Sex therapy isn’t a one-size-fits-all solution. Different people (and different relationships) need different things, so it’s important to find a therapist and a treatment method that’s the right fit for you. In this post, we’ll break down everything you need to know about the various types of sex therapy: what they are, who they’re for, and their unique benefits.
What is Sex Therapy?
Sex therapy is a specialized form of psychotherapy or "talk therapy." Sex therapy became popular in the 1950's when Dr. William Masters and Virginia E Johnson began working with couples experiencing sexual dysfunction or relationship concerns connected to sex. Since then, the field of sex therapy has grown to address a variety of concerns that clients experience around sex and sexuality.
No matter the reason you seek sex therapy, a sex therapist will often start with a review of your sexual history, gather information about your current sexual challenges or concerns, discuss your goals for treatment, and provide their feedback for treatment options.
The next section will discuss reasons for sex therapy and common methods used by sex therapists.
Different Types of Sex Therapy
Individual vs Relationship Therapy
Just like traditional talk therapy, one decides whether they are needing individual therapy or relationship therapy with a partner(s). Individual therapy, or solo sex therapy, focuses on a person's personal sexual concerns to improve sexual function and experience; whereas, relationship sex therapy focuses on addressing sexual concerns between partners to improve relationship and sexual satisfaction.
Painful intercourse
Many people experience painful intercourse or pain with penetration. There is a wide assumption that painful sex is a women's sexual health issue. However, painful sex can occur with vaginal penetration and anal penetration. People of all gender identities and sexual orientation can experience painful sex.
Signs or symptoms of painful sex are inability to achieve penetration, pain with penetration, pain during sexual intercourse, and tightness in the abdominal, butt, or back during intercourse. The pain can feel dull, fiery, sharp, or tight. Painful sex can begin at the onset of sexual activity or after years of sexual activity.
Painful sex can be treated in both individual therapy and relationship therapy as it creates challenges in experiencing a fulfilling sex life on the individual and relationship level. Painful sex can also be a medical condition and treatment is in conjunction with other medical providers. Your sex therapist will be able to provide you information about your specific needs.
Erectile Dysfunction
There are many forms of erectile dysfunction, or ED, including difficulty obtaining or maintaining erection, premature ejaculation, and delayed ejaculation. Similar to painful intercourse, sex therapy addressing ED can be treated in both individual and/or relationship therapy. ED has several causes and can impact individuals and relationships in many different ways. A thorough assessment will help your therapist offer treatment options.
Gender Identity
In recent years, a newer niche has formed in the sex therapy field. Often, you'll hear a therapist refer to themselves as a gender therapist or offering gender therapy.
Gender therapy provides support for clients exploring or evolving their gender identity. This type of therapy provides a supportive space for clients to be their authentic self without shame or criticism.
Many sex therapists can provide gender therapy while also treating other sexual health concerns and changes in relationship with an evolving or transitioning identity.
Sexual Trauma
Sexual trauma occurs in many forms including sexual abuse, sexual assault, sexual shame, religious trauma, intimate partner violence, and racial or cultural trauma. Unfortunately, many people experience more than one of these in their lifetime.
Sexual trauma can be direct or indirect. A direct trauma is something that happens to you whereas an indirect trauma is something you are aware of or witnessed. Sexual trauma can also happen at any age and to any gender identity or sexual orientation. Sexual trauma can be occur from strangers or people we know in our lives.
Sexual trauma can not only impact the individual but it can also impact a person's relationship with an intimate partner, friendships, and family relationships.
Although therapy can help in recovery of trauma, if you are currently in an abusive relationship or experiencing abuse, immediate resources are available to you.
Methods Used in Sex Therapy
Cognitive Behavioral Therapy or CBT
CBT is a common approach in sex therapy that helps clients identify negative thoughts around sexuality and how these thoughts impact their sexual behavior and experiences. CBT is often a shorter term modality that addresses present issues instead of resolving concerns or experiences in the past. The goal is to change one's thoughts or perspective in order to create a behavior change. CBT, often, involves behavioral exercises at home.
Solution Focused Therapy
Solution focused therapy (SFT) is another shorter term modality with the goal to focus on what is currently working and doing more of what works. SFT does not focus on negative experiences and, often, encourages the client to only focus and speak about what is working.
SFT is often used in sex therapy to treat a variety of sexual dysfunction including anxiety with sex or differing sexual desires between partners.
PLISSIT
PLISSIT stands for Permission, Limited Information, Specific Suggestions, and Intensive Therapy.
Permission is first, and foremost, the therapist modeling consent by asking permission from the client and also giving the client permission to seek information. For some clients, just being given permission to be who they are or enjoy sexual activities is enough.
Limited Information information is what most clients need when experiencing sexual problems and seeking sexual therapy. Limited information provides the client with information around a certain area of human sexuality. For instance, a client seeking therapy due to low sexual desire may be informed that sexual desire ranges from person to person.
Specific Suggestions is when a client needs more than just education around sexual health and they need suggestion on how to improve their sexual concerns. Specific suggestions are often provided when a sexual dysfunction occurs and is often an exercise done by the client at home.
