What Can I Expect in Sex Therapy?

Even qualified sex therapists may differ widely in their basic approaches to the treatment of sexual problems, but some generalizations can be made.

First of all, you can expect to be talking in detail about sex. One cannot solve sexual problems by talking around them! Neither can one gain new sexual information unless clear, direct information is given.

Second, you might expect to be offered the opportunity to add to your knowledge by reading selected books and/or specific handouts specifically for use in sex therapy. You should not, however, do anything which you do not understand, and you must reserve for yourself the right to question the purpose of an assignment. It is your right to decline or postpone acting on the suggestions of your therapist.

Third, you should expect to be treated with regard. While you might expect to be challenged and confronted on important issues, you should also expect to experience a respectful attitude toward those values which you do not wish to change.

Fourth, sexual contact between client and therapist is considered unethical and is destructive to the therapeutic relationship. Know that you will not perform sexually in any manner with your partner in the presence of your therapist. It is important to know the talk, material and the assignments must, by the nature of the problem, be specifically sexual and at times bluntly explicit.

Sex therapy is a dynamic approach to very real human problems. It is based on the assumptions that sex is good, that relationships should be meaningful, and that interpersonal intimacy is a desirable goal. Sex therapy is by its nature a very sensitive treatment modality and by necessity must include respect for the client’s values. It must be nonjudgmental and non-sexist, with recognition of the equal rights of each partner.

What is Sex Therapy?

Sex Therapy is the application of professional and ethical skills to deal with the problems of sexual function of people. It assumes recognition of the concept that sexuality is of legitimate concern to professionals and that it is the right of individuals to expect expert knowledge when seeking remedies with sexual concerns. Sex Therapists and Clinical Sexologists focus their specialized skills to help individuals and/or couples to deal with their sexual concerns.

The importance of sexual function for individuals varies, of course, but for many it is closely tied in with their total concept of self identity. For these, problems in sexual function may lead to devaluation of self – “When I cannot feel good about my sexuality, how can I feel good about myself?” We are also in a time when marital and family units seem to be quite vulnerable. Concepts of these traditional relationships are being reevaluated, challenged and restructured. Alternatives to marriage are becoming more widely accepted than at any other time in our history. Regardless of the structure of the intimate relationship shared, sexuality serves a valuable function for most couples. It becomes an expression of caring, not only for the partner, but for oneself. It can become a powerful bonding element in a relationship, which, in today’s society, must withstand considerable demands on time, energy and commitment. Dissatisfaction with the sexual relationship and the loss of that shared intimacy, in many instances, may lead to negative feelings and attitudes which are destructive to the relationship. Many marriages end therefore, because of unresolved sexual differences and difficulties.

Who Goes for Sex Therapy?

The sex therapist works with a wide variety of problems related to sexuality.People seek help with such problems with arousal (desire discrepancy/sexual anorexia), as well as problems with orgasm (either inability to climax or the inability to control ejaculation). In addition to seeking medical evaluation and treatment, many people who experience painful intercourse also seek the assistance of a sex therapist. Couples often seek help when it becomes apparent that differences exist in their sexual desires or when they sense that their sexual relationship is not growing as they would wish. The need for additional information, more effective verbal/physical communication, and for sexual enrichment lead many couples to the sex therapist’s office in their quest to enhance their intimate relationship.

How Does Sex Therapy Differ From Other Therapies?

Sex therapy employs many of the same basic principles as the other therapeutic modalities, but is unique in that it is an approach developed specifically for the treatment of sexual problems. That is, sex therapy is a specialized form of treatment used with one aspect of the wide range of human problems. Herein lies its value and also its limitation! Sex therapy techniques, when applied by an unskilled counselor or therapist, might focus too readily on mechanical sexual behavior, to the exclusion of the total individual and the total relationship.

Are There Limitations?

As with any therapy for personal or behavioral difficulties, sex therapy has its limitations. Although usually brief and effective with most sexual concerns, sex therapy does not offer a miracle cure for all interpersonal problems.

Success of treatment depends upon many factors, not the least of which are the nature of the problem, the motivation of the patient, the therapeutic goals and the therapist’s skills. The motivated prospective patient and/or couple should choose a therapist carefully and establish realistic goals early in the counseling.

How Does One Know if a Sex Therapist is Qualified?

One must realize that with any field, a variety of definitions and expectations will exist for a time, and that a wide variety of people will claim expertise in accordance with their own definition of the field. The expectations presented here might be criticized by some as too rigid, but it is purposefully intended to present a fairly strict set of guidelines for selecting a sex therapist. Very few states license sex therapists, so the client must exercise caution and must choose wisely!

Five criteria need to be met in choosing a sex therapist. First of all, the therapist must have a sound knowledge of the anatomical and physiological bases of the sexual response. The sex therapist may, therefore, have a basic medical background or may come out of another non-medical profession but with post-graduate education in the biological aspects of human sexuality. A qualified non-medical sex therapist will usually work closely with physicians or may function as a non-physician in a medical clinic or university school of medicine.

Secondly, the qualified sex therapist must be skilled in providing counseling and psychotherapy, and most sex therapists will be found to have a sound background in psychology, social work or psychiatric nursing. This background in the behavior sciences is essential to the understanding of the total individual and to the planning of an individualized treatment program. There are, however, some notable exceptions to the rule that sex therapist should have a traditional mental health training background, in that there are also highly respected and well trained sex therapists who began as clergy. These clergy, however, need to demonstrate specific post-graduate training in pastoral counseling or in equivalent mental health areas.

The third criterion is that the sex therapist, having both biological and psychological sophistication, must be able to demonstrate extensive post-graduate training specifically within the areas of sexual function and dysfunction, sex counseling, and sex therapy. A weekend workshop or possession of a few sex therapy films does not meet this criterion, and the prospective client should feel free to ask for a list of specific training experiences in these specialized areas. </span>

The fourth requirement to be met is that of having expertise in relationship counseling. That is, the sex therapist should also be a skilled marital, family and/or group therapist. In order to work effectively with sexual problems, the sex therapist must be able to work effectively with non-sexual relationships as well. Sexual behavior does not occur in a vacuum – it occurs within a relationship! The total relationship must, therefore, be accurately evaluated and treated.

The fifth requirement is the therapist’s adherence to a strict code of ethics! Prospective clients have the right to request a copy of the therapist’s ethical code before agreeing to any treatment.