What Exactly Is Sex Therapy, Anyway? Here's What Happens In A Session

November 29, 2021 — 16:05 PM

What comes to mind when you think of sex therapy? Some people imagine it to be an uncomfortable and invasive process, others assume it involves sex with or in front of a sex therapist, and others think it's only for people in troubled relationships.

Consider those myths debunked.

Sex therapy is a specialized area of psychotherapy that addresses an individual's or couple's sexual issues, explains Jenni Skyler, Ph.D., LMFT, CST, an AASECT-certified sex therapist and director of The Intimacy Institute for Sex & Relationship Therapy.

This form of therapeutic treatment involves using a measured approach during sessions with a sex therapist, who will assess any sexual function issues or intimacy concerns, identify any diagnoses, and create a comprehensive treatment plan, she explains. "For sexual dysfunctions, we teach specific behavioral exercises to address sexual concerns so that clients learn how to be students of their own and their partner's sexuality."

Sex—however you define it—is a key aspect of life for many people, both single and partnered. Sex therapists can help you tackle experiences, concerns, and emotions related to issues you have inside and outside the bedroom, explains AASECT-certified sex therapist Laura Berman, LCSW, Ph.D.

"It can be for anyone," she adds, not just for couples. "In fact, I often work with single people who aren't currently in a relationship but want to work on their intimacy issues before they get into another partnership."

People seek sex therapy to navigate a range of problems, so there's no one-size-fits-all experience. In general, sex therapy is meant to be a supportive and compassionate environment that aims to address any psychological, physiological, or cultural factors of your presenting challenge.

Different sex therapists may have general approaches and different issues or focus areas they specialize in. For example, Berman's work with clients includes helping them recover from past sexual trauma or overcoming sexual dysfunction. She also helps clients cope with intimacy issues that arise from aging, illness, childbirth, and much more. Skyler's approach includes helping clients learn to understand the connection between the mind and the body to enhance sexual pleasure, as well as to connect with their desire and arousal to "become more sexually alive."

To create a specific treatment plan for you, your therapist will ask about your sexual history to better understand how your attitude toward sex has been shaped. "As sexual beings, we all carry complex sex histories [that] include lifelong family and societal messages that affect our sexual functioning, body image, and relationships," Skyler explains. "Sex therapy can help a person explore their past sex history and find solutions to enhance the present and future."

The sessions are often educational and provide techniques to help clients experience more pleasure and sexual satisfaction. Clients receive practical sex therapy homework exercises that are often supplemented with relevant readings and/or videos.

What they'll never do, however, is include or require nudity or sexual behavior in sessions. "I rely mainly on talk therapy," says Berman. "I never touch my clients in an intimate way. It is a professional therapist/client relationship as in traditional psychotherapy."

Skyler says anyone who wants to enhance or heal their sexuality can go to sex therapy—it's as simple as that. 

Whether you go alone or with a partner, sex therapy can help with common issues such as:

Recovering from an affair Healing from sexual trauma or a sexually distressing past Healing from childbirth Menopausal issues Erectile dysfunction Pain during sex Difficulty or inability to reach orgasm Communication issues Enhancing sexual and emotional communication Sexual anxiety Recovering from abusive relationships and learning to form new, healthy partnerships in the future Physical challenges or difficulty with sexual function Exploring psychological blocks that prevent the full expression of emotional and/or sexual intimacy Finding new ways to reconnect Exploring alternative sexual expressions

In your quest to find a sex therapist, there are plenty of ways to ensure you're finding the best one to suit your needs. It may require meeting a few therapists to find the perfect fit for you, says Berman, but keep looking!

"The right sex therapist will honor your boundaries, listen to your goals, and be a nonjudgmental positive force for good in your life and in your relationship."

Always look into the accreditation and licensure of any sex therapists you're considering. Sex therapy is a type of therapy, and in the U.S., all therapists require a license from their state to practice. Specific licenses will vary from state to state, but typical professions legally allowed to practice psychotherapy include licensed mental health counselors (LMHC), licensed marriage and family therapists (LMFT), licensed clinical social workers (LCSW), or licensed psychologists. They typically hold a master's degree or doctoral degree in a related field. 

