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TeleTherapy for Infertility, Birth Trauma, and Reproductive Loss

Millions of Americans are impacted by infertility, birth trauma, and reproductive loss. Black women are more likely to be diagnosed with infertility but are less likely to seek treatment, according to Dr. Kristy Christopher-Holloway, director of New Vision Counseling Center, in Douglasville, Georgia, and an expert on the mental health impacts of infertility. In an interview with Raymond Barrett, CEO of the Telehealth Certification Institute, Dr. Christopher-Holloway discussed how telehealth is helping expand her practice in the midst of the COVID-19 pandemic.

Dr. Christopher-Holloway says about 20% of the U.S. population is impacted by an infertility diagnosis every year. Black women are about 1.5 times more likely to experience the diagnosis of infertility, but they typically will seek help or treatment for the diagnosis at lesser rates.

Her current research includes perinatal mental health and infertility. “We know that this is an under-researched population area, and when there is no research we cannot do an effective treatment.”

Christopher-Holloway said studying this population is very important to her – to make sure that the mental health impact of infertility of Black women and Black couples is being researched.

She said that 1 in 7 women will experience a perinatal mood and anxiety disorder (and 1 in 10 men), but Black women are about two times less likely to get treatment for a postpartum or perinatal mood and anxiety disorder.

Christopher-Holloway said that infertility and miscarriage bring an ambiguous loss where the parents are not even sure how to grieve. She tells clients they are “grieving the future” – all of the birthday parties, visits with friends, late-night feedings, the pitter-patter of little feet, and all of those things that they thought would happen.

That connection [to the child] starts for many people if they know they want to be a parent, even before conception. Then once they do conceive, that attachment is there. If a person is asked, “How many children do you have?” Do you count the ones you lost? What if there were multiples, like twins or triplets, and one didn’t make it?

Parents have to give themselves permission to grieve or to acknowledge the loss, in a society that sometimes views it very differently.

It wasn’t until her own pregnancy with twins almost six years ago that Christopher-Holloway made the shift to telehealth. 

“The bigger I got, and the slower I moved getting to the office, I knew it was time to make that shift and transition [to telehealth] and still be able to do the work that I love.”

Fast-forward to 2020 when COVID-19 hits and therapists had no choice but to do telehealth. She said it took a while for her staff and their clients to get used to change.

“Our clients needed to get used to telehealth, and get used to doing telehealth in the midst of trying to teach their own children, be away from work, work from home.”

She said there were technology issues at first – choppy internet and overloaded video platforms, but now her office is serving clients all around Georgia rather than just three to four counties near her office in Douglasville, Georgia.

Telehealth has worked so well that Christopher-Holloway has decided not to fully reopen her office to in-person sessions this year. 

“All of the therapists [in her practice] said, “You know my clients have gotten used to it. I feel better. I've seen an increase in my caseload because now people aren't concerned about needing to battle traffic to get to the office.”

One of her clinicians has even switched to a night shift to see clients who need later hours. 

“So we've seen the increase...we've seen our clients get more used to it.”

Christopher-Holloway said there are still issues, like not being able to get a stable internet connection. But now her staff has a backup plan, and they just call the client on the phone.

She said that telehealth is here to stay for her practice, even after the pandemic ends.

“It's actually been working out really well to the point where we decided that whenever we do open back up and return to some type of normalcy, we will still maintain some virtual days, and have providers that are solely just virtual.”

Some clients do still want to return to in-person therapy.

“Maybe they don't feel safe, or feel like they have a secure enough area in their home to do the sessions,” she said. “Sometimes people come to therapy to get away from all of that other stuff and so that therapy office was their outlet.”

She has worked to help telehealth clients find a safe zone. For instance, some clients do their session from a store parking lot. 

But she thinks there is now a good mixture of those who are okay with remaining virtual and those who are ready to get back to the office. She’s working to safely accommodate the clients who do want in-person sessions.

Christopher-Holloway is also trying to help her team and herself develop self-care plans for the pandemic.

“For me, I had to literally shut down my computer, not just close the laptop. I have to cut it off because I know me, I'll come back [and say], oh let me go look at this email real quick.”

She would also encourage clients to reclaim their “me time” and take breaks while working at home including lunch breaks.

“We’re seven months into [COVID-19]. We're all tired. We're done. It's like those first few months you're like “okay, yeah, yeah.” But now our bodies and our minds have been in this

crisis mode...in this trauma mode for seven months, and it's not like we can see the light at the end of the tunnel.”

She is keeping tabs on her staff via text and they are having group consultations via video conference. They share laughs and memes. 

“They know when all of this is over we're having a big party...we're having a big celebration.”

As a leader, she said she genuinely cares for the well-being of her team members and they’ve talked about pandemic fatigue. 