Intensive Therapy is provided to a small percentage of clients and only needs to be provide by a licensed sex therapist or licensed psychologist. Intensive therapy is often provided when there is a history of trauma or psychological symptoms that impact a client from daily functioning.
Erotic Blueprints (TM)
What some refer to as the sexual love languages, the Erotic Blueprints (TM) addresses a wide variety of sexual issues and sexual dysfunctions. It ultimately focuses on increasing sexual desire and intimacy in the relationship to improve sexual health and sexual satisfaction.
Erotic Blueprints (TM) focuses on five different types of sexual intimacy:
Energetic which loves tease, anticipation and yearning.
Sensual which are turned on by taste, smell, touch, and sound.
Sexual which have high libidos and love anything to do with physical body parts and orgasms.
Kinky who are often folks are turned on by the "taboo" or "edgy."
Shapeshifter which loves everything and anything and are turned on by all the blueprints.
The Erotic Blueprints (TM) are often used in mindfulness based sex therapy. Sex therapists who incorporate the Erotic Blueprints (TM) have found the method beneficial in individual and relationship therapy treating sexual dysfunction to help decrease sexual problems while improving sexual well being and relationship satisfaction. This is achieved due to the sex therapist being able to educate and somatically help clients apply tools and techniques to their own bodies.
Sensate Focus
Sensate focus was created by Dr. William Masters and Virginia E. Johnson and has become a popular method to use with couples in sex therapy. However, over the years, therapists have found ways to incorporate sensate focus into individual therapy and therapy with multiple partners.
The goal of sensate focus is to create mindfulness during sexual intimacy as well as improve communication with a partner(s). Another benefit and goal of sensate focus is gaining a deeper understanding of one's own experience during sex.
There are often phases or steps when using sensate focus. This is to ensure that all participants are comfortable with the exercise and to focus on the goal of connection versus a specific outcome such as orgasm or penetration.
The method has shown to improve sexual dysfunctions including ED and performance anxiety related to sex.
Eye Movement Desensitization Reprocessing (EMDR)
EMDR is often used to treat trauma though can also treat other mental health concerns including anxiety, substance use, and depression. Recently, EMDR has been used by sex therapists to treat sexual trauma or assualt as well as sexual dysfunction including ED and painful sex.
EMDR is a longer term modality. The sex therapist first helps the client reprocess experiences in the past and then reprocesses present experiences and ends by creating a desired future template for the experience.
As example, a client reports a present concern of inability to maintain erection during partnered sex. The sex therapist and client then identify experiences in the past similar to the present experience and then discuss how the client would like future experiences with his sex life.
The therapist then facilitates the reprocessing of each identified experience until the client reports no disturbing feelings related to the experience(s). The goal is for the client to also report an ideal experience during sexual encounters instead of sexual dysfunction or disturbing memories or thoughts.
Benefits of Different Methods Used in Sex Therapy
Peer reviewed studies have shown that sex therapy can improve various areas of one's sexual experience. Some reported areas of improvement include:
Sex education
Communication
Resolution of sexual dysfunction
Sexual self esteem
Many clients report very little to no sex education during their formative years. Sex therapy can help provide much needed information for clients to understand sexual health. Many clients report not getting basic information during school based sex education classes. Once they learn about these areas, they report an improvement in satisfaction with just knowing how to talk to their partner about both of their bodies and experiences.
Communication is another area where sex therapy can show improvement. Besides not having the sex education to talk about sex or sexual health, many partners have different communication styles which create trouble in their sex life. Sex therapy can also help clients better communicate with each other.
A lot of sexual dysfunction stems from a lack of sex education and trouble communicating about the topic. Sex therapy creates a space not only for clients to learn, but also for them to share their experiences and needs with sex. This can lead to a resolution of sexual dysfunctions.
Finally, sex therapy can help create a healthy sex life and increase sexual self-esteem. This increase in sexual satisfaction is also true for clients who report a life-long or chronic condition impacting sexual behavior; they often report finding a "new
Learn more about which type of sex therapy is right for you
Sex therapy provides a space to talk about anything related to human sexuality including sexual health, sexual behavior, sexual dysfunction, and sexual desire to name a few. Sex therapy can be for yourself or with your partner(s).
Atlanta Therapeutic Collective specializes in sex therapy with several sex therapists available to support you in your journey whether creating a more fulfilling sex life, improving your relationship satisfaction, exploring your sexual identity, or working through past traumatic experiences.
The sex therapists with Atlanta Therapeutic Collective have a sex positive approach to treatment and are either certified sex therapists with the American Association for Sex Educators, Counselors, and Therapists or are sex therapists in training under the mentorship of a certified sex therapist.
To schedule your first appointment, call 404-850-9495 or email info@atlantatherapeuticcollective.com
Contributed by Courtney Geter, LMFTS, CSTS and Dawn Quintanilla, MFT, Certified Eroctic Blueprint Coach and certified meditation teacher