What Happens in Sex Therapy? The Real Scoop
Do you wonder what happens in sex therapy? The idea of participating in sex therapy is very intimidating for most people. They wonder whether it’s the right fit for their needs. Many people have very varied ideas about what sex therapy is and typically, their imaginations run wild. Heck, before I started training in sexual health, I wasn’t sure what happened in a sex therapy session.
As a Certified Sex Therapist based in Kansas City, I can’t begin to tell you the questions I get from people at cocktail parties or on planes when they find out what I do for a living. Sometimes, I get smirks and jokes, but other times, I get nervous - but sincere - questions. Because no one talks openly about their sex life, most people have no idea how theirs compares or what they need to do differently to enjoy more sexual pleasure. The majority of the people I chat with are genuinely curious.
Unfortunately, there is a lot of misinformation about sexual health. I want to dispel some common myths and help you better understand what it is, what it isn’t, and how to find the right therapist. Here’s the first question I’m typically asked.
Do Sex Therapists Have Sex with Their Clients?
Take a minute to think about sex therapy. What comes to mind? If you’ve seen Gwyneth Paltrow’s Netflix series “Goop,” you may have some graphic images. Goop’s episodes about sex showed a professional inserting her fingers in another woman’s vagina, another helping a woman with tantric practices that caused her male partner to have a full-body orgasm, and a third vignette in which a sex professional stood naked next to a client while they explored body image concerns.
None of these professionals were sex therapists practicing sex therapy. They were sex coaches, not sex therapists. In some states, such as California, a sex coach can touch a client. But that is not the case in most states.
Some people think sex therapists have sex with their clients. Is this true? Absolutely not! All therapists are held to ethical standards regarding relationships with clients. A certified sex therapist cannot touch a client, and cannot have any sexual contact with a client.
What is Sex Therapy?
Sex therapy is a specialized form of talk therapy designed to help individuals and couples navigate sexual concerns, improve intimacy, and address emotional barriers to a satisfying sex life. See the section below for a list of some of the many sexual concerns that are commonly addressed in sex therapy.
What Happens in Sex Therapy?
You might be wondering what sex therapy actually looks like—and you wouldn’t be alone. Pop culture often gives us exaggerated or comedic versions of the profession. A memorable example is Barbra Streisand’s character, Roz Focker, in Meet the Fockers, where she plays a cheerful and exuberantly open sex therapist for seniors. While hilarious, it’s not quite what most people will experience in a real-life session. Sex therapy is far less theatrical and much more grounded in evidence-based psychological support, communication tools, and emotional insight.
Sex therapy sessions vary depending on individual needs, but they typically include the following components:
1. Initial Assessment and Goal Setting
During the first session, a sex therapist gathers information about the client’s sexual history, relationship dynamics, medical background, and any emotional or psychological factors contributing to their concerns. This assessment helps the therapist develop a personalized treatment plan.
2. Education and Communication Strategies
Many sexual concerns stem from misunderstandings, lack of communication, or misinformation about sex. A sex therapist provides accurate, evidence-based information about anatomy, arousal, desire, and intimacy. Very few people grow up learning accurate information about sex and most of us learn how to satisfy a partner through experience. I think there are too many societal myths about what a real man or woman is like sexually.
I also think that too many people think they aren’t good enough in bed and they lack sexual confidence. Think about how Hollywood portrays sex. Usually, it’s two people hotly kissing, ripping their clothes off, and then having intercourse with mutual orgasms. If that’s your benchmark, you’re setting yourself up to feel bad about yourself because this is absolutely not the type of sex most people have, and only a small percentage of people can achieve mutual orgasms.
I help my clients explore what turns them on and off, and what they need to have a successful sexual encounter. Sometimes, I help my clients (talk therapy only) with the nitty-gritty of how to do sexual acts or suggest props or sex toys that will enhance their experience.