“What happens with the clients can definitely also happen with us as we're trying to navigate how to do this. I've had people say, ‘I haven't had a hug since March.’”

Her advice to other therapists?

  • If it's a group practice, stay in constant communication with your team. Help your team get the tools they need to be successful in their job.
  • For solo practitioners, make sure you're still connecting with other colleagues.
  • For all therapists, we're in this together so we need to be healthy; when we return to the “real world” – or some type of normalcy  – we still want to be well and in business.

By: Amanda Barnett, LPC, NBCC, MS, EDS

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Course was very informative!
David Hopkins
MS, LPC / Thriveworks Woodstock
Informative and brief
Tracy Gilbert
Well designed. informative, comprehensive program broken down into manageable segments.
Dawn M. Miskus
Licensed Clinical Professional Counselor (LCPC) / Conscious Counseling & Coaching, Ltd.
This course offered a great overview of TeleMental Health and the important considerations that should be addressed when establishing an online practice.
Helen Geris
Registered Psychotherapist
Wonderful and approachable presenter, great information!
Sabrina Eads
I have completed the course requirements. Thank you a great program of videos and information.
Linda Lovisi-Dwyer
LCSW-R / Linda Lovisi-Dwyer, LCSW-R
Good introduction
Sylvia D. Jessup, MBA, MA
Owner / Sylvia Jessup Counseling Services PLLC
Very clear emergency planning laid out in this course, Helpful for many situation and settings.
Jane Schindler
The course was detailed.
Kelly Villarreal
MFT / Alan Behrman & Associates
EXCELLENT PRESENTATION
DAVID F. CIAMPI, Ph.D., LMHC.
Really chuck full of information and very helpful
Carolyn Spencer
social work
Great course!
Lashonda Jones
Ray's program is engaging and informative. I'm excited to extend my professional reach online.
Pamela Madsen
LAPC / Empower Counseling Center, LLC

Very informative session.

Valrey Richards-Lucas

Video was good, a little slow

Jessica Walraven

This is great material!

Erika T Johnson

Very Informative!!!!

DALAYNA MILLER

Really good training so far!

Erika T Johnson
LAC

Excellent information, extremely generous resources and so well paced. I am really grateful.

Carolyn Spencer
LCSW / Carolyn Spencer

Very thorough and informative

DALAYNA MILLER

This program is very informative and easy to use.

Gania Bruno Harrold
LCSW / IN THERAPY WE TRUST

Love the convenience and easy-to-understand information in this course.

Natalia Gourlay-Fernandez
LAMFT / Rock Springs Positive Coaching, Caring, and Counseling

Very informative. Help give an overview of tele therapy and starting an online practice.

Meg Maginn
L.C.S.W Private Practice / Eating Disorder Associates

The course was easy to follow and provided a lot of valuable insight into the benefits and limitations to teletherapy.

Katie-Ann Magnuson
Mental Heath Therapist / Kwenyan Professional Health Services

Wonderfully compact and rich in information, many areas i had not even considered!

VIRGINIA PROVENCHER
therapist / private practice
Very informative and guiding in educating all that you need to grasp to be properly compliant and aware.
Dena Damaskinos
A great overview for telehealth, including state to state
Susan Cortilet Jones
Integrative Lifeskills Coach

Great presentation!

Cristina Lazaro-Garcia
Mental Health Clinician, APC / CETPA, View Point Health
Oustanding presentation!!!
Michelle Collins

Helpful and inviting information to get started. Feel empowered to get this going and eager to start!

Dena Damaskinos

Well presented, easy to access and understand.

Sedonia Perrier
CEO / Steelhead LLC

This was very informative.

Wendy Pazdur
Substance Abuse Counselor / Transformation therapy
This course was full of detailed information, that I will utilize in my practice. I highly recommend this training to all interested in adding to their existing practice or transitioning to Telehealth Services.
Utopia Session
Class was informative.
Kimberly Horrell
This course was short yet informative.
Annette Cornish
Therapist / Dust 2 Destiny Counseling & Wellness
Great training!
Jacqueline Hayes, M.Ed., LPC, LMHP
Professional Counselor 4 / State of LA
Ray was a wonderful, interactive instructor who really captured the heart of counseling in the world of Telehealth. The course was thorough and beneficial. Two thumbs up!
Rachel Morales
Licensed Professional Counselor
Ray does a spectacular job presenting the ethics in technology! Thank you!
Elaine Marie Barclay
Licensed Professional Counselor/ Assistant Professor / Shorter University/ Capella University
Very beneficial and useful to the direction i am moving of providing therapy
Linda Marie Margosian, MS, NCC, LMHC
I thought the video was very informative and gave me a good back ground on Telehealth , hippa laws and things I needed to know to run an ethical and hippa complent practice .
Meg Maginn
Director /private practitioner / Eating Disorder Associates

I believe this is a good course to take because this is the new wave of society. As a therapist I would like to be able to offer clients the best tools available.

