What is Sex Therapy?
Sex Therapy is a professional and ethical treatment approach
to problems of sexual function and expression.
It reflects the recognition that sexuality is of legitimate
concern to professionals and that it is the right of individuals
to expert assistance with their sexual difficulties. Sex
therapy, then, is the focusing of specialized clinical skills
on helping men and women as individuals and/or as couples
to deal more effectively with their sexual expression.
Why is Sex Therapy Necessary?
Sex therapy is the result of relatively recent scientific
attention to human sexual function and dysfunction. Out
of the increased knowledge of the physiology and psychology
of human sexual behavior has come a new professional appreciation
for human sexual response. At a time in our society when
sexuality is being more openly discussed, we are beginning
to realize how uninformed many people really are about this
important personal topic.
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 now being more openly tried and 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 (impotence and frigidity), 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.
The qualified sex therapist is also available to those wishing
to resolve troublesome sexual inhibitions or change undesirable
sexual habits. People with questions about their sexual
identity or sexual preferences seek out the trained sex
therapist for consultation. Parents consult the therapist
about the sexual curiosity and experimentation of their
children and seek insight into ways to foster the healthy
development of their youngsters through effective sexual
education in the home. Sex therapists also assist those
experiencing sexual difficulties as a result of physical
disabilities or as the consequence of illness, surgery,
aging or alcohol abuse.
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.
If you are not comfortable with your therapist or feel that
the therapist has set unrealistic performance goals for
you, discuss these concerns with him/her. All therapy depends
upon trust and mutual respect, but this is particularly
true when working with intimate issues of sexuality.
How Does One Know if a Sex Therapist is Qualified?
One must realize that with any new 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,
psychiatry, psychiatric 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 psychiatric mental health areas.
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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.
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.
How Does One Find a Qualified Sex Therapist?
Most qualified sex therapists do not depend on ads in the
newspaper, as most professionals have made themselves and
their credentials known to other professionals in the community.
If you need a sex therapist, you might begin by consulting
your family physician, gynecologist or urologist. Ask for
a referral to someone your doctor has used confidently in
the past. In addition to this, you might be inclined to ask
a trusted clergyman for a referral. As you begin to collect
information about available resources, you might then wish
to turn to the telephone directory Yellow Pages, looking under
such headings as "Psychologist," "Social Workers,"
"Marriage and Family Counselors," and elsewhere.
Remember, there is probably no legislative control of the
title "Sex Therapist" in your state, so simply finding
the title in the phone book does not document that individual's
clinical skills! In all states, however, licensing laws control
who can list as a "Psychologist" or as a "Physician."
A small number of states now also restrict the listings of
"Social Workers" and/or "Marriage Counselors."
When calling a professional, be sure to ask questions about
qualifications, experience and fees! It is recommended that
you call and ask, "Do you have a specialty?" rather
than stating, "I have a sex problem - can you help?"
Perhaps the most useful referrals will come from other knowledgeable
professionals within your community. However, it is also helpful
to be able to discover which therapists belong to recognized
national professional associations having high membership
requirements and enforcing rigid codes of ethics. Specifically,
The American Association for Marriage and Family Therapy (AAMFT)
is a national professional association which credentials marriage
and family therapists and which would provide a list of its
clinical members in your geographical area. More specifically,
The American Association of Sex Educators, Counselors and
Therapists (AASECT) is the largest national group which certifies
sex educators, sex counselors and sex therapists. You can
learn the names and addresses of the certified professionals
in your area by writing to this association. AASECT will also
provide you with a copy of their Code of Ethics for Sex Therapists
upon request. Addresses for AAMFT and AASECT are provided
at the end of this page.
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 explicitly
and in detail about sex. One cannot solve sexual problems
by talking around them! Neither can one gain new sexual information
unless clear, direct instruction is given!
Second, you might expect to be offered the opportunity
to add to your knowledge by reading selected books and/or
viewing clinical films designed 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,
rather than allowing yourself to be pushed into behavior which
might actually increase your discomfort. Every assignment,
task, or experience presented by the therapist should fit
into an understandable and acceptable treatment plan - and
you have the right to question the procedures.
Third, you should expect sex therapists to be non-judgmental
and to portray their own comfort in giving and receiving sexual
information. 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
which to change.
Fourth, unless your therapist is a licensed physician
wishing to conduct a physical examination, you should not
expect to be asked to disrobe in the presence of your therapist.
Sexual contact between client and therapist is considered
unethical and is destructive to the therapeutic relationship.
Neither should you expect to be required to perform sexually
with your partner in the presence of your therapist. Overt
sexual activities just should not occur in your therapist's
presence, even though the talk, material and the assignments
must, by the nature of the problem, be specifically sexual
and at times bluntly explicit.
Finally, you should feel that you are heard and adequately
represented in your sexual therapy. That is, you should that
you have been stereotyped as "female," as "gay,"
as "too old," or in any other way that interferes
with your sense of unique identity within the therapeutic
setting. You should feel that you are being treated as an
individual, not as a category!
Sex therapy is a new, 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 man
and woman to full expression and enjoyment of healthy sexual
relationships.
Professional Associations
American Association for Marriage and Family Therapy (AAMFT)
1100 17th Street, N.W., 10th Floor
Washington DC 20036-4601
Phone: 202.452.0109
American Association of Sex Educators, Counselors
& Therapists (AASECT)
P.O. Box 5488
Richmond, VA 23220-0488
Phone: 804.644.3288
E-Mail: assect@worldnet.att.net
Web Site: http://aasect.org
American Academy of Clinical Sexologists (AACS)
1929 18th Street, N.W., Suite 1166
Washington DC 20009
Phone: 202.462.2122 |
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