A Behavioral Activation Prenatal and Postpartum Intervention for Depressed Pregnant Smokers

Eligibility Criteria

• 1. Pregnant (or within 4 months post-partum for aim 1 only)
• 2. Score ≥ 10 on the PHQ-9 at baseline.
• 3. ≥ 18 years of age
• 4. Have a telephone
• 5. Self report smoking, even a puff, cigarettes, little cigars and/or cigarillos in the past 30 days.
• 6. Aim 1 Criteria: Approximately two thirds of the sample will be gestational age up to 36 weeks, and approximately one third will be within 4 months postpartum Aim 3 Criteria: gestational age between 32 to 36 weeks Aim 4 Criteria: gestational age up to 28 weeks
• 7. Able to speak and read English
• 1. Rated on the Columbia-Suicide Severity Rating Scale113 at screening as in the past month having had active suicidal ideation with some intent to act or active suicidal ideation with specific plan and intent (indicated by answering "YES" on both Q3 and Q4, and/or 5) and/or endorsing "YES" to having engaged in preparatory acts towards or attempting suicide in the past 3 months (as indicated by answering "YES" to both parts of Q6)
• 2. Have a lifetime or current diagnosis of Psychotic Disorder as assessed by specified Mini International Neuropsychiatric Interview (MINI) 7.0.2 modules.
• 3. Have a past or current diagnosis of Bipolar Disorder I or II or have a past or current diagnosis of Other specified Bipolar and related disorder as assessed by specified MINI 7.0.2 modules.
• 4. Any otherwise not specified medical or psychiatric condition, illness, disorder, or concomitant medication that could compromise participant safety or treatment, as determined by the Principal Investigator and/or Study Physician.
• 5. Participant considered by the investigator as unsuitable candidate for full participation in the study.
• 1. Currently participating in individual psychotherapy
• 2. Currently participating in other smoking cessation treatments and refuses to refrain from use for the duration of the study
• 3. Currently using psychotropic medication
• 4. Rated on the Columbia-Suicide Severity Rating Scale113 at screening as in the past month having had active suicidal ideation with some intent to act or active suicidal ideation with specific plan and intent (indicated by answering "YES" on both Q3 and Q4, and/or 5) and/or endorsing "YES" to having engaged in preparatory acts towards or attempting suicide in the past 3 months (as indicated by answering "YES" to both parts of Q6)
• 5. Have a lifetime or current diagnosis of Psychotic Disorder as assessed by specified Mini International Neuropsychiatric Interview (MINI) 7.0.2 modules.
• 6. Have a past or current diagnosis of Bipolar Disorder I or II or have a past or current diagnosis of Other specified Bipolar and related disorder as assessed by specified MINI 7.0.2 modules.
• 7. Any otherwise not specified medical or psychiatric condition, illness, disorder, or concomitant medication that could compromise participant safety or treatment, as determined by the Principal Investigator and/or Study Physician.
• 8. Participant considered by the investigator as unsuitable candidate for full participation in the study.
• 1. Masters degree in psychology, social work, or other counseling degree
• 2. Training in the delivery of psychotherapy and counseling interventions