Sex Therapist

Sex, and discussing sex lives, can be a vulnerable topic for many individuals and couples, resulting in stigmas surrounding therapy for sexual topics and sexual issues. However, sex therapy can benefit those experiencing sexual dysfunction, arousal difficulties, intimacy struggles, sexual function issues or past sexual trauma. With a salary of up to $77,000 annually, becoming a sex therapist can be a competitive and valuable career path. Understanding the functions of a sex therapist can help clients and prospective therapists learn more about this area of psychology.

What does a therapist who specializes in sex do?

Sex therapists are licensed counselors, social workers, therapists, or psychologists with specialized training who can provide specialized services to clients seeking sexual advice and support for sexual difficulties. Most sex therapists have psychotherapy training and are trained in many forms of therapy but may have taken extra courses in topics like, sexuality, sexual trauma, pain during sex, sexual dysfunctions, or intimacy skills. A sex therapist, like all therapists, is not a medical doctor and cannot prescribe medication (though they may have a doctoral degree). However, they have extensive training in identifying intimacy issues and relationship issues stemming from sex.  Therapy sessions may include different types of therapy including cognitive behavioral therapy or emotion-based therapy. Sex therapists work with individuals, couples, or groups of clients. 

Sex therapy can involve various lessons, support, and advice from your therapist. Although sex therapists may teach couples activities to try together, any sexual, sensual, or romantic touching exercises will be done in secret, at home outside of sessions without the therapist present. It’s important to note that sex therapy does not involve flirtation or sexual activity with a therapist. 

In some cases, a psychologist may work with a client to find a surrogate partner for surrogate partner therapy. Surrogate partners are separately licensed independent contractors who are not therapists. The surrogate partner will act as a partner for an individual without a sexual partner to practice the exercises learned in sex therapy. These activities are also done outside the session, and the therapist does not participate in or witness it. 

According to the American Psychological Association, sex therapy today is heading in five emerging directions. These include:

• Mindfulness-based interventions
• Psychotherapy interventions over medications
• Expanding inclusivity
• Considering the couple’s perspective
• Changing attitudes toward sex

Becoming a sex therapist

Sex therapists can be various types of mental health professionals, including psychiatrists (a doctor with a medical degree), marriage and family therapists (LMFT), clinical psychologists, clinical social workers (LCSW), or licensed practicing counselors (LPCs). In addition, sex therapists often attend further educational courses in sex therapy, sexual health, sexual medicine, and couples therapy. 

In many cases, sex therapists obtain a sex therapy certification through a board like the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). In addition, they must have at least a master's degree in a related field, clinical hours under supervision, and an up-to-date state license to practice counseling or therapy. 

Some graduate schools may have specific sex therapy programs within the mental health training curriculum. You may also need to finish a certain number of hours in human sexuality education through your school or a continued learning course to become a sex therapist. The specifics may depend on the state which you live in. This type of work can be fulfilling, especially if you’re comfortable talking about sex and want to help others address sexual concerns.

Sex therapy methods and techniques

A licensed sex therapist uses various traditional forms of therapy to help clients address concerns, thoughts, and feelings surrounding sexuality, intimacy, relationships, sexual life, sensuality, and sexual function. These professionals provide resources, homework, activities, and advice to individuals, couples, and groups who may be experiencing sexual issues.

You do not have to have a mental illness, be in a relationship, or struggle to have intimate sex to talk to a sex therapist or social worker. Many of these providers also support those frequently sexually active, those looking to learn more about their bodies, and couples trying to connect in new ways. Sex therapy can be a positive process that aims to reduce shame and open the conversation about sex positivity.

In addition, sex therapists aren't necessarily limited to discussing sexual topics. Often, emotional topics can connect to sex, body image, and sexual activity. Sex therapists may also help individuals and couples address the following: 

• Family planning
• Life transitions like moving, having a baby, or getting a new career
• Emotional challenges
• Difficulty communicating in relationships
• Past non-sexual traumas
• Unhealthy relationship dynamics
• Finding local resources
• Mental illness 
• A lack of romance in a relationship 
• Dependency on sexual behaviors like watching pornography 

After understanding the client's challenges, sex therapists recognize a couples goals and can develop a treatment plan to guide them. Sex therapists can also lead support groups for individuals seeking a community with similar challenges. Often, support groups can be free or low-cost. 

What happens during this therapy?

Sex therapy does not involve sex, intimacy, or physical touching during sessions with the therapist or your partner. Instead, it is often a form of talk therapy about a sexual problem involving a professional conversation about your goals, experiences, feelings, and needs. If you feel uncomfortable meeting with a sex therapist for the first time, you can ask questions and get to know their approach to sessions. 

What does a sex therapy session look like?

Sex therapy sessions with a sex therapist may begin with the client describing their intimacy concerns or sexual concerns with their therapist. The therapist can take notes and start to develop a treatment plan while asking questions to get an idea of the client's goals. For example, a personal goal for one client might be feeling more emotionally connected with their partner. One goal for another may be to reduce sexually compulsive behaviors or other sexual problems. While yet another may be to increase sexual desire. The treatment for each goal can differ. 

Assessments from sex therapists

Your sex therapist can assess your sexual background, including experiences with past sexual partners, and how it integrates with your current concerns. They may offer a diagnosis or discuss research surrounding the sexual challenges you've come to discuss. For example, suppose you're experiencing pain during sex related to psychological distress. In that case, the therapist may offer physical exercises to increase pelvic muscle strength, individual activities to improve psychological comfort, and support your emotional responses to pain so that you can find more comfort during sex.

What happens during the homework portion?

A sex therapist may give you and your partner exercises to work on in-between sessions. These exercises might include communicating in new ways, reading about sexual health, changing your interactions with your partner, role playing, or trying a new form of touch. These activities might be challenging or awkward initially, but connecting with your partner may improve your sexual connection. 

In individual sex therapy, exercises might involve self-touching, body exploration, journaling, or similar coping mechanisms. These exercises also take place at home. After a couple or individual has practiced their homework, they can tell their therapist how it went and how they feel about themselves or their relationship afterward. 

Is discussing sexual intimacy with a sex therapist during therapy weird?

Speaking with a stranger about something as intimate as sex, for many individuals, seems uncomfortable and can be nerve-wracking. However, sex therapists are licensed professionals trained to support these concerns and may have had clients with similar challenges as you in the past. They are not there to judge you and are ethically required to have an empathetic, open-minded, and supportive practice. 

Sex therapy can also lead to support within other mental or physical health realms. If the problems arise from something physical, such as the side effect of a medication, you can be referred to a doctor or other healthcare providers to adjust the medication. In addition, if sexual problems are present because of a mental illness, such as anxiety or depression, you can partake in available treatments for these conditions to also see results in your sex life. A holistic evaluation of all mental and physical issues that can alter your sex life may help your therapist determine the most effective treatment.

Does sex therapy last long?

Each client differs, and the amount of time you remain in sex therapy can be your choice. If you're experiencing a short-term challenge, sex therapy may last a few weeks or months. Therapy may take longer if you're experiencing a long-term challenge, mental illness, or memories of a past traumatic experience. Either way, there's no "right" or "wrong" way to do therapy. 

Should I go to sex therapy?

When deciding whether to see a sex therapist, ask yourself what benefit you might gain from treatment. If any of the challenges above seem to be present in your life or you feel you need to talk to someone about your body, intimacy, or sexual touch, a sex therapist may suit you. Note that your family therapist or some "regular" therapists may be able to offer sex therapy techniques as well. 

Online therapy for sexuality and mental health

As a client, practice what is most comfortable for you. If you struggle to get yourself to go in person to an office, you can consider online sex therapy to avoid feelings of awkwardness or shame. Through an online platform like BetterHelp for individuals or Regain for couples, you can find a sex therapist and use a nickname during sessions. In addition, you can choose between phone, video, or live chat sessions for flexibility. 

If you're unsure about the effectiveness of online sex therapy, note that internet-based intervention has been found effective in treating symptoms of sexual dysfunction and increasing improved sexual functioning in clients.