This chapter addresses the role, and importance, of individual counseling and psychotherapy in providing psychological assistance and support to patients who are struggling with infertility and loss. Depression and anxiety are the two most frequent emotional sequelae of the infertility experience.The chapter therefore speaks not only to what factors contribute to making fertility counselors effective in their work, but also addresses specific treatment approaches that can yield positive outcomes in working with this unique population. These approaches include psychodynamic psychotherapy, cognitive–behavioral therapy (including dialectical behavior therapy and trauma-focused therapy), and supportive counseling. A brief history and description of each approach is presented in addition to a discussion of ways in which these psychotherapeutic treatments can be effective in working with fertility patients. Each of these approaches can be longer term or time-limited, often depending on the needs and preferences of the patient.The chapter also emphasizes the importance of appropriate professional mental health training as well as an understanding of the unique medical treatments that are an inherent part of the personal experiences of fertility patients. A strong therapeutic alliance is critical to effective individual treatment, and each psychotherapy approach provides strategies for assisting individuals who are emotionally challenged by infertility.