology Review analyzing research on CBT efficacy for perinatal depression across 79 randomized controlled trials found that CBT-only interventions produced a short-term standardized mean difference of -0.69 for perinatal depression and -0.63 for perinatal anxiety.
Both effects were maintained at long-term follow-up. These are clinically meaningful effect sizes, particularly for a population where pharmacological treatment options are complicated by pregnancy, breastfeeding, and concerns about infant exposure.
Despite the evidence, treatment gaps remain significant. According to NCBI StatPearls, perinatal depression affects approximately 1 in 7 people during pregnancy or the first year after childbirth, with up to 50% of cases going undiagnosed in part because symptom overlap with pregnancy itself makes identification difficult. Even among women who are identified, the majority never access professional treatment.
This gap points directly to the need for clinicians who are trained, confident, and equipped with practical clinical frameworks. That is precisely what this book provides. It does not require clinicians to choose between a warm, relational approach and a structured, evidence-based one. Wenzel and Kleiman demonstrate that effective CBT with perinatal clients integrates both, and the chapter on the therapeutic alliance alone sets this text apart from other CBT guides in the perinatal space.
For clinicians working in the Philadelphia area, the Main Line, or anywhere in the country, a sound framework for cognitive behavioral therapy for perinatal distress is increasingly relevant as demand for specialized perinatal care continues to outpace available training.
Praise for Cognitive Behavioral Therapy for Perinatal Distress
The book has received endorsements from prominent clinicians in perinatal mental health and psychotherapy.
Jeanne Watson Driscoll, PhD, RN, PC, co-author of Women's Moods and Traumatic Childbirth, described the book as a comprehensive guide that draws on genuine clinical expertise with perinatal women, making it both readable and directly applicable for providers in this specialty area.
Additional endorsements from clinicians across the field praise the balance between clinical specificity and accessibility for practitioners at varying levels of experience with perinatal populations.
About the Authors
Amy Wenzel, PhD, ABPP, is an internationally recognized expert in cognitive behavioral therapy, perinatal psychology, and suicide prevention. She is the author and editor of more than fifteen books on topics including CBT, perinatal anxiety, and clinical decision-making. She lectures internationally and provides supervision to clinical psychologists, social workers, and psychiatric nurses.
She is also the developer of Therapeutic Relationship-Focused CBT (TRF-CBT), an approach that integrates relational attunement with the structure of evidence-based cognitive behavioral practice. Her clinical background and areas of expertise are detailed at dramywenzel.com/biography.
Karen Kleiman, MSW, LCSW, is an internationally recognized authority on postpartum depression and anxiety, with more than 36 years of clinical experience treating pregnant and postpartum women and their families. She is the founder of The Postpartum Stress Center in the Philadelphia area, a premier treatment and professional training center for perinatal mood and anxiety disorders.
She has authored several books on perinatal distress and developed The Art of Holding Perinatal Women in Distress, an intervention approach used in clinical and training settings worldwide.
Together, their combined expertise across clinical practice, research, and professional training makes this book an authoritative resource for anyone specializing in perinatal mental health.
Related Perinatal Mental Health and CBT Books
Dr. Wenzel has authored and edited several additional clinical resources relevant to perinatal mental health and cognitive behavioral therapy.
Anxiety in Childbearing Women is a focused clinical text on the assessment and treatment of anxiety disorders across the full perinatal period, from conception through the postpartum year.
The Oxford Handbook of Perinatal Psychology provides a comprehensive academic and clinical reference on perinatal psychology, covering a wide range of topics from psychological adjustment in pregnancy to the latest intervention research.
Dropping the Baby and Other Scary Thoughts, 2nd Edition addresses unwanted intrusive thoughts in new parents, a common but often misunderstood perinatal phenomenon, and bridges clinical knowledge with accessibility for both professionals and families.
Handbook of Cognitive Behavioral Therapy offers a broader foundation in CBT theory, research, and application for clinicians seeking to deepen their practice across populations and presentations.
Purchase the Book
Cognitive Behavioral Therapy for Perinatal Distress is available in paperback and digital formats through Amazon, Barnes and Noble, and the Routledge catalog. Purchase links are at the top of this page.
Dr. Wenzel's work in perinatal psychology and cognitive behavioral therapy extends well beyond this volume. Her biography outlines her full clinical background, academic appointments, and areas of specialization, including her development of Therapeutic Relationship-Focused CBT. Her publications page lists her peer-reviewed research and book contributions for clinicians seeking to explore the evidence base behind her clinical frameworks. For those who learn best through demonstration, her videos page includes recorded presentations and clinical teaching material, and her audiobooks page offers an accessible format for practitioners with limited reading time.
If you are a clinician seeking a deeper framework for applying CBT with pregnant and postpartum clients, the work in this book reflects the same evidence-based, individualized approach that grounds Dr. Wenzel's clinical practice. To learn more about her work in Bryn Mawr, reach out through the contact page.
Wenzel, A., with Kleiman, K. (2015). Cognitive behavioral therapy for perinatal distress. New York, NY: Routledge.
Countless studies have established the efficacy of cognitive behavioral therapy (CBT) for many manifestations of depression and anxiety. This book discusses the benefits of CBT for pregnant and postpartum women who suffer from emotional distress. The myths of CBT as rigid and intrusive are shattered as the authors describe its flexible application for perinatal women. This text teaches practitioners how to successfully integrate CBT structure and strategy into a supportive approach in working with this population. The examples used in the book will be familiar to postpartum specialists, making this an easily comprehensive and useful resource.
Praise for Cognitive Behavioral Therapy for Perinatal Distress:
Wenzel and Kleiman have done a superb job in writing this comprehensive guide utilizing CBT with a unique population. Their clinical expertise, in the care of women living with perinatal distress, informs their presentation, making it easy to read and highly applicable to providers in this specialty practice area.
— Jeanne Watson Driscoll, PhD, RN, PC, Co-author of Women’s Moods; Postpartum Mood and Anxiety Disorders: A Clinician’s Guide; and Traumatic Childbirth.
We usually think of pregnancy and the postpartum as times of happiness and joy, yet for a number of reasons, depression and anxiety are actually very common experiences during these times. All too often, these problems go unrecognized by healthcare providers. This book, which emphasizes cognitive-behavioral therapy, the most effective treatment for emotional distress, is sure to be of great use to practitioners and patients alike. The many personal examples and illustrations of therapeutic techniques make this a very usable workbook.
— Jonathan S. Abramowitz, PhD, Professor and Associate Chair of Psychology, University of North Carolina at Chapel Hill
Two experts in the field of perinatal mental health have teamed up to produce an outstanding volume on the identification and management of perinatal distress. This book recognizes that few women present with pure perinatal depression or anxiety and it provides a thorough going guide to working with the perinatal woman who is suffering from a mixture of symptoms. Cognitive Behavioral Therapy for Perinatal Distress should be read by any clinician or student who works with women suffering from perinatal depression or anxiety.
— Michael W. O’Hara, PhD, Professor of Psychology, University of Iowa
