7.) KP:  What is the greatest barrier to individuals or couples pursuing fertility counseling?

Diane: There are several reasons.  A new study has come out that shows that IVF clinics don’t suggest it or provide referrals.  A lot of the big clinics have a mental health professional on staff, so sometimes that person will do an assessment and then refer people out to see a clinician on an ongoing basis, but it’s not as robust as I’d like to see it.

The other situation involves people who have never had a need to do any kind of counseling.  They are high functioning people often times, who are relatively emotionally stable, so it’s not even in their consciousness that they might need some help, along with where and how to get it.

The other barrier can be cost.  Infertility treatments are expensive, so counseling is one more thing that they have to pay for and sometimes they feel that they have to cut a corner somewhere and they won’t pay for the counseling because they feel they need to use that money for the medical interventions.

I also think that with specific cultures there’s a lot of shame and guilt.  This is a generalization, but sometimes in Asian cultures, for example, it can be very shameful to go outside of your family or community to seek help.  So, that can sometimes be a barrier as well.

KP:  The cultural piece is understandable.  And, what you said about how there are people where the idea of counseling has never really crossed their mind, so they’re not going to be considering it. Continuing to educate people seems so important because fertility counseling can provide a lot of assistance, guidance and healing.  As you said earlier, contending with infertility can be quite a traumatizing experience.  Navigating it more in isolation seems so much harder than with the assistance of a professional or group.

Next: What is your typical treatment process when working with clients with infertility?