Sex Therapy Models Transcript
Hello, and welcome to the kick-off presentation on sex therapy. In this presentation, I will discuss what sex therapy is and then introduce four models of sex therapy. I will wrap up the presentation with a discussion on one Major Marriage and Family Therapy Model and how it could affect sex therapy.
Sex Therapy
Sex therapy refers to a type of talk therapy aimed at helping couples and individuals address interpersonal, personal, psychological or medical factors affecting their sexual satisfaction. The main goal of sex therapy is to aid individuals in moving past their emotional and physical challenges to have a more satisfying relationship as well as a pleasurable sex life. Most people experience sexual dysfunction. Studies have shown that about 43 per cent of women and 31 per cent of men have experienced at least one type of sexual dysfunction in their lifetime (Rosen, 2020). Such dysfunctions include low libido, erectile dysfunction, premature ejaculation, excessive libido, low confidence, lack of interest, distressing sexual thoughts, inability to control one’s sexual behaviour and unwanted sexual fetishes. Romantic relationship stability and satisfaction are key to healthy adult functioning. Studies reveal that unhappy couples tend to attribute about 50 to 70 per cent of the distress in their relationship to sexual problems that they encounter (Morgis et al., 2019). It is highly challenging for most couples to talk about their sexual intimacy. Consequently, many choose to rely on stereotypes to help understand their awareness of the sexual preferences of their partners as opposed to openly communicating about their sexual needs, likes, and dislikes. According to Morris et al. (2019), when partners find a way to develop a secure and strong romantic attachment bond with each other, built on emotional security and safety as well as vulnerability, they can better communicate their sexual needs and concerns. This enhances the satisfaction of their sex life and their whole relationship. Sex therapy can help struggling couples and individuals attain this. Hire our assignment writing services in case your assignment is devastating you. We offer assignment help with high professionalism.
Psychosocial Approach to Sex Therapy
The psychosocial model is a model that focuses on sexual dysfunction as a multidimensional and multicausal couple problem as well as relapse prevention, treatment, and approach assessment by respecting value, cultural, couple, and individual differences (McCarthy & Wald, 2017). This model seeks to deal with the whole persona physically, psychologically, and medically. For change to occur, there is a need to use psychological, relational, and biological resources, with an increased focus on heightened satisfaction and desire. This model defines sexuality as a range of scenarios, feelings, and attitudes. Besides aiding in orgasm and intercourse, this model also looks into other sexual dimensions. The main goal of this model is to replace the desire for a perfect individual sexual performance and replace it with “good enough sex” with realistic and positive couple expectations. Having a “good enough sex” approach puts emphasis on flexible and variable sexual outcomes instead of a “cure” that focuses on a perfect performance. According to McCarthy and Wald (2017), even among sexually and relationally functional couples, it is common to have about 5 to 15 per cent of sexual encounters that are dysfunctional, mediocre, or dissatisfying. Consequently, the psychosocial model, together with the good enough sex model, focuses on the acceptance of a normal complexity and variability of the couple and individual sexuality. Even though an ideal situation would be one where there is a mutual synchronous experience in which partners experience orgasm, arousal, desire, and sexual satisfaction, this is not considered a realistic expectation of normal sexuality in every encounter.
Mindfulness Approach
The mindfulness approach incorporates a “here and now” approach to building sexual intimacy (Thouin-Savard, 2019). Mindfulness practices can include a wide variety of activities and exercises that can be used to help individuals in their sexual relationships. Such practices are aimed at helping individuals to observe themselves and the world around them in a non-judgmental and open manner. This tends to heighten their awareness of experiences, emotions, feelings, and thoughts at the moment. Thouin-Savard (2019) discusses an approach known as embodied mindfulness, which focuses on where one’s attention comes from in their body. In this case, the observer of sensations, emotions, and thoughts is the moment-to-moment awareness that focuses on the experience that is present to the senses and not the conventional narrative of a historical self. Mindfulness helps people to develop empathy and have a sense of being non-judgmental. When individuals become more mindfully attentive to their own and other peoples’ feelings and thoughts in the present moment, they have a high likelihood of finding common ground and engaging in greater intimacy in their relationships, allowing them to engage in higher degrees of valued action and enhance their general quality of life in the process, moment after moment (Thouin-Savard, 2019). Mindfulness practices have been linked with increased lubrication, sexual arousal, sexual desire, sexual satisfaction, and general sexual functioning among women (Thouin-Savard, 2019). Mindfulness practices also encourage more direct access to one’s body sensations by lessening negative self-evaluation and training attention. The lessened frustration, self-criticism, guilt, and anxiety that most people encounter will likely enhance sexual arousal and boost sexual satisfaction that aids in partners’ sexual relationships.
