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Also known as
Sexual counseling, sexual therapy, psychosexual therapy, couples sexual therapy, sexual function therapy, psychosexual counseling
Definition
Sex therapy is a specialized form of psychotherapy that draws upon an array of technical interventions designed to effectively treat male and female sexual dysfunctions.1 It focuses on addressing the psychological, emotional, and interpersonal factors that contribute to sexual difficulties through evidence-based therapeutic approaches.2 Sex therapy can be conducted in individual, couple, or group formats, depending on the initial problem and the motivation of both partners.1 Unlike traditional approaches that concentrate primarily on intercourse and orgasm, contemporary sex therapy focuses on desire, pleasure, and satisfaction to bring attention to the best sexual experience outside of how it is done.1 Sex therapists are licensed healthcare professionals with specialized training in sexual health who help individuals and couples identify and work through sexual challenges such as low sex drive, pain during sex, and difficulty having an orgasm.3 Importantly, sex therapy does not involve sexual contact between clients and therapists.3
Clinical Context
Sex therapy is clinically indicated for individuals and couples experiencing various forms of sexual dysfunction that have psychological components or impacts.4 Before initiating sex therapy, it is important to examine the patient’s or couple’s sexual history, current sexual practices, relationship quality, and to assess all relevant medical and biological factors that might be contributing to the development or maintenance of the current problem.1
The PLISSIT model is a commonly used framework in sex therapy that tailors interventions to patient needs:1
- Permission (P): Using professional authority to alleviate unnecessary anxiety or guilt
- Limited Information (LI): Providing correct anatomical and physiological information
- Specific Suggestions (SS): Offering practical exercises tailored to each case
- Intensive Therapy (IT): Addressing complex underlying causes through long-term intervention
Sex therapy can address various sexual dysfunctions including:3,4
- Disorders of sexual desire (hypoactive sexual desire disorder)
- Erectile dysfunction (ED)
- Premature ejaculation (PE)
- Female orgasmic disorder
- Female sexual interest/arousal disorder
- Genito-pelvic pain/penetration disorder (including vaginismus)
- Sexual trauma-related issues
Therapeutic techniques commonly employed include cognitive-behavioral therapy, mindfulness-based interventions, sensate focus exercises, systematic desensitization, interpersonal therapy, behavioral assignments, sex education, communication and sexual skills training.1,4 Research suggests that approximately two-thirds of men suffering from erectile dysfunction will be satisfied with their improvement at follow-up from 6 months to 6 years after sex therapy.1 Additionally, combining trauma-based therapy with sex-positive techniques may be more effective in helping individuals with a history of sexual trauma than using trauma-based therapy alone.3