What is the first step in sex therapy and how to be prepared
When our clients are thinking about starting sex therapy, the process can feel overwhelming. There are some misunderstandings about what sex therapy really is.
We’re going to answer the question “what is the first step in sex therapy” and talk about what sex therapy actually is and what it isn’t. This will help those who are looking for help with their sexual relationship, whether it’s with their partner or themselves.
The hope is to take the feeling of the unknown out of the first sex therapy session and beyond.
Let’s get started by talking about what sex therapy really is.
What is sex therapy
Sex therapy is talk therapy that is focused on the person’s sexuality, sexual functioning, and/or sexual dysfunctions. It is very broad and covers anything about human sexuality.
AASECT, or the American Academy of Sexuality Educators, Counselors, and Therapists, certifies sex therapists who work with clients both in individual and couples therapy. Like all therapy, sex therapy is conducted within the bounds of confidentiality in a non-judgmental environment.
Sex therapy at times is part of couples therapy or general individual therapy. It might also be a stand-alone service for an individual or a couple who are solely struggling with their sexual relationship.
Like any mental health counseling with a licensed professional, sex therapy does not involve touching.
What does sex therapy help with?
Our clients come to sex therapy for a variety of concerns or issues.
Here are a couple of the possibilities, though this is not all of the possible reasons they may come to see us;
Concerns about sex drive, arousal difficulties, or sexual dysfunction
One of the most common reasons partners seek out sex therapy is mismatched sexual desire, also called desire discrepancy or libido mismatch.
They also may seek out help for low arousal or lack of desire.
Performance issues are also an issue that people seek help for, including performance anxiety, erectile dysfunction, or other issues interfering with intimacy.
Sexual pain
Many couples where one partner is experiencing sexual pain, like vaginismus or vestibulodynia.
When one member of the couple is experiencing sexual or pelvic pain, a sex therapist can help the individual couple to process, understand, and cope with the impact this pain has on their sex life.
A sex therapist can also help the couple decrease the impact this pain is having on their intimacy.
Communication and relationship concerns
Sex therapy can help when a partnership is struggling with communication around sex or relationship concerns are interfering with their sex life.
Some concerns the individual or couple might bring to sex therapy might include feeling disconnected from your partner, communication breakdown, or other intimacy concerns.
Sexual trauma and relationship history
A history of trauma, sexual abuse or otherwise, for example, sexual harassment, physical abuse, sexual exploitation, emotional abuse, sexual assault, a life-threatening accident, or any other negative experience that might cause intrusive thoughts or memories can interfere with a person's sex life.
Sex therapy can help alleviate this.
Past negative relationships and even a difficult relationship history with your current partner can interfere with the sexual intimacy between partners. This also can be treated by a sex therapist.
Identity concerns
A sex therapist can provide a non-judgmental environment for a person to work through gender identity and sexual orientation questions.
They can help a person to find clarity in who they are and become more comfortable with that part of themselves.
Emotion and body image factors
Many clients struggle with feeling comfortable in their body for a variety of reasons. Others raised in sexually restrictive cultures may struggle with sex and sexual activity.
Sex therapy can help you to become more comfortable in your body and with sexual activity. They can help you to engage in an intimate sex life that you are happy with.
A sex therapist won’t just help you get past these issues; they will also help you cope and process the hard feelings that these concerns might bring up.
Before your first sex therapy session
The first step is reaching out for an intro video call with a therapist. It’s complimentary, and you can start by scheduling yourself here. During this video call, we’ll talk about your goals and see if we are a good fit.
Often we will schedule your first appointment during this first video phone call. You will then receive your paperwork.
Intake and history taking: The first step in sex therapy
Now let’s talk about the actual first step in sex therapy, your initial sessions.
During these first couple of sessions, the therapist’s goal is to get to know you, your struggles, and your goals. Your therapist is also creating a safe space between you, your partner (if couples therapy), and your therapist.
Part of getting to know you and learning more about your goals is your therapist doing an assessment of your communication, history, and relationship.
Among other things, they are looking for negative sexual experiences, substance use/abuse, mental health history, and medical history or concerns (like sexually transmitted infections or menopause related changes and current medications).
This is how your therapist creates a treatment plan or a path to help you meet your goals.
They will ask questions about your sexual history, what has gone well, and what has not. You will answer questions about your relationship history, including your current relationship and what your strengths are, what you enjoy together, and what your struggles have been.
Throughout the whole process, your therapist is helping you to rebuild trust and safety with your partner.
This step can take between 1-3 sessions.
After the assessment phase,, we can work through the next steps of sex therapy. Of course, your therapist continues to gain an understanding of who you are and what’s going on throughout therapy, but these are the first steps.
What does long-term sex therapy look like
After the initial stage of sex therapy, it’s time to start the work and start moving towards your goals.
You’ll work together with your therapist to develop open communication, increase pleasure, and engage in more open sexual expression between you and your partner.
Many sex therapists will use sex therapy skills training to teach you how to use sensate focus, or pleasure enhancement skills.
For most people, sex therapy is about building the type of intimacy you want to have, on your own terms. Your therapist will help you figure out what that is, and how to get there.
For some people, sex therapy also includes education about sexual development, as well as sexual and reproductive anatomy/physiology. This allows for better self-understanding and problem-solving.
If it fits your needs, your sex therapist may assign you and your partner homework to practice at home (such as mindfulness, personal reflection skills, or communication exercises). The therapist always moves at your pace and tailors every step to you.
If you have a history of trauma that is impacting your sex life,, your therapist may suggest a specific treatment for trauma, such as eye movement desensitization therapy (EMDR).
Your first step to start sex therapy in Washington, D.C.
At the Center for Intimacy and Relationships, our therapists are experts in sex therapy, including working with the LGBTQ+ community, including kink, BDSM, polyamory, and consensual non-monogamy.
Now that you know what the first step in sex therapy is, if you’re ready to get started, reach out for your free consultation here.
