What exactly is a sex therapist, how do I know if I need one, and where can I find a sex therapist that’s qualified to work with me?

Ian: Unlike many other mental health professions, sex therapy is a largely unregulated field that does not require licensure in most states. As a result, there are lots of people who call themselves sex therapists that are largely unqualified to practice. A sex therapist is very often someone who was originally trained in a related field such as psychology, social work, or counseling and has chosen to go on to specialize in the treatment of sexual issues. A sex therapist might also be a person who did not previously come from a related clinical field, but has received both a proper education, as well as clinical supervision, from a university that offers a qualified graduate program in Human Sexuality.

When dealing with sex and relationships, it’s often difficult to separate the sex part from the relationship part. But that’s exactly what a sex therapist tries to do -- not that sex therapists don’t care about your bigger relationship concerns, or don’t want to talk about them, but very often it’s important to isolate the actual sexual issues from the underlying relationship factors. Experience has shown that fixing your relationship won’t necessarily fix your sex life, so sex therapists like to focus on specific behavioral therapies that are known to successfully address a broad range of sexual problems.
Some of the more common problems that sex therapists deal with include premature ejaculation, erectile disorder, female orgasmic dysfunction (inability to reach orgasm), female sexual unresponsiveness, low libido and lack of desire, interpersonal psychodynamics around sexual issues, and lack of communication between couples about their sex lives.

Heidi: Oh. So, it’s not going to be like the sex therapist on HBO’s Real Sex?

Ian: Uh -- no. This reminds me of a time I was running late for a session with a newly married couple and when I finally walked through the door, they were both sitting on the couch completely naked, nervously covering their private parts. When I asked them why they were undressed, the husband said, “Isn’t this sex therapy? Aren’t you going to watch us have sex and then give us tips and pointers?” I explained that sex therapy was talk therapy and all homework assignments would be done outside the office. I thought they’d be relieved when I told them to get dressed, but they were disappointed. Turns out, they were looking forward to getting it on while someone else was watching.

Heidi: Well there go -- I guess there’s a little bit of the exhibitionist in everyone.

Ian: If you go to a sex therapist, you will not be asked to get undressed or engage in sexual activity. Sex therapists use their time with patients to foster communication and understanding, as well as to pinpoint the precise nature of a given sexual problem.

Sex therapists will often give their patients “homework” that includes intimacy-building activities of a sexual nature and then discuss the results of those assignments later during an in-office session. Sexual dissatisfaction is the number two reason for divorce in this country and, unfortunately, lawyers far outnumber sex therapists. But if you’re having a sexual problem and would like help, you can locate a qualified sex therapist by contacting organizations such as AASECT (the American Association of Sex Educators Counselors and Therapists), www.aasect.org, and the American Board of Sexology, www.americanboardofsexology.com, or the American Association for Marriage and Family Therapy, www.aamft.org.