Table 1 Summary of intervention module
Module | Focus |
|---|---|
1. Values | Encourages participant to reflect on their life values and consider how their daily actions align with those values. The participant completes an exercise aimed at identifying values that may be currently neglected, potentially due to challenges associated with infertility. This module introduces the concept of “choice point”, which is a moment in time when one must choose between a behaviour that is consistent with one’s values and one that is inconsistent. Examples include calling one’s pregnant sister and deciding whether or not to attend a friend’s baby shower. Homework: Try 80th birthday exercise |
2. Cognitive Defusion | Introduces the idea that we have little control over our thoughts and that it is counter-productive to try to stop ourselves from having unpleasant thoughts and emotions. Instead, the participant is encouraged to make space for unpleasant thoughts, such as “I will never get pregnant” or “my partner deserves someone that can give them a child”—by allowing them to simply occur, we are giving them less power than if we were to expend energy trying to stop them. Homework: Practice using daily cognitive defusion strategies (e.g., thanking your mind, using external voice) |
3. Present Moment Focus | Introduces the concept of “mindfulness” and has the participant practice being focused on the present moment and identify instances when they might struggle being in the moment. An example is given of an individual being preoccupied about a call they’re expecting from their fertility clinic and having difficulty enjoying a meal with their partner. The analogy of examining one’s thoughts like leaves on a stream is given. Homework: Listen to mindfulness recording daily |
4. Acceptance and Willingness | Emphasizes the idea that pain is an inevitable part of life and that accepting one’s pain can decrease the suffering associated with that pain. If we are willing to experience pain, we can live our lives again because we no longer have to avoid situations that are potentially unpleasant (e.g., family get-together with children present). Homework: Practice mindfulness when experiencing distressing thoughts or emotions |
5. Self as Context | Encourages the participant to reflect on how their experience with infertility has influenced their view of themselves. They are encouraged to consider that they are still the same person despite all that events occurring around them (e.g., pregnancy loss, infertility, family members not understanding). The aim is to foster a more nuanced understanding of one’s identity that incorporates all of their experiences. Homework: Listen to “continuous you” recording once a day |
6. Committed Action/ wrap up | Provides an overview of the program’s content and encourages the individual to reflect on what they’ve accomplished as well as areas for further development. Revisits the concept of avoidance (e.g., withdrawing from friends and family, avoiding children and pregnant women) and encourages the individual to consider ways to reduce avoidance without worsening their distress. Homework: Reflect on their progress in the program and identify how they want to continue to work towards their values |