The Viability, Necessity, and Acceptability of Text Message Group Therapy Among Low-Income Racial-Ethnic Minority Mothers: A Qualitative Study

PurposeThis qualitative focus group study conceptually explored the viability, necessity, and acceptability of a proposed text message group therapy (TMGT) intervention as a psychotherapy delivery format among racial-ethnic minority, low-income peripartum mothers. MethodThree semi-structured, virtual focus groups facilitated in-depth interviews with 12 adults who gave birth in the previous 24 months, self-identified as a racial-ethnic minority, had at least mild depression (PHQ-9 >5), participated in a government program requiring low-income (e.g. Special Supplemental Nutrition Program for Women, Infants, and Children [WIC]), and were fluent in English. Recruitment, data collection, and analyses were performed concurrently. This allowed theme saturation (no emergence of new themes) to determine the sample size of 12 participants. The qualitative analysis framework was Grounded Theory. Krippendorffs alpha was set to > 0.8 for interrater reliability. ResultsTen of the 12 participants were willing to engage in the proposed TMGT. Participants reported a need for psychotherapy tailored to motherhood that was not met by their current support system or healthcare providers, which the proposed TMGT could meet. While all participants communicated via text messaging about motherhood and baby care, they varied in terms of how much. Text messaging has the unique strength of being resilient to interruptions by young children and allowing for multitasking. Text messaging can be a less emotionally stimulating form of communication for an often overstimulated parent. Some mothers found it easier to share their emotions via text message, whereas others found it more difficult. Drawbacks include that information could be lost (increasing frustration or making it possible to hide their true feelings), conversational turns could take too long, and keeping track of the conversation and mobile devices could increase the mental load. ConclusionThese racial-ethnic minority, low-income mothers with peripartum depression expressed a strong need for a safe space to share their lived experiences of motherhood, receive emotional support, and obtain high-quality information about motherhood and baby care tailored to their situation. The proposed text message group therapy is viable, acceptable, and necessary and could meet the needs of many women and increase access to group psychotherapy for this important, underserved population.