Sensate Focus Model
The sensate focus model is a developing model that offers clinical work and direction around emotions and sensory or stimulus experiences (Hunt & Nelson, 2017). This model is aimed at enhancing communication and intimacy between partners around the topic of sex, lessening sexual performance anxiety, and shifting attention away from goal-oriented and ingrained patterns that might not serve the interests of a couple. The technique involves touching exercises that couples need to complete in a series. The practice begins with non-genital touching, then touching, including breast touching, touching including genital touching, mutual touching, including insertion of toys and fingers but no intercourse, and finally, intercourse without orgasm (Hunt &Nelson, 2017). The couple can pay attention to the sensual feelings of each other, allowing them to explore their own and their partner’s responses to touch, thus helping them to reduce the anxious feelings and thoughts that raise sexual concerns and interfere with sexual functioning (Linschoten et al., 2016). Thouin-Savard (2019) show that when mindfulness practices like embodied mindfulness precede these activities, they can result in heightened sexual satisfaction, lubrication, sexual arousal, sexual desire, and general sexual functioning between couples. The aim of sensate focus is to enable partners to abandon their judgments and expectations about mutual touching and instead concentrate on the sensory aspects of touch, like pressure, texture, and temperature. This allows the couple to relax and become mindful of the experience of sensual touching without being weighed down by certain preconceived concepts of what ought to happen. Sex therapists tend to recommend this technique to couples who wish to address issues surrounding body image, premature ejaculation, orgasm, desire, arousal, as well as erectile dysfunction. However, sex therapists need to understand that other medical conditions might be underlying the problem. Therefore, a physical examination is required to rule out any probable causes for sexual dysfunction.
Masters and Johnson, the individuals behind the sensate focus therapy, believed that offering sensations upon which distressed sexual partners could concentrate on their own sensorial participation would help lessen the anxious feelings and thoughts that attended their sexual concerns and got in the way of their sexual functioning. Linschoten et al. (2016) argue that concentrating on reliable and vivid sensations through sensate focus is the most effective way of honouring the fact that sex is a natural process and not something that one should be embarrassed about. This process is vivid in that it captures one’s immediate attention and is reliable in that it is always available for focus. Sensate focus provides a way for one to get the conscious mind out of the way and allow autonomic functions to take place. One key concept of sensate focus is for one to control their fear of spectating and performance; they need to be involved in their own sensory absorption. This implies that every partner touches themselves so that the toucher experiences sensation for the purpose of attending to their sensations. For this to work effectively, touch needs to be attended to mindfully, with no regard for any physiological or emotional reaction, including the emotions of pleasure, enjoyment, arousal, or relaxation for the partner or self. This shows that mindfulness is an important tool in the process of sensate focus. Sensate focus helps to identify and resolve relationship problems like poor communication, couple dynamics, and power struggles that tend to interfere with the couple’s goals. Notably, it focuses on the couple’s communication levels and skills. As such, equal time in every role is important, and 15 minutes for each partner is usually recommended.
The PLISSIT Model
The PLISSIT model is a method that incorporates conversations around sex into practice (Clairborne & Rizzo, 2006). This model was developed by Annon as a framework that would help sex therapists to offer help in ordering and treatment of various sexual problems. The acronym refers to the four stages involved: permission, limited information, specific suggestions, and intensive therapy (Rutte et al., 2015). The first step involves allowing patients permission to air their sexual problems. The second stage is about giving patients limited information regarding the sexual side effects of treatment. The third stage is about making particular suggestions that are based on a full assessment of the presenting issues. Lastly, a referral to intensive therapy is conducted, including psychological interventions, sex therapy, and biomedical approaches. According to Clairborne and Rizzo (2006), every treatment level builds on the former one, and a therapist has the freedom to move back and forth between the different treatment levels. As treatment shifts from one level to the next, the degree of skill needed from the therapist heightens, and so does the intensity of work with the client. This model is applicable to homosexuals and heterosexuals alike since the interventions are client-specific and are also specific to the sexual concern and chronic health condition of the client and their partner (Clairborne & Rizzo, 2006). The PLISSIT model is commonly used among clients with certain chronic illnesses like type II diabetes who tend to face various sexuality problems. However, the model was not specifically formulated for this population.