Beyond holding a license to practice therapy, sex therapists should also have additional training and/or credentials specific to practicing sex therapy, as not all therapists have expertise in treating sexual issues. The largest national organization certifying sexuality professionals is the American Association of Sexuality Educators, Counselors and Therapists (AASECT), which requires their certified sex therapists to hold licensure and advanced degrees in psychology, medicine, social work, counseling, nursing, or marriage and family therapy. There are also other certifying bodies and universities that offer advanced certificates in sexuality-related fields. Always make sure to do your research.

In addition to their credentials, do a thorough search of their online presence to get an idea of who they are and what they believe in. 

Check their:

Website Social media Client testimonials Articles, videos, and podcasts Professional associations Accreditation Curriculum vitae (CV)

If credentials check out, Skyler suggests you look for areas of expertise and strength that indicate their ability to handle your issue. If not, you can always ask for recommendations for a better-suited clinician.

For example, she strongly believes that to work with couples, sex therapists should have a solid foundation in couples' work. That could mean they're licensed in your state as a marriage and family therapist, or they have additional training in human sexuality and clinical sex therapy, preferably certified by an accredited organization.

Berman and Skyler say that most therapists offer a complimentary consultation to discuss what you'd like to work on in therapy and whether you'd be a good fit for each other. 

"During this time, ask questions regarding their clinical approach," says Skyler. "See if they seem confident in their knowledge but also curious about your experience." Berman adds that the consultation also gives you the opportunity to see what modalities they use to help address client needs. 

Although your sessions will largely depend on your therapist and the work you're trying to accomplish, you can expect a talk therapy session similar to what you'd experience with any other licensed therapist. 

"For sex therapy, the therapist will do a thorough assessment of your presenting issue to understand your relationship to intimacy, touch, and sex," Skyler tells mbg. "The therapist may offer a diagnosis or review of the issue at hand and will spell out some treatment options and approaches." Because all experiences are unique, she says homework or home "play" is tailored for each individual.

"If you're struggling with low libido or mismatched libidos, for example, your therapist might ask you to take sex off the table for a while," explains Berman. This takes the pressure off the couple and allows them to start rebuilding their intimacy from the ground up. "That can look like date nights and traditional talk therapy, but in general, we often go much deeper."

In the following sessions, you'll discuss ways to find a path forward and review insights from the homework exercises. These assignments can include new patterns of communication, says Skyler, or learning how to name and address each other's needs. "Once the emotional foundation is strongly built, homework can include physical, sensual, and eventually erotic exploration."

As you dive deeper into your sex therapy journey, expect to learn a lot about your body. Berman says you may need to get a hormonal checkup(s), look into medications potentially causing sexual dysfunction, cut back on drinking, or get more active. 

Still, the expert says sex therapy often goes to our very roots: "To the very first lessons we had around sexuality and sexual pleasure, and learning how to recover from some of these painful and harmful messages and rebuild our self-worth." 

Enhance and rejuvenate your marriage or relationship.  Help you pick better partners and find more stable relationships. Empower you to reclaim your sexual pleasure and your body after trauma.  Change the way you look at your and your partner's body.  Help you become a more loving, open, and brave person.   Identify the ways you want to love and the places you haven't been allowing yourself to be loved.  Help individuals and/or couples emerge from a sexless relationship.  Find solutions for desire discrepancy.  Heal an affair or breach of trust. Expand function amid sexual dysfunction, such as erectile dysfunction, premature ejaculation, delayed ejaculation, and anorgasmia.  Find overlap between partners where one might be kinky or enjoy unconventional turn-ons while the other prefers more "vanilla" sex.  Help those navigating cancer or chronic illness create a new narrative for sexual connection.  Identify and help the psychological and relational components of painful intercourse from dyspareunia or vaginismus.  Help couples with communication issues related to sex. Support couples looking to open their relationship with intention and integrity.  Help individuals explore nuances of gender, such as gender identity, gender expression, and gender roles.  Help individuals explore nuances of sexual orientation and identity.  Support parents who want to talk with their kids about sexuality. 

Berman always assures her clients that everyone (yup, you, too!) can benefit from sex therapy. 

"If you crave a meaningful and passionate sex life—and most of us do—you're probably going to need help at some point in your life with intimacy issues," she says. "Intimacy issues are normal and also generally fixable."

Wanting or needing sex therapy doesn't mean there's anything wrong with you, your relationship, or your preferences. Instead, it can help you lead a satisfying, shame-free life that honors your sexual needs.