Counseling patients through their journey to conceive can be challenging. When a therapist becomes pregnant, the therapeutic alliance alters.This chapter explores the unique dynamics between the pregnant fertility counselor and reproductive clients. Questions around the “who, what, where, when, why and how” of pregnancy disclosure are used as a tool to help think about the various elements to the therapeutic alliance. Intense feelings can be triggered for a patient who is struggling with infertility or pregnancy loss, but can also trigger emotional reactions for the fertility counselor. The transference and countertransference that arises with the self-disclosure of a pregnancy is likely to unfold complicated dynamics and emotions. The positive and negative implications that a pregnancy disclosure can have from the patient’s point of view, as well as that of the therapist, are addressed. Additionally, the postpartum experience and the return back to work after parental leave are also discussed. While this chapter focuses on the pregnant therapist, the issues raised pertain to all pregnant reproductive medical staff treating infertility patients.

TBT-S mirrors multidisciplinary ED research by utilizing a multidisciplinary treatment team. The ED treatment team is traditionally composed of a clinician, a dietitian, and a medical professional. TBT-S brings the recipients of treatment, the client and their Supports, into the treatment team recognizing their unique roles and critical input for effective progress and change over time. The TBT-S treatment team folds in the adult client, as the expert, and at least one Support into adult AN treatment. TBT-S, virtually or face-to-face, advocates that food intake is practiced with Supports during treatment sessions at all levels of care, to stimulate brain re-wiring of productive habit formation.

Access to effective psychosocial treatment for psychosis continues to be elusive in the United States. For years, the literal and figurative costs associated with the diagnosis of schizophrenia have been known, policies to promote improved national mental healthcare have been in place and recommendations for evidence-based treatments have existed. And yet, the implementation and uptake of such policies and recommendations within psychosis treatment have only been moderately successful because clinicians have been overlooked as agents of change. Continuous development and transmission of the latest evidence and practices for psychosocial treatments for psychosis are essential, but so is the support of the individual clinicians who will implement them. The path forward must attack this problem from a number of directions and can follow the recommendations put forth by the President’s New Freedom Commission. We conclude with concrete action steps individual providers can take to facilitate change.