Counsellors: Canada

Updated: October 2019


[The following information is from the Background Document provided to participants who attended the April 2006 Patient Workshop held in Toronto by the Assisted Human Reproduction Implementation Office (AHRIO) of Health Canada. Although the Assisted Human Reproduction Act received Royal Assent and became law on March 29, 2004, there are still not any AHR regulations in place regarding counselling.]

Assisted Human Reproduction (AHR) activities are different from other medical treatments in that they do not solely address a medical or physical problem. The use of AHR touches upon complex social, ethical, emotional, cultural and legal issues. These issues, in addition to the invasive and potentially risky nature of the medical treatment, can cause psychological risk to the individual (e.g. depression, anxiety and stress) as well as psychosocial risk to families, communities and society in general (e.g. work absenteeism and marital breakdown). Counselling in the context of AHR involves the balancing of medical issues and technology with the social, emotional, legal and ethical impacts of the technology.

In Canada, there is no national standard with respect to AHR counseling services. It is currently a matter of clinic policy to decide whether, when and how to recommend and/or provide counseling services to patients. A June 2005 telephone survey by the AHRIO of 20 IVF clinics revealed that:
•    All made counseling available to clients to varying degrees.
•    Only 1 required mandatory counseling for all individuals.
•    13 made counseling mandatory for donors &/or recipients of 3rd party donated gametes/embryos
•    44% of the counselors were psychologists, 21% social workers, 8% psychiatrists, 27% ‘other’ (including nurses, doctors, office staff, as well as other types of counselors)

Infertility counseling is not a formally recognized profession. Like counseling in general, there is no provincial or territorial legislation that regulates it. There  are also no academic or training programs that focus on counseling in the context of AHR. Psychologists, social workers, psychiatrists, nurses, physicians have professional licensing requirements dictated by provincial bodies; office staff and other types of counselors do not.

Under the AHR Act, counselling prior to any AHR procedure was supposed to become mandatory. All clinics and physicians were to ensure that counselling services were received prior to accepting human reproductive material (HRM) [eggs or sperm], in vitro embryos, and/or health reporting information (HRI). This includes all individuals providing their own gametes for their own reproductive purposes (e.g. a couple using their own gametes for an IVF cycle). The requirement for counselling was to provide additional insurance that consent is fully formed and freely given.

The ACT only mandated counselling be provided prior to the giving of HRM, in vitro embryos or HRI, although clinics could recommend additional counselling during or after AHR procedures. The regulations could set further specific requirements with respect to the timing and frequency of counselling sessions. The counselling requirements for one controlled activity (e.g. IVF with the couple’s own gametes) could be different from those for another controlled activity using third party reproductive material.

List of Candian Counsellors

NB: Some public and private insurance plans cover the services of registered psychologists, nurses & social workers, as well as MD’s (family doctors, psychiatrists); some types of counsellors may be covered under your EAP (Employee Assistance Plan) at work. Some counsellors have a sliding fee schedule based on the ability to pay.
 

See also: