Pathways to Parenthood

Is this therapy or a consultation?

It's a structured consultation designed for decision support and meaning-making in the family-building process, with a pathway into ongoing therapy if you decide that's what you need afterward. The five sessions are time-limited on purpose. You come in with a decision in front of you and leave with a framework for it.

We're already working with a therapist. Is this duplicative?

Usually not. General couples therapy and this consultation serve different purposes. Your therapist may be excellent at your relationship dynamics, but fertility-specific decisions (donor selection, surrogacy logistics, disclosure planning, what genetics means in your particular relationship) often need different structure and different specific training. This consultation is time-limited and decision-focused. Many people complete the five sessions and return to or continue with their existing therapist with a clearer picture of what to keep working on.

Do I need this if I've already decided on my path?

The question isn't whether you've decided — it's whether you're carrying ambivalence or uncertainty about the decision itself. Many people book after deciding, realizing they want expert perspective on implications they hadn't surfaced. Some book beforehand. Either timing works. What matters is whether the decision is sitting comfortably or whether something about it keeps circling back.

My partner is reluctant or skeptical. Can I still reach out?

Yes. It's more common than you'd think. One partner usually leads the inquiry. We're glad to have a brief conversation with the more hesitant partner about what the consultation involves and what it doesn't ask of them. We're not trying to turn skeptics into therapy believers. We're trying to help you both make important decisions more clearly. Many partners who start ambivalent find the structured, time-limited format easier to enter than open-ended therapy.

I'm pursuing this as a single parent. Is this series for me?

Yes. The Core Series is designed for couples and co-parenting constellations, but the individual sessions within the model work well for solo intended parents too; a structured space to think through donor decisions, surrogacy, disclosure, and what solo parenthood will ask of you. Reach out and we'll tell you honestly how the structure would work for your situation.

Do you work with non-traditional parenting constellations?

Yes. Couples, friends co-parenting, polyamorous parenting arrangements, and solo intended parents are all welcome.

Do we need to have our donor or surrogate selected before we start?

Not at all. In fact, the consultation is often most useful before that decision is made. The Core Series is specifically designed to help you arrive at those decisions with a shared framework rather than starting from an already-made choice you're not sure about. That said, we also work with families who are mid-process and stuck, or who have completed IVF and are processing what happened.

Can you help us plan how to talk to our child about donor conception or surrogacy?

Yes. Children revisit origin questions across development. We help with both the language and the emotional process so those conversations stay grounded and safe at age two, at age five, at age nine. Our work with you is part disclosure-planning and part tending to your feelings, so your child's questions don't become a crisis for you.

What happens in the five sessions?

A joint intake, individual sessions for each intended co-parent, and joint sessions to integrate what emerged and deliver the written formulation. See the session outline for the default shape. We adapt for solo intended parents, co-parenting constellations beyond two, and families who come in further along in the process.

Do you meet with co-parents together and individually?

Both. We find meeting intended parents together and individually provides the most depth and efficiency. You can keep what you share in your individual sessions private, or bring it into the joint work — that's your choice.

What happens after the five sessions?

Most families complete the five sessions and proceed with clarity. The Core Series includes a brief written decision summary, and with your consent, a short note to your fertility clinic or surrogacy agency describing the framework you've developed. For families who want to continue, we offer individual therapy, ongoing couples work, parent guidance, or additional focused sessions on specific questions around disclosure, extended family dynamics, or the transition into pregnancy and parenthood. The consultation is designed to be complete on its own. Any further work is optional and offered session by session, not as a commitment.

Do you work with surrogacy agencies in Boston or elsewhere?

We don't place surrogates or manage the legal and logistical side of surrogacy. That's the agency's central role. What we offer is the psychiatric consultation that intended parents often need alongside that process: a structured space to think through the emotional, relational, and identity questions that surrogacy raises before, during, and after. Many of our patients come to us while already working with a Boston-area surrogacy agency, and we're happy to coordinate with their team when useful.

What does it cost, and will insurance cover it?

The five-session core series is $3,000. Webster Clinic is a private-pay practice. Many families use HSA/FSA funds for this work (eligibility varies by plan). We can provide a superbill and supporting documentation if you'd like to seek out-of-network reimbursement for eligible services. Because coverage varies widely, we recommend checking with your insurer and benefits administrator in advance.

Can we meet by telehealth, or in person?

Both. Our office is at 745 Boylston Street, Suite 405 in Back Bay — quiet, well-appointed, designed for this kind of work. Many families choose telehealth for convenience; many choose in-person for the particular shape of this work. You can mix both across the five sessions.

How is this different from the mental-health evaluation my IVF clinic or surrogacy agency requires?

The evaluation your fertility clinic or surrogacy agency requires is a clearance. It's designed to screen for contraindications and satisfy a legal or clinical checkbox. It's typically one session and results in a letter.

Our consultation is different in purpose. It's not about clearance; it's about preparation. Over five sessions, we help intended parents think through the harder questions: How will we talk to this child about how they came to be? What happens if the surrogate or donor relationship becomes complicated? What are we each hoping for — and are those hopes aligned? These don't have right or wrong answers, but thinking them through carefully before you're in the middle of the process makes a real difference.

The two serve different functions. Most families who come to us have already completed or are completing the required evaluation elsewhere.

Why a psychiatrist rather than a couples therapist or social worker?

Three reasons specific to this work:

• Medical training: Psychiatrists complete medical school and residency before specializing — which means we can recognize when anxiety, depression, or trauma history is shaping a decision and address it directly, not just as background context.

• Psychoanalytic depth: Our clinicians' psychoanalytic and psychodynamic training enables a depth of relational work that is less common in shorter-term counseling models.

• Practically: Couples working through fertility decisions often carry grief, medical anxiety, and identity-level questions that benefit from clinical precision and medical familiarity — not just good listening.

Is this the same as a fertility counselor?

No. "Fertility counselor" is typically a masters-level clinician with a one-year fertility-counseling fellowship most commonly offering one-session psychological evaluations or open-ended therapy. This consultation is delivered by psychiatrists (MDs) with additional psychoanalytic training, structured as a time-limited series with a written formulation deliverable. The two roles don't compete so much as serve different moments in a family-building journey.

Is this the same as coaching?

No. Coaches can be excellent supports, and LGBTQ+ family-building coaches in particular have built real communities. They're not clinicians they don't hold medical or psychological licenses, can't bill HSA/FSA-eligible services, can't recognize or treat a mood or anxiety condition underneath the decision, and don't produce a clinical formulation. If you want peer coaching plus our consultation, both can work well together.

Can't we just use an AI chatbot, Google, or talk it through with friends?

You can, and many couples do. Each has a specific limit when the decision is one you're making together.

• AI chatbots and Google are good at information. They aren't built to hold two people at once, to notice when one partner says "I'm fine" but isn't, to recognize when anxiety or grief is shaping what sounds like a values position, or to tell which of a dozen reasonable answers fits your specific relationship. They don't see clinical patterns, mood, trauma history, the way a family-of-origin dynamic is quietly showing up in this decision and they aren't accountable to you across five sessions. They give everyone the same general answer. This consultation is built to give you two a specific one.

• Friends love you. That's why they're friends. They also carry their own histories with family-building, their own opinions about what you should do, and their own feelings about your choices. They can't be neutral, they can't hold confidentiality the way a clinical relationship does, and they shouldn't be asked to sit with the hardest material. Many couples find that telling a friend too much about these decisions actually strains the friendship over time.

• What a clinical consultation adds that none of those can: a trained observer holding both of you at once, recognition of the psychological patterns underneath the surface disagreement, and a written formulation you keep specific to your relationship, not a generic article.

Use AI, use Google, talk to your friends. When the decision stops moving — or when the two of you keep ending up in the same argument with better vocabulary — that's what this work is for.

Who's on the clinical team?

Dr. Cecil R. Webster, Jr. — founder, child, adolescent, and adult psychiatrist, psychoanalyst, Harvard-trained, Boston Psychoanalytic Society & Institute board trustee. Dr. Jacqueline Buchanan — child, adolescent, and adult psychiatrist, Harvard residency, and couples and family therapy training.