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F~A FREE COMMUNICATIONS-COUNSELLING & PSYCHOSOCIALFSA FREE COMMUNICATIONS-COUNSELLING & PSYCHOSOCIALIntroduction - RationaleTHE EFFECT OF FIRST CYCLE FOLLOW UP BY COUNSELLORSLouise O'BymeMelbourne IVF 320 Victoria Parade East Melbourne 3002Over m~ny years our counselling unit has sought ways of improving access to counselling services for peopleundergomg IVF treatment. Although counselling is available free of charge, it is believed that the well documentedstr~sses oftreatment (depression, i~~lati~n, ~~f, s?ame etc) mean that. patients are less likely to seek the counsellingass1~tance they may need. In add1tion, mfertIhty 1S often the first major life crisis faced by a couple and the act ofseekmg couns~lling assistance may be quite foreign. Therefore improving the accessibility ofthe counselling servicedeserves attentlOn.MethodThe study te~ts the hypothesis that counsellor follow up after a patient's first cycle will increase subsequentco~sellor/pat1ent contaC!. Over a three month period, a total of 133 new patients were offered follow up contact bythe1r counsellor after theIr first treatment cycle. Subsequent contact with the counselling service was tracked over 8months and compared with that ofa ~ontrol group (~= 133). ~he data was also examined to measure the patient uptakeof the f~llow up offer; the capaCIty of the servIce to delIver follow up; gender differences; patterns of highcounsellmg need and the outcome ofdifferent types ofcounsellor contact.ResultsPatients in the follow up group were more t~an twi~e .as likely to have further counselling contact (34% v 14%), in thefirst 8 ~onths oftreatment. An overwhelmmg maJonty (96%) of patients wanted follow-up after their first cycle andthe:efVIce was abl~ t.o. meet 86% ofthese requests. The vast majority ofcounsellor contact was with women or couples(93 %) and no men InItIated contact on their own.Most contact (7()oJO) ~th counsellors occurred within the first 8 months of treatment. Counsellor initiated telephonecalls or.messages ~oth mcreased subsequent contact with counsellors (31% and 47% patients made further contact), butcareful mterpretatlOn ofthese results is necessary.. ConclusionTh~ study supports !he hypothesis that offering 1st cycle follow up will increase subsequent counsellor / patient contact.PatIents are. clearly m favour offollow up and the counselling service was generally able to deliver it. While 1st cyclefollow up I~ not a total ~olution in itself it ~ould be on of a number of measures used to improve counsellor access.The paper wIll also examme other study findmgs relevant to counselling service provision.SELF-CONCEPT DISCREPANCY THEORY: A MODEL FOR UNDERSTANDINGINDIVIDUAL VARIABILITY IN REACTIONS TO INFERTILITY.Meredith 1. Krust-McKayReproductive Medicine Unit, The Queen Elizabeth Hospital and Wakefield Clinic, University ofAdelaide,Adelaide, SA, 5000.Purpose: Empirical investigation of the psychological sequelae of infertility has so far produced an inconsi,stentcharacterisation of the emotional demands of this experience. It has been suggested that such inconsistencies mayreflect individual variability in the response to infertility, which few studies have considered to date. This resea.iChinvestigated Higgins' (1987) Self-Discrepancy Theory (SDT) as a conceptual alternative for understanding individ~variability in psychological reactions to infertility. Higgins' theory proposes that people possess more thanone~nPe,~tof themselves and that discrepancies between these self-concepts results in either dejection or agitation relatedemotional discomfort. SDT is therefore proposed as a model for understanding the type and magnitude of emotionalreactions a person may experience, based upon the type and magnitude ofself-concept discrepancies.Aims: The research aimed to (a) validate the application ofSDT to the problem ofinfertility and (b) draw conclusionsabout the clinical utility ofSDT as a model for predicting the type and magnitude ofindividual emotional responses toinfertility.Method: Participants were 20 male and 26 female fertility patients, diagnosed with primary and secondary infertility.Participants completed a postal questionnaire containing self-report measures ofdepression, anxiety, psychologicalsymptomatology, and self-concept discrepancy.Results: The results ofthis research indicate that people with fertility problems do experience discrepancies betweenthe different self-concepts proposed by SDT. Correlational analyses revealed that as the magnitude ofself-conceptdiscrepancies increased levels ofemotional discomfort also increased (r's ranged from.32 to .41, p