A talk for a group of psychiatric residents to introduce them to concepts and principles of sex therapy and the training involved in becoming a sex therapist.

1. An Overview of Sex Therapy
SexPositiveTherapist.com

2. Multi-disciplinary Field
Masters level clinicians, Psychologists and Medical
professionals, academics, PTs all provide sexuality-
related services
Requires these characteristics:
• Self-knowledge
• Professional judgment
• Ability to monitor and manage own reactions
• Willingness to research new perspectives, practices
and identities

3. World Association for Sexology’s
Declaration of Sexual Rights
• The right to sexual freedom
• The right to sexual autonomy, sexual integrity, and safety of the
sexual body
• The right to sexual privacy
• The right to sexual equity
• The right to sexual pleasure
• The right to emotional sexual expression
• The right to sexually associate freely
• The right to make free and responsible reproductive choices
• The right to sexual information based upon scientific inquiry
• The right to comprehensive sexuality education
• The right to sexual health care

4. Sex Therapists and Values
What qualities and behaviors do sexuality
professionals consider in determining sexual
health?
How do we support clients in identifying their
sexual needs and aspirations?
How do our personal beliefs and experiences
inform or interfere with this aspect of our
work?

5. Common concerns addressed
in sex therapy
• Differences in desire
• Lack of libido
• Erection problems: ED, EE, DE
• Pelvic pain/ painful intercourse
• Difficulties with orgasm
• Sexual abuse recovery

6. Other important issues
• Sex during and after chronic illness/disability
• Gender transitions and gender fluidity
• Concerns of GLBTQ clients
• Clients who identify as kinky, BDSM, fetishists
• Poly-amorous/open relationships/swingers
• Concerns of sex workers and performers
• Erotic recovery after affairs
• Managing effects of infertility on sexuality
• Sex/porn addiction/hyper-sexuality/OCSB

7. Kinsey Scale
0- Exclusively heterosexual with no homosexual
1- Predominantly heterosexual, only incidentally homosexual
2- Predominantly heterosexual, but more than incidentally homosexual
3- Equally heterosexual and homosexual
4- Predominantly homosexual, but more than incidentally heterosexual
5- Predominantly homosexual, only incidentally heterosexual
6- Exclusively homosexual

8. Klein Sexuality Grid

9. Sexual orientation
Our pattern of
sexual,
romantic, and
emotional
attraction to
others

10. Gender identity
Our deepest
feelings about our
gender, and the
display of our
identity and
personhood

11. GLBTQ*
Language keeps
changing
Must educate
ourselves
Best of all, ask
people what
they like to be
called

12. Sexual diversity is
everywhere
There is some overlap
between the GLBTQ and
alternative communities,
but only a minority of
GLBTQ people report
considering themselves
kinky or in open
relationship
Kinky sexual practices and
flexible relationship
structures occur in all
populations, age groups
and social strata

13. Sex Therapy Principles
• P-permission
• LI-limited information
• SS-specific suggestions
• IT- intensive therapy
• Psycho-education, information and resources
• Mindful awareness and relaxation skills

14. Postmodern and integrative
approaches
Bring together:
• Narrative
• Cognitive-Behavioral
• Solution-Focused
• Contemporary Psychoanalysis
• Existential-Humanistic

15. Controversies in Sex Therapy

16. Gender dysphoria in
kids and teens
How do we assess and
treat children who feel like
they should have been
born another gender?
Many have expressed
gender variation from an
early age. This therapy is a
new field that involves
complex and thoughtful
evaluation of family
background and gathering
a richly detailed history.

17. Pathology and Diverse
Expressions of Sexuality
Fetishism,
homosexuality,
nymphomania, gender
variance, bondage and
domination, sadism
and masochism have
all been considered
illnesses in the past.
How do we sort out
sexual health from
social stigma?

18. Sex and porn
addictions
Although these concepts
are broadly-accepted by
the general public, no
wide-spread acceptance by
sex therapy community
Need for differential dx
before assigning terms like
this to clients
Increased trend of
inpatient and residential
programs incorporating
this as co-morbidity
requiring treatment

19. Surrogacy
Use of sexual
surrogates remains
debatable in clinical
practice and legality
varies
Can make partnered
sexual experience an
educational
opportunity beyond
talk therapy but
therapists hesitate to
refer due to sanctions

20. Aging and sexuality
We’re still not sure
how best to help older
adults express and
value their sexuality
Is more sex better?
Should everyone
maintain an active sex
life? How do we help
older people keep a
healthy body image
and a sense of vitality?

21. Lack of cultural
awareness & diversity
Our profession does
not represent general
population
Need to develop
cultural, racial, ethnic,
sexual class awareness
among ourselves
Make educational
opportunities and
professional events
accessible to an array
of interested people

22. Professional Organizations
• AASECT American Association of Sexuality
Educators, Counselors & Therapists
• SSSS Society for the Scientific Study of
Sexuality
• SSTAR Society for Sex Therapy & Research
• Kinsey Institute
• WPATH World Professional Association for
Transgender Health