What is sex therapy?

Topics:

• Professional Ethics

• Specialized Focus

• Levels of Care

Sex therapy is a form of psychotherapy or “talk therapy” where a trained, and preferably certified, sex therapist assists with addressing problem areas and in finding reasonable solutions. Before addressing more specifics of what sex therapy is, let’s address what it is not. 

• Nudity or Sexual Contact - Okay, I wish I didn’t have to state what seems like the obvious, but there is no sexual contact or nudity of any kind in sex therapy.  Sex therapy is different from sex surrogacy or sex work, and those who cross these boundaries with a client lose their license and reputation. 

• Touch - Sex therapy is not touch-based, and ethical guidelines prohibit such.  While there are other professional modalities, such as massage and different types of bodywork, where touch is permitted, the emotional vulnerability that sex therapy entails requires clear boundaries prohibiting touch. 

• Just about sex - Sex therapists are trained on when to focus on sex and when not to. Like a repairman fixing a hole in a bedroom wall, we address the problem thoroughly, including systems and influences that are not about sex. When the work is done, we don’t linger longer in the bedroom than is needed. 

• Medical treatment - Sex therapists do not diagnose or treat physical problems and do not prescribe medication.  We recommend that medical issues be addressed, or the possibility of such be ruled out.  Sex therapists focus on the mental, emotional, relational, and spiritual aspects, and approach problems with a focus on sexual health. 

With that out of the way, let’s talk more about what sex therapy is. 

• Functional - Many seek help from a sex therapist when there has been a change or challenge to sexual functioning.  This includes issues such as 

  • Low sexual desire (often referred to as libido)

  • Discrepancies in sexual desire (in a partnership) 

  • Discrepancies in sexual attraction (mixed orientation couples) 

  • Arousal or erection difficulty 

  • Premature or delayed ejaculation 

  • Orgasm difficulty 

  • Pain related to sexual touch or penetration 

  • Infidelity 

  • Compulsive sexual behavior 

  • Problems related to inadequate sex education 

  • Religious or spiritual conflict with sexuality 

These problems may be related to medical, mental health, life-stage transitions, trauma, or other factors. 

• Levels of Treatment - Sexuality issues and needs are quite diverse. Given client differences in history, culture, functioning, sex education, and the sensitivity in addressing sexuality, sex therapists are trained to meet clients where they are at, providing the level of treatment that is needed.  Sexologist Jack Anon developed a model to assess the needed level of treatment.  Anon’s model is known as the PLICCIT model.  According to this model, the client may need: 

  • Permission - Consent and support to talk about and address their questions and concerns. 

  • Limited Information - Accurate and empirically based information specific to one’s needs. 

  • Specific Suggestions - Professional and informed recommendations and assignments.

  • Intensive Therapy - More involved and focused therapy to address more complex, severe, or long-standing issues. 

Not all clients need prolonged therapy or even therapeutic suggestions.  We start at level one and provide support at the level of need. 

• Experiential - As therapists, we can talk about and around issues all day (and many do), but change does not occur without action and new experience.  Sex therapists have a behavioral orientation and invite their clients to complete exercises and assignments in between sessions to put concepts into action.

• Sexual Health - Though it may be dysfunction and problems that bring clients in, one of the primary strengths in the sex therapy field is the ability to visualize what health, functioning, and thriving look like and to identify the principles and practices that can move clients in that direction. 

There you have it, a start to identifying what sex therapy looks like. Given the sensitive nature of sex therapy work, matching the expectations, skills, and personalities of therapist and client is especially important. This may have answered your questions, and then again may have generated a viral explosion of additional questions.  If so, let’s chat.