Wihletta Michelle Davis MA, LPC
Therapist / Find the Miracle Within...

Thank you for the introduction to telemental health.

Michele Frances Purvin
Psychotherapist / Michele Frances Purvin, LCSW, LCDC

Very good.

Franklin Castillo

Really excellent training full of valuable information and resources - surpassed my expectations!

Dori Ryherd
Therapist / The Cognitive Refinery

Great information with step by step instructions

Donna Tucker
Addiction Counselor / Spectrum Health

What a superb introduction to telemental health, well organized and packed with useful tips. I so appreciate this. Thank you.

Ann P Cahouet
Owner - Clinician / Equine Assisted Solutions LLC

Awesome job! This is a very insightful presentation.

ZUNILDA CHAUDRY
Licensed Therapist, LPC / Seasons of Change Behavioral Health Services, Inc
Ray is down-to-earth, warm, pragmatic and exceptionally well-informed.
G. Reid Doster, LPC, LMFT
Director of Behavioral Health, EXCELth Inc.Primary Health Network & Private Practice Psychotherapist / www.excelth.com

An excellent course, but needs more legal information regarding where the patient needs to reside.

Barry Barmann
Clinical Psychologist / Behavior Therapy & Family Counseling Clinic
This legal course was phenomenal saturated with much detail and clarity!
Elaine Marie Barclay
Licensed Professional Counselor, Assistant Professor / Capella University and Shorter University
Great and very informative! Will help me take my skills to a new level. Gave me a great idea of how the session should go.
Jessica Latin
LPC / JL Counseling

Course provided several case scenarios regarding Interstate counseling and resource websites for further research.

Cowenda Jefferson
Clinical Director / Wise Life Choices LLC
Course provided additional information regarding the legal aspects of TeleMental Health.
Cowenda Jefferson
Clinical Director / Wise LIfe Choices LLC
I have completed prior training by Raymond and greatly appreciate his detailed and thorough trainings.
Dr Lynn Duffy, PsyD, LCPC, NCC, CCMHC, BCPCC, BC-TMH, Diplomate/CMH in Trauma
Director/Counselor/Mediator / Lighthouse Counseling & Consulting Services
This course was most helpful in helping me make my practice more compliant for me and my clients.
Marlene Small
Private Psychotherapist
This is the 4th TMH course I have taken with Ray and it is BY FAR the best TMH training out there. I've learned so much that I can use every day in my practice.
Dawn Ferrara
LPC-S, LMFT

Very Informative

Naomie Pierre
community clinician / nps
I loved this course. It was very informative and provide a great deal of information about ethics.
Tracey Marshall
Easy to learn and easy to follow. User friendly on-line course.
Kelly Johnson
Licensed Mental Health Therapist

Awesome

Melissa J Davis
LAPC- counselor
This was a phenomenal training and necessary for the continued growth of all helping professionals. This will certainly improve the manner in which I conduct counseling.
Elaine Marie Barclay
This training was extremely informative and supportive for professionals looking to gain further knowledge in Telemental health.
Marcy Abramsky
LCSW / Marcy Abramsky LCSW, InspireAmind TM Counseling and Consulting
I found this video to be very informative and helpful.
Michelle Parker
Contract Therapist

Great course, very informative!

Ashley Simmons
BCBA / Northstar Psychological Services

Love the course, worth every penny!!! Definitely helped jump start my Tele-mental health services!

Nakia Clark
Owner/ Therapist / Insightfullly You, LLC

This gave me and my staff some important insights and information regarding telehealth..

Larry Cowan
Executive Director / Samaritan Counseling and Growth

This course was easy and user friendly

Vanessa Reiser
Social Worker / JBFCS

I learned a great deal from this program and look forward to implementing telemental health in my therapy practice.

Michelle Hitchcock
Therapist

It was fantastic! Just the forms he provides are worth the cost of the course!

Mark Wagemaker, LPC, NCC, DCC, CPCS
Counselor, Clinical Supervisor / Transitions Counseling

This was an excellent class and worth my time.  Ray provided great information and is clearly an expert in TMH!

Jennifer Stuckert
Director / Restoration Counselor of Atlanta, LLC

I found these courses informative and helpful. They make establishing best practices policies and procedures for telemental health services and supervising those who provide them. so much easier. I highly recommend his courses.

Nena Rybarczyk, MA, EMBA, LPC, NCC, CPCS
Counselor / Strategies for Life Counseling, LLC

Ray's workshop was one of the most informative I have taken in years. He brought clarity to took a topic which has been intimidating and I left feeling empowered!

TRUDY POST SPRUNK, LMFT-S LPC CPCS RPT-S CPT-S EMD
Clinical Supervisor and Play Therapist / Georgia Association for Play Therapy