Cognitive Behavioral Therapy
The cognitive behavioural therapy of MFT assumes that family relationships, emotions, behaviours, and cognitions mutually affect each other. Cognitive inferences tend to evoke behaviour and emotion. Behavior and emotion, in a similar manner, affect cognition. This theory is based on schemas, which are core beliefs about the world, as well as the organization and acquisition of knowledge. Since positive sexual fantasies are linked to positive affect, general sexual arousal, and physiological arousal, a cognitive therapist would encourage the client to deliberately identify any arousing sexual fantasies that they might have. The ideal couple for CBT therapy is one with a particular sexual dysfunction, is in a committed marriage, has no severe non-sexual relationship issues, and is willing to recognize sexual relations style as a task to be performed by the couple. The three main components of the cognitive behavioural approach include replacing anxiety about sexual interactions with sexual comfort, making use of positive attitudes about sex as well as learning sexual skills, and using a program that has exclusively planned sexual exercises which need to be performed between the therapy sessions. The goal of CBT is to develop a comfortable, satisfying, and functional sexual life. Sex therapists normally work with couples who are already established, but sex therapy can be executed with people who lack steady sexual partners. Cognitive behavioural sex therapy can be best theorized as a form of couples’ psycho-therapy. During CBT, it is important to assess the sexual complaints and functioning of the couple. A detailed sex history will be important in determining any underlying issues. It is important to perform a medical examination to rule out any possible medical factors contributing to sexual dysfunction (McCarthy, 2019).
Conclusion
Romantic relationship stability and satisfaction are critical for healthy adult functioning, but various factors can make attaining and sustaining relationship satisfaction difficult. Various studies have shown that sexual satisfaction is a key indicator of relationship satisfaction. Accordingly, when couples are dissatisfied with their sex lives, they tend to generally be dissatisfied with their relationship. There are very few couples who have a clear understanding of the concerns of their partners regarding sexual relationships. Effective sexual communication can help couples to attain better well-being. Sex therapy is considered a major tool that some couples seek to help address the various sexual dysfunctions that they might face. However, most couples fail to address the sexual issues that they face due to the vulnerability, emotional closeness, trust, and effective communication required. When partners are able to develop a secure and strong romantic attachment bond with each other, built on emotional security, safety, and mutual vulnerability, they can communicate their sexual needs and concerns better. This results in a better and more satisfying sex life. Sex therapists can make use of various models to help couples attain a more satisfying sexual relationship. The commonly known approaches and models include the psychosocial approach, mindfulness approach, sensate focus model, and the PLISSIT model. Even though these models are different, they all seem to have the goal of enabling couples to manage their sexual problems through better communication and understanding of the needs, likes, and dislikes of one another. In addition, cognitive behaviour therapy can be used in understanding sex therapy as a therapy that looks at how cognitions, behaviours, and emotions can impact the sexual relationship of couples.
References
Claiborne, N., & Rizzo, V. M. (2006). Addressing sexual issues in individuals with chronic health conditions. Health & Social Work, 31(3), 221–224.
Hunt, Q. A., & Nelson, M. (2017). In T. Carlson & S. Dermer (Eds.), The sage encyclopedia of Marriage, family, and couples counselling (Vol. 4, pp. 1495-1497). SAGE Publications, Inc.
Linschoten, M., Weiner, L., & Avery-Clark, C. (2016). Sensate focus: A critical literature review. Sexual and Relationship Therapy, 31(2), 230-247.
McCarthy, B. (2019). A cognitive-behavioural approach to sex therapy. In Comprehensive Handbook of cognitive therapy (pp. 435-447). Springer, New York, NY.
McCarthy, B., & Wald, L. M. (2017). A psychosocial approach to sex therapy. In Z. D. Peterson (Ed.). The Wiley Handbook of Sex Therapy (pp. 190-201). John Wiley & Sons.
Morris, B. L., Ewing, E., Liu, T., Slaughter-Acey, J., Fisher, K., & Jampol, R. (2019). A hold me tight workshop for couple attachment and sexual intimacy. Contemporary Family Therapy, 41(4), 368-383.
Rosen, R. C. (2020). Prevalence and risk factors of sexual dysfunction in men and women. Current Psychiatry Reports, 2(3), 189-195.
Rutte, A., van Oppen, P., Nijpels, G., Snoek, F. J., Enzlin, P., Leusink, P., & Elders, P. J. (2015). Effectiveness of a PLISSIT model intervention in patients with type 2 diabetes mellitus in primary care: design of a cluster-randomized controlled trial. BMC Family Practice, 16(1), 1-9.
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Question 
This week, you will create a PowerPoint presentation that highlights some of the basics of sex therapy. Be sure to gear this presentation toward MFT internship students who are thinking about increasing their skills and understanding of sex therapy.
Sex Therapy Models Transcript
Be sure to address the following key points in your PowerPoint:
• Describe sex therapy.
• Define at least four sex therapy models or approaches and describe how these can be applied when working with relationships.
• Discuss how one MFT model could address sex therapy.
Note: Provide a transcript for the presentation.
Length: 7-8 slides with speaker notes of 250-300 words per slide