Infertility: A Quantitative Report of Clinical Psychologists' Therapeutic Contact with Sub-Fertility Clients and a Qualitative Analysis of the Experience of these Clients and their Subsequent Psychological Adjustment, Following the Discontinuation of In Vitro Fertilisation Treatment.

Smith, Rebecca J. (1998). Infertility: A Quantitative Report of Clinical Psychologists' Therapeutic Contact with Sub-Fertility Clients and a Qualitative Analysis of the Experience of these Clients and their Subsequent Psychological Adjustment, Following the Discontinuation of In Vitro Fertilisation Treatment. The Open University.

DOI: https://doi.org/10.21954/ou.ro.0001024b

Abstract

Objectives:- The aims of this investigation were two-fold. First, within the literature no firm conclusions have been drawn about the nature of the psychological and therapeutic needs of individuals with fertility problems. The first section of this investigation, therefore, attempted to explore in more depth the interaction between Clinical Psychologists and the infertile population.

Second, research examining the psychology of receiving treatment for infertility (namely, In Vitro Fertilisation - IVF) has largely overlooked the experiences of those for whom treatment has been unsuccessful and a decision to stop has been made. The aim of the second section of the investigation was therefore, to gain a more detailed understanding of the experience of individuals stopping IVF, and to look closely at their adjustment and coping.

Design:-
Section One - A survey design was employed.

Section Two - A qualitative research paradigm using a grounded theory methodology was employed.

Method:-
Section One - A survey instrument was developed to explore Clinical Psychologists therapeutic contact with persons with fertility problems. Of a total of 1000 questionnaires distributed, a response rate of 43.6 per cent was achieved.

Section Two - Eleven participants were recruited from a population of patients who had discontinued unsuccessful IVF treatment. Face-to-face interviews were conducted, exploring participants' feelings and experiences across three areas. (1) their experience of the IVF treatment process; (2) their decision to stop treatment; (3) their lives ‘post decision’.

Results:-
Section One - only a small proportion of the sample were found to be working with individuals with fertility problems. Female clients were more likely to have been seen therapeutically, with those undergoing infertility treatment during therapy essentially receiving the most Clinical Psychology service resources. Clients were unlikely to be referred to services for issues related to their infertility, whilst the primary therapeutic task was often identified as dealing with issues of infertility.

Section Two - Transcripts of participants’ interviews were analysed using aspects of grounded theory methodology. Five themes were identified as unifying the data.

Conclusions and Implications:- The quantitative survey findings suggest that at present, services may not be fully addressing the therapeutic needs of the infertile population. Specific difficulties were found to exist at the point of initial referral. Suggestions are made for improving the service delivery to this client group.

A tentative theoretical framework was developed to explain the experience and adjustment of individuals discontinuing IVF treatment. This preliminary process model suggests that certain psychological and social factors exist which have the potential to lead to a greater or lesser degree of adaptation for individuals (the effects of these factors are mediated by a core process within the individual, namely their belief system). The implications of this model for preventative and therapeutic interventions are discussed, both in relation to services provided by Clinical Psychologists and for other professionals working in specialist infertility services.