WHAT CAN I EXPECT FROM COUNSELLING?
You can come and talk to a counsellor about anything that is troubling you in relation to fertility before, during or after fertility treatment at the Edinburgh Fertility Centre (EFC). The service offers emotional support during what can be a stressful time. The impact on oneself and relationships; fear of treatment and treatment outcome, and pain of loss are some of the issues people bring. The aim of counselling is to encourage people to find their own solutions in a safe and supportive space – it is not always about giving advice. The counselling team are knowledgeable about fertility treatment but are not clinicians, therefore cannot offer any medical advice – our role is purely to support you emotionally.
If you are considering storing sperm, eggs or embryos for later use, or are considering being the recipient of donor eggs, sperm or embryos in your fertility treatment, you will be invited to attend a mandatory ‘Implications Counselling’ session. This session has more of an information sharing basis, as it will outline for you the HFEA (Human, Fertilisation & Embryology Authority) legislation as well as exploring some of the possible psychological aspects. The counsellors support you to consider the immediacy of the situation and also longer-term implications for yourself, your partner if you have one, and your wider family. The aim of this is to ensure that you feel informed and comfortable about going forward for fertility preservation or treatment with donor gametes or embryos.
Confidentially is imperative in counselling work and offers you the space away from the treatment to explore your feelings, however there are times when we may be obliged to share information with the medical team. Please be reassured that the times when we need to consult the medical team are rare and outlined further in the ‘What about Confidentiality’ section below.
WHEN CAN I SEE THE COUNSELLOR?
Counselling is available to access from Monday to Friday between 08.15 am & 3pm. Counselling sessions run at set times during the day and delivered either face to face or via the online platform called ‘Near Me’; this is a secure NHS video platform.
All counsellors are experienced, qualified therapists and members of the British Infertility Counselling Association (www.bica.net) and abide by their ethical framework.
- Ruth Phillips
- Mallory Van Nek
HOW LONG IS EACH APPOINTMENT?
An appointment usually lasts one hour.
HOW DO I MAKE AN APPOINTMENT?
You can refer yourself for counselling by calling the administration line directly on 0131 242 2409 or by asking any of the nurses or doctors to arrange an appointment for you. This can be done during a clinical appointment or by telephoning the nurses’ station on: 0131 242 2450/49. On some occasions a member of the team may ask you to see the counsellor and will write a referral note giving a brief outline of the reason for counselling. If you are unsure why you have been referred, you can discuss this with your doctor or with the counsellor.
HOW OFTEN CAN I BE SEEN?
The counselling offered is not open-ended, but available to you before, during and after treatment. The number of sessions available to access will depend on your treatment as the aim is to support you through this. If you or the counsellor feels that other support would be beneficial, they will help to signpost you to alternative organisations who could help.
WHAT ABOUT CONFIDENTIALITY?
The team of counsellors work within the remit of EFC and adhere to the best practice guidelines of BICA and, also to the accredited regulatory body to which they belong.
You will work with one counsellor who is there to support you and offer space to explore aspects of fertility treatment that are impacting on you. These can be wide-ranging, and it is the counsellor’s role to assess what can safely be worked with in the short time they can offer you support. Counsellors hold their own notes on the patients they see. The notes are saved in a password protected folder in the NHS system.
If you are attending ‘Implications Counselling’ as outlined above; the counsellor will upload a file note to your patient record; this will reflect that all major points have been explored and discussed. It is then clear to the clinicians that you have attended this session and are informed before treatment begins. If later, you are unsure of anything, you are welcome to return and discuss things further.
If you are attending for general therapeutic support, the counsellor is not obliged to copy anything to your patient file; notes are purely kept for the counsellor’s record and to keep track of who they see. Counselling records are destroyed after a number of years agreed with the unit and in accordance with BICA and clinic guidelines.
Please also see NHS Lothian Data Protection Noticeand guidance, which has embedded within it The General Data Protection Regulation and the Data Protection Act 2018 which describes what information is stored, how and why.
As explained, counselling sessions aim to be confidential and specific details of your discussion with the counsellor will not be passed on to the other members of the team. However, confidentiality is not always absolute. The counsellor always works holding in mind duty of care for any child born from fertility treatment. (Welfare of the Child (WoC)). If the counsellor has concerns under these guidelines, they should outline and these concerns to you and work with you on how to take their concerns to the medical team if necessary.
Equally, a member of the medical team might have concerns under WoC guidelines and ask you to attend counselling. It would be clearly outlined to you that this session would not be confidential, and the counsellor should make every attempt to share with you any information that they need to share with the team or that would be entered on your clinical file to which you have full access as part of your patient record.
To retain accreditation and ensure best practice and welfare for patients, all counsellors are required to attend monthly supervision. This is with an accredited supervisor outside the NHS. It is only the content of the therapeutic work that is shared; no identifying details are disclosed.
DO I COME ALONE OR WITH MY PARTNER?
This will depend very much on the issues people bring and what you want. If you are trying to reach a decision or are concerned about the impact of treatment on your relationship, it can be useful to come as a couple. If you are struggling with your own feelings, you may prefer to come alone. There may be times when you are asked to both attend, such as if you have been asked to attend counseling as part of an assessment or to discuss implications of certain treatment.
WHAT IF I CAN’T KEEP AN APPOINTMENT?
It is important that you let us know if you cannot keep an arranged appointment with the counsellor. Please give as much notice as possible – preferably a week- if you cannot attend. You can do this by telephoning the unit on 0131 2422409. Patients who do not attend and fail to inform us will have their non-attendance documented in their records. If you cancel at short notice it is unlikely we can fill the counselling slot.
IF I DECIDE TO HAVE TREATMENT AT ANOTHER CENTRE, CAN I CONTINUE TO SEE THE COUNSELLOR?
Our counselling service is only funded for patients of the Royal Infirmary of Edinburgh. Should you choose to attend another Fertility Centre, either in the United Kingdom or in another country, at a suitable stage of the counselling we will support you in seeking counseling elsewhere.
IF I ALREADY HAVE A CHILD CAN I BRING THEM TO MY COUNSELLING APPOINTMENT?
Making full use of a counselling session is not always easy with a child being present; therefore it will be important for you to arrange childcare for the duration of your one hour counselling appointment.
PATIENT FEEDBACK
We would appreciate it if you could take a few moments to tell us what you think about our fertility counselling service. You can complete the feedback form online on our website at any stage during your counselling.
CANCELLING AT SHORT NOTICE
We understand that sometimes patients need to cancel their appointment at short notice. If this is the case please do let us know by phoning 0131 242 2460 so we can offer the space to another patient. Thank you.
References:
BICA Guidelines for Good Practice in Fertility Counselling Fourth Edition 2019
