Strauss Involuntary Childlessness

Psychological Assessment, Counseling, and Therapy
1. Auflage 2001
ISBN: 978-1-61676-198-1
Verlag: Hogrefe Publishing
Format: PDF
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, 203 Seiten

A high proportion of couples in western industrialized countries are unable to have children, and in many cases these couples need psychosocial support. This book describes a range of counseling and therapy approaches that can be used in a variety of circumstances. The approaches described here provide concrete assistance and advice on psychosocial interventions for all professionals who are active in reproductive medicine, fertility treatment, and counseling or therapy for couples. The book introduces the most recent knowledge about psychosomatic treatment of fertility disorders, and describes assessment methods that can be used in everyday practice by those providing both medical treatment and counseling for fertility disorders. On the basis of numerous case examples, various different approaches to counseling and therapy are described, including, for example, specific approaches that can be taken by primary care or family physicians, or how to approach the problems in couples with different cultural backgrounds. A manual for gynecologists in the final chapter provides concrete advice and guidelines for a holistic, psychosomatic course of treatment for childless couples.

Autoren/Hrsg.

Strauss, Bernhard

Strauss, Bernard

Fachgebiete

• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Beratungspsychologie
• Sozialwissenschaften Psychologie Psychotherapie / Klinische Psychologie Kinder- und Jugendlichenpsychotherapie
• Sozialwissenschaften Psychologie Psychologische Disziplinen Gesundheitspsychologie

Inhaltsverzeichnis

1;Table of Contents;6
2;Foreword;8
3;Preface;10
4;I. Introduction to the Subject;14
4.1;Psychological and Psychosomatic Aspects of Involuntary Childlessness: State of Research at the End of the 1990’ s;16
4.1.1;Introduction;16
4.1.2;1 Psychological Characteristics of Infertile Women, Men, and Couples;17
4.1.3;2 The Influence of Stress on Fertility;19
4.1.4;3 Psychosocial Stresses Connected with a Fertility Disorder;21
4.1.5;4 Psychological Stress in the Context of Reproductive Medical Treatments;22
4.1.6;5 Gender Differences in the Stress Experienced Due to a Fertility Disorder;26
4.1.7;6 Aspects of the Relationships of Involuntarily Childless Couples;29
4.1.8;7 Further Developments;30
4.2;Psychological Diagnosis, Counseling, and Psychotherapy in Fertility Medicine – An Overview;32
4.2.1;Introduction;32
4.2.2;1 The Tasks and Goals of Psychological Diagnosis and Intervention in Fertility Medicine;33
4.2.3;2 Effects of Psychological Care;44
4.2.4;3 Outlook;46
4.3;Primary Medical Care of Infertile Couples – Limitations and Opportunities;48
4.3.1;1 Target Population;48
4.3.2;2 Background;48
4.3.3;3 Content and Goals of Primary Medical Care in Relation to the Wish to Conceive;49
4.3.4;4 Specific Aspects of Diagnosis in Family Practice;50
4.3.5;5 Approach;50
4.3.6;6 Special Problem Configurations in Patients Wishing to Conceive;58
4.3.7;7 Implications for Practice;60
4.4;The Unfulfilled Desire for a Child of Oriental Couples – Infertility Counseling and Treatment of Turkish Immigrants in Germany;64
4.4.1;1 Introduction;64
4.4.2;2 The Psychosocial Situation of Turkish Immigrants in Germany;65
4.4.3;3 Special Features and Difficulties in Gynecological Care;67
4.4.4;4 The Unfulfilled Desire for a Child;69
4.4.5;5 Conclusions;71
4.4.6;6 Indications for Practice;71
5;II. Specific Counseling and Therapy Approaches;74
5.1;Psychological Therapy in Idiopathic Infertility: A Stress Reduction Approach;76
5.1.1;1 Indications, Target Population, Motivation, and Selection;76
5.1.2;2 Reasons for the Development of the Program;77
5.1.3;3 Content and Goals;80
5.1.4;4 Distinctive Features of the Diagnosis;81
5.1.5;5 Treatment;83
5.1.6;6 Advantages and Disadvantages, Contraindications;90
5.1.7;7 Results and Effects;90
5.1.8;8 Implications for Practice;91
5.2;Focal Counseling for Women and Couples with an Unfulfilled Desire for a Child:A Three Step Model;92
5.2.1;1 Indications, Target Population, Motivation, and Selection;92
5.2.2;2 Reasons for the Development of the Program and Theoretical Background;95
5.2.3;3 Content and Goals;97
5.2.4;4 Distinctive Features of the Diagnostic Process;98
5.2.5;5 Treatment;100
5.2.6;6 Effects of the Counseling;112
5.2.7;7 Implications for Practice;115
5.3;Solution-Focused Counseling for Involuntarily Childless Couples;118
5.3.1;1 Indication and Target Population;118
5.3.2;2 Reasons for the Development of the Program and Theoretical Background;119
5.3.3;3 Goal of the Couple Counseling;120
5.3.4;4 Setting, Diagnosis and Evaluation;120
5.3.5;5 Treatment Model;121
5.3.6;6 Advantages and Disadvantages, Contraindications;130
5.3.7;7 Results and Effects;131
5.3.8;8 Summary and Implications for Practice;137
5.4;Couple Counseling and Therapy for the Unfulfilled Desire for a Child – The Two-Step Approach of the “Heidelberg Infertility Consultation Service” ;140
5.4.1;Introduction;140
5.4.2;1 The Two-Session Couple Counseling;141
5.4.3;2 Ten-Session Couple Therapy;151
5.4.4;3 Advantages, Disadvantages, and Contraindications;160
5.4.5;4 Effects of Couple Counseling and Therapy by the “ Heidelberg Infertility Consultation Service”;160
5.4.6;5 Implications for Practice;161
5.5;The Relationship of Research and Practice in Fertility Medicine;164
5.5.1;1 The Implementation of Psychosomatic Research Projects in Reproductive Medical Institutions;165
5.5.2;2 Transference of Research Results to Clinical Practice;166
5.6;Bibliography;168
5.7;List of Authors;184
6;III. Appendices;186
6.1;Practical Therapy in Sterility – A Manual for Gynecologists from a Psychosomatic Point of View;188
6.1.1;Introduction;188
6.1.2;1 The Wish for a Child;189
6.1.3;2 The Problem of Sterility – The Case History;189
6.1.4;3 Initial Interview with the Gynecologist;190
6.1.5;4 Diagnostic Phase;191
6.1.6;5 Contraindications Against Medical Therapy in Sterility;192
6.1.7;6 Focusing on Psychological Aspects;193
6.1.8;7 What is a Treatment Success?;194
6.1.9;8 Problems in Care;196
6.1.10;9 Key Questions;197
6.1.11;References;200
6.2;List of Contact Addresses for Organizations;202

