THE EMOTIONAL IMPACT OF INFERTILITY & A.R.T. Rita Alesi Manager of Counselling Services Counselling Psychologist
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1 THE EMOTIONAL IMPACT OF INFERTILITY & A.R.T. Rita Alesi Manager of Counselling Services Counselling Psychologist
2 THE ROLE OF COUNSELLING IN A.R.T. OVERVIEW Part 1: How counselling operates in A.R.T. Clinic Part 2: The patient journey: the psychological issues associated with infertility 2
3 PART 1: HOW COUNSELLING OPERATES IN AN A.R.T. CLINIC Victoria counselling is mandatory for everyone having A.R.T. Other states only for donor /recipient/ surrogacy treatment 3
4 TRAINING REQUIREMENTS FOR COUNSELLORS Must be a registered psychologist, social worker. Very specialized area. Different from other grief & loss work. Training and orientation on-site in all areas. Follow the patient journey. 4
5 THE ROLE OF COUNSELLING IN A.R.T. PRE-TREATMENT Psycho-educational, information Assessment of mental health and provision of care Review of legislation and impact on decision making Support networks 5
6 THE ROLE OF COUNSELLING IN A.R.T. THERAPEUTIC COUNSELLING Follow-up counselling available Anxiety, depression, phobias Marital / relationship counselling Grief miscarriage, tx failure, still birth 6
7 PART 2: PSYCHOLOGICAL ISSUES ASSOCIATED WITH INFERTILITY THE DIAGNOSIS OF INFERTILITY Grief response shock, anger, sadness, denial Different coping styles between men and women Defining support networks who to tell? 7
8 PSYCHOLOGICAL ISSUES ASSOCIATED WITH INFERTILITY Added burdens : Victoria only National police checks (& O.S. Police checks if applicable) Child protection order checks DHS Presumption against treatment Patient Review Panel 8
9 PSYCHOLOGICAL ISSUES ASSOCIATED WITH INFERTILITY THE JOURNEY THROUGH IVF Anxiety about treatment process Anxiety about treatment outcome Coping with failure Other people s babies / pregnancies Secrecy, shame 9
10 PSYCHOLOGICAL ISSUES ASSOCIATED WITH INFERTILITY THE JOURNEY THROUGH IVF Relief is only temporary. Grief continues with every failure, and gets worse as time passes. In some cases, causes depression, marriage problems. 10
11 THE IMPACT OF THESE STRESSORS Profound grieving process, different from a death. Loss of control Hypersensitivity to others pregnancies Obsession with becoming pregnant Identity and self esteem issues Self blame 11
12 THE IMPACT OF THESE STRESSORS Feelings of isolation, not feeling normal Life cycle issues no children,no grandchildren Existential issues- who am i? What is my purpose in this life? The meaning of life? 12
13 PSYCHOLOGICAL ISSUES ASSOCIATED WITH INFERTILITY & A.R.T. LIFE AFTER IVF WITH BABY Expectations realistic / unrealistic? Risk of post-natal depression Coping with multiple birth IVF stops infertility is ongoing 13
14 PSYCHOLOGICAL ISSUES ASSOCIATED WITH INFERTILITY & A.R.T. LIFE AFTER IVF WITHOUT BABY Coming to terms with childlessness Grieving process Exploring other options such as adoption or treatment with donor gametes Beliefs systems and values challenged 14
15 THE IMPACT OF THESE STRESSORS Dreams and plans shattered Need to redefine identity and roles Need to restructure life goals 15
16 GRIEF AND A.R.T. 1.Those still active in treatment chronic grief 2. Those who have finished treatment closure (* * Complicated grief) 16
17 STAGES OF GRIEF 5 STAGES MODEL Denial Anger Bargaining Depression Acceptance 17
18 GRIEF Roller coaster, treatment represents hope. Failure = grief over time compounds Cannot reach acceptance at this stage requires more immediate coping strategies 18
19 GRIEF & STRESS Treading water 19
20 GRIEF AND STRESS IVF may cease but infertility experience is forever, many triggers throughout life cycle. Grief never goes away, you don t get over it, you just become more adept at carrying it with you and making it part of your life. 20
21 CONCLUDING REMARKS Everyone has a story a history which impacts on their capacity to cope with IVF. IVF is temporary. Infertility is lifelong. A person s experience of IVF will impact on the level of trauma experienced. We can change that. 21
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