Nonetheless, most studies have demonstrated that interventions combining mental health treatment and parenting support, or at least including a component focused on parenting, often lead to better outcomes relative to programs that focus solely on the illness. A systematic review of the impact of maternal-infant dyadic interventions on postpartum depression included 19 single group pre-post and randomized controlled studies. The author concluded that strategies focused on the dyad and maternal coaching were most effective at reducing psychiatric symptoms and demonstrated modest improvements in the mother-child relationship and maternal responsive-ness (Tsivos et al., 2015). Not all such approaches are successful, however.A 2015 Cochrane review assessing the impact specifically of parent-infant psychotherapy versus control or an alternative intervention found no significant effects of the psychotherapy on maternal depression or the mother-child dyad (Barlow et al., 2015).