Leseproben

The Unfulfilled Desire for a Child of Oriental Couples – Infertility Counseling and Treatment of Turkish Immigrants in Germany (p. 51-52)

Lucia Gacinski, Emine Yüksel, and Heribert Kentenich

1 Introduction

In the discussion of appropriate medical and psychosocial care, the consideration of the ethnic and sociocultural marked attitudes, and expectations of the patients are of great significance.

In the Federal Republic of Germany, the Turkish population represents the largest immigrant group, numbering around two million people. They usually live in big cities and population centers. Since birth rates are higher among Turkish immigrants than among German women, institutions of obstetrics and gynecology are frequented more by Turkish people. Sterility consultations are also in increasing demand by Turkish couples.

This chapter focuses on the counseling and treatment of Turkish couples with a desire for children, as they often present particular problems for clinicians. Due to sociocultural conditions related to origin and immigration, the meaning of an unfulfilled wish for children is different and more complicated for Turkish couples than for German couples. It is often not easy for therapists to comprehend the specific form of the foreign couple’s desire for a child. Frequently there are also language comprehension problems, so that communication with the couples is impeded. Even when comprehension of the language is good, misunderstandings can arise from differing sociocultural contexts.

In order to overcome these problems and to develop an adequate approach for counseling, diagnosis and therapy, a closer consideration of the psychosocial situation, the specific motivation for a child and the medical idiosyncrasies of this patient group is helpful. Knowledge of the respective legal residency status is imperative, as absorption of the costs of treatment and the length of stay of the patients in Germany are dependent on these basic conditions. These conditions will only be examined in the following text, if they are meaningful for the understanding of the psychosocial situation of the patients.

2 The Psychosocial Situation of Turkish Immigrants in Germany

- The first generation of immigrants:
The large majority of Turkish people in Germany originally came from rural, unindustrialized regions of Turkey, where Islamic-patriarchal societal norms and values predominated. They came in the first phase of immigration in order to insure the subsistence of their family and to enable its social advancement. As a rule, through their continuing stay in the Federal Republic, they were able to improve their economic situation, but not their social status in comparison with their situation in the country of origin. In terms of employment, income, education and living situation, immigrants are usually living in more deprived circumstances. Meanwhile, this first generation of immigrants is increasingly reaching retirement age. The dream of returning to their homeland after retirement is very common, but seldom actually realized. The older generation is compelled to stay in the country of immigration because their descendants live in Germany and because of infirmity or sickness.

- The second generation of immigrants:
The children of the first generation came as children to Germany or were born here. At least a part of their time at school was spent in Germany, so that, in most cases, there is a good understanding of the German language. The second generation has to confront the problems of differing social values and norms. They experience transcultural upheaval, and have to struggle with the question of their cultural identity.

- Third generation:
This generation grows up in Germany, and also face the problem of differing values, as well as the question of identity. Language difficulties are rarely present because they have learned the German language as children whilst attending kindergartens and schools. However, there are certain family situations in which third generation children enter school without any knowledge of German, and consequently are disadvantaged in their educational opportunities.

- "Extended" second generation of immigrants:
Members of this group are born in Turkey and marry a Turkish partner who is already living in Germany. They know little about the German language, do not hold a work permit, and their residency permit is restricted in its length. Their lack of employment limits their contact with the German population.