Two psychiatrists who treated Lindsay Clancy in the months before she strangled her three children to death told jurors on Friday that Clancy did not show signs of psychosis prior to the killings.

“I did not have any concerns about her safety or her risk for anybody else,” psychiatrist Alia Goodheart, who treated Clancy during a brief inpatient stay in early January 2023, testified on the stand.

Speaking to Clancy’s alleged suicidal thoughts prior to the killings, Goodheart recalled Clancy saying her family — namely her children and her mother — was the main reason she did not want to harm herself.

Clancy, 35, has pleaded not guilty to three murder charges in connection with the deaths of her 5-year-old daughter Cora, 3-year-old son Dawson, and infant son Callan at her family’s home in the Boston suburb of Duxbury on Jan. 24, 2023.

Clancy’s defense attorney, Kevin Reddington, has argued she had postpartum psychosis and severe mental illness, and that she attempted to take her own life after strangling her children.

Postpartum psychosis is a rare but serious medical emergency characterized by severe, rapid onset psychiatric episodes such as mania, depression or hallucinations. It can have rapid onset in the days or weeks after birth, research shows.

Prosecutors have attempted to cast doubt on Clancy’s claim that she was not properly treated for her mental health issues, arguing that she was not serious about treating her condition and alleging she changed doctors and medications frequently.

Prosecutors say Clancy’s medical team is not to blame for her actions.

While Goodheart testified on Friday that she did not see signs of psychosis, she acknowledged on cross examination that she never treated a patient with postpartum psychosis, a mental health condition that is far less common than postpartum depression.

Postpartum psychosis — symptoms of which can include delusions or hallucinations and may include suicidal or homicidal action — affects roughly 1 to 2 mothers per 1,000 childbirths, according to estimates from a 2017 systematic review in the journal BMC Psychiatry.

Goodheart said in her testimony that sleep deprivation — one of the major reasons Clancy opted for inpatient treatment — could contribute to a manic episode. She said Clancy had reported feeling “numb” and that she wanted to further observe her sleep when she checked out of the facility.

“She was future-orientated. She was clearly invested in her children. She was a caring mother,” Goodheart recalled. “She had family support. We ensured that she would have outpatient psychiatric care for follow-up.”

Jennifer Tufts, a psychiatrist who treated Clancy beginning in September 2022, told jurors that she began treating Clancy after she came in with concerns about her anxiety.