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  Fertility Counseling for Couples

  Brennan Peterson and Kristy Koser

  This chapter addresses the role, and importance, of individual counseling and psychotherapy in providing psychological assistance and support to patients who are struggling with infertility and loss. Depression and anxiety are the two most frequent emotional sequelae of the infertility experience. The chapter therefore speaks not only to what factors contribute to making fertility counselors effective in their work, but also addresses specific treatment approaches that can yield positive outcomes in working with this unique population. These approaches include psychodynamic psychotherapy, cognitive–behavioral therapy (including dialectical behavior therapy and trauma-focused therapy), and supportive counseling. A brief history and description of each approach is presented in addition to a discussion of ways in which these psychotherapeutic treatments can be effective in working with fertility patients. Each of these approaches can be longer term or time-limited, often depending on the needs and preferences of the patient. The chapter also emphasizes the importance of appropriate professional mental health training as well as an understanding of the unique medical treatments that are an inherent part of the personal experiences of fertility patients. A strong therapeutic alliance is critical to effective individual treatment, and each psychotherapy approach provides strategies for assisting individuals who are emotionally challenged by infertility.

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  Fertility Counseling for Couples

  Brennan Peterson

  "The purpose of this chapter is to provide fertility counselors with the tools necessary to effectively assess and treat couples experiencing fertility problems so that these couples can improve their relationships, reduce psychological and infertility related distress, and regain control and direction in their lives. The chapter will outline the challenges unique to couples experiencing infertility, and will integrate several case vignettes which portray common profiles of couples who fertility counselors may encounter. Gender differences in how couples communicate and cope with infertility distress will be presented. The chapter will also examine the impact of infertility on a couple’s sexual relationship, strategies to help couples best share infertility related treatment information with others and the importance of working through grief and loss. The challenges unique to couples experiencing age-related fertility decline will also be presented, as will the usefulness of mindful meditation as a method for approaching fertility related thoughts and feelings."

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  Building a Circle of Care in Same-Sex Couple Relationships: A Socio-Emotional Relational Approach

  Jason C. Richards, Naveen Jonathan, and Lana Kim

  Comparison studies have long found that same-sex couples maintain more equal relationships than their heterosexual counterparts. In a previous study of committed same-sex couples, partners reported that their relationship processes emerged based on a desire for mutuality and attunement. Socio-Emotional Relationship Therapy (SERT) is a therapeutic practice model which posits that four conditions—shared relational responsibility, shared vulnerability, mutual influence, and mutual attunement—create a “Circle of Care” that counters harmful power differentials. Since gender differences generally do not influence power disparities in same-sex relationships, this chapter examines the dynamics of power and equality in committed same-sex relationships and considers how these may apply to clinical practice. We provide examples from qualitative research to illustrate how same-sex couple relationships enact the Circle of Care processes as partners create and maintain equality. We also identify unique socio-contextual issues affecting vulnerability among same-sex partners and use a case example to show how a SERT therapist helped a same-sex couple address power imbalances in the relationship.

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  Understanding and Treating the Psychosocial Consequences of Infertility

  Arthur L. Greil, Lone Schmidt, and Brennan Peterson

  Psychological distress and infertility are linked in a complex pattern, such that distress may be a cause of infertility and reduce the probability of achieving a pregnancy at the same time that infertility may be a cause of psychological distress. Although infertile women are not more likely to be characterized by psychopathology, they are more likely to experience higher levels of distress than comparison groups. Infertile men also experience psychological distress, but women experience more infertility distress than men. Both infertility and its treatment are stressors putting a heavy psychological strain on couple relationships. Whereas there is general agreement about the need for psychological interventions to treat infertility distress, little is known about the efficacy and effectiveness of psychosocial intervention. Given the prevalence of infertility and the fact that the numbers of individuals and couples seeking infertility treatments are increasing, it is essential that mental health professionals understand the emotional challenges faced by this population.

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  Working with Chronic Illness

  Arpita Lal

  "Chronic illness is one of the most trying periods in the life of the patient and his family... The interactions among the different care providers in the medical setting as well as their interaction with the patient influence the patient's functioning and recovery. That is why, the family therapist can play an important role in helping the family tide over the difficult period, facilitating the recovery of the patient, and providing that unobtrusive nudge which may guide the family towards putting the opportunity provided by chronic illness to good use."

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  Mental Health Practitioners and Trainees

  Brennan Peterson, Joyce West, Terri L. Tanielian, Harold Alan Pincus, Jessica Kohout, Georgine M. Pion, Marlene M. Wicherski, Rita E. Vandivort-Warren, Margaret L. Palmiter, Elizabeth I. Irwin, Jeanne C. Fox, Tom W. Clawson, S. Christian Smith, Rex Stockton, Amy Gibson Nitza, John P. Ambrose, Laura Blankertz, Larry D. Sullivan, Kevin P. Dwyer, Michael S. Fleischer, Harold F. Goldsmith, Michael J. Witkin, Joanne E. Atay, and Ronald W. Manderscheid

  Late in 1987, research staff from the American Psychiatric Association, the American Psychological Association, the National Association of Social Workers, and representatives of professional psychiatric nursing formed a work group on human resources data with staff from the National Institute of Mental Health (Dr. Manderscheid). This group had several major purposes, including identifying common, core data on human resources from each discipline, preparing a chapter for Mental Health 1990, identifying data gaps, coming up with plans to address those gaps, and improving survey compatibility between the involved disciplines.

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  An Update on Human Resources in Mental Health

  Brennan Peterson, Joyce West, Harold Alan Pincus, Jessica Kohout, Georgine M. Pion, Marlene M. Wicherski, Rita E. Vandivort-Warren, Margaret L. Palmiter, Elizabeth I. Mirwin, Jeanne C. Fox, Tom W. Clawson, Kathryn K. Rhodes, Rex Stockton, John P. Ambrose, Laura Blankertz, Kevin P. Dwyer, Victoria Stanhope, Michael S. Fleischer, Harold F. Goldsmith, Michael J. Witkin, Joanne E. Atay, and Ronald W. Manderscheid

  In 1987, staff from the American Psychological Association, American Psychiatric Association, National Association of Social Workers, and professional psychiatric nursing formed a work group on human resources data. Their purposes were to identify common, core data on human resources from each discipline, to prepare a chapter for Mental Health 1990, to identify gaps in the data, to determine how to address or fill those gaps, and to improve survey compatibility between their disciplines.