Clients also learn effective communication strategies to express their needs and desires. I tell my clients, “If you can’t tell your partner how to load the dishwasher when they aren’t doing it correctly, then how can you expect to tell them how to touch you differently when you are having sex?”
3. Cognitive and Behavioral Interventions
Sex therapists use cognitive-behavioral therapy (CBT) and mindfulness techniques to address performance anxiety, negative self-perceptions, and self-defeating thought patterns. I often give my clients exercises to practice at home, such as guided touch exercises or mindfulness-based techniques to reduce anxiety and enhance intimacy.
4. Addressing Emotional and Relational Factors
Many sexual issues are deeply intertwined with emotional and relational dynamics. Sex therapy may involve exploring past trauma, attachment patterns, or unresolved conflicts in relationships. By addressing these underlying factors, individuals and couples can create a stronger base for a satisfying sex life. Great sex in long-term relationships is built upon the foundation of a great relationship.
What Types of Issues Are Addressed in Sex Therapy?
Sex therapy can help with a wide range of sexual and intimacy-related concerns, including:
Desire Discrepancies: When partners have different levels of sexual desire, leading to frustration or disconnect.
Low Libido: Exploring psychological, emotional, or medical reasons behind low sexual desire.
Erectile Dysfunction and Performance Anxiety: Addressing anxiety, negative thoughts, and confidence issues related to sexual performance.
Painful Intercourse (Dyspareunia & Vaginismus): Helping individuals address pain-related sexual concerns through education, relaxation techniques, and medical referrals if needed.
Orgasm Difficulties: Understanding barriers to orgasm and finding techniques to enhance pleasure and satisfaction.
Recovering from Sexual Trauma: Providing a safe space to process past trauma and rebuild a positive relationship with intimacy.
Rebuilding Intimacy in Relationships: Strengthening emotional and physical connection between partners.
Navigating Changes in Sexuality: Adjusting to changes in sexual function due to aging, menopause, illness, or lifestyle shifts.
What Sex Therapy Is and What It Isn’t
Sex therapy is a professional, talk-based therapy that helps people address emotional and psychological barriers to sexual well-being.
Sex therapy is not a hands-on or physically interactive treatment. Therapists do not engage in any form of sexual activity with clients.
Sex therapy is a safe, non-judgmental space to explore concerns related to intimacy, pleasure, and relationships.
Sex therapy is not only for individuals with sexual dysfunction; it can also help couples strengthen intimacy and connection.
Who Is the Right Client for Sex Therapy?
Sex therapy is beneficial for individuals and couples experiencing:
Low sexual desire or mismatched libidos
Erectile dysfunction or performance anxiety
Painful intercourse or difficulties with arousal
Shame, guilt, or trauma affecting sexual well-being
Relationship conflicts impacting intimacy
A desire for greater emotional and physical connection
How Do I Find a Sex Therapist?
Finding the right sex therapist is essential for effective treatment. If you want a better understanding of how to find a sex therapist, especially a certified sex therapist, please read my blog post, “Sex Therapist vs. Certified Sex Therapist: What’s the Difference and Why it Matters.” Consider the following:
Visit the AASECT.org website: AASECT is the credentialing body for Certified Sex Therapists (CST). They have a directory that allows you to search for a CST by state.
Check Their Credentials: Look for specialized training in sex therapy and licensure in a mental health field.
Ask About Their Experience: Ensure they have experience treating concerns relevant to you.
Seek a Comfortable Fit: A trusting relationship with your therapist is crucial for open conversations.
Conclusion
Sex therapy is a valuable resource for individuals and couples looking to improve their sexual well-being, overcome challenges, and enhance intimacy. Whether you're struggling with desire, performance anxiety, past trauma, or relationship dynamics, working with a skilled sex therapist can provide the support and tools needed for a fulfilling and healthy sex life. If you’re considering therapy, take the first step by finding a qualified professional who aligns with your needs and goals. A healthier, more satisfying sex life is within reach.
