One evening, as I was sitting with friends and colleagues discussing my chosen occupation, one of the questions that popped up (sorry, no pun intended) was “What exactly do sex therapists do?”
I realized that although this was common knowledge to me, an other in the profession, it’s likely that many people do not really know what being a sex therapist means. Let me clear things up.
To begin with, the most prominent certification body in North America is The American Association for Sex Educators, Counselors and Therapists (AASECT). They generally outline the requirements needed to become a sex therapist, counselor, or educator. I will only be focusing on the “sex therapist” designation here.
Generally speaking, sex therapy is a subspecialty within the psychology field, much like oncology is a specialization in the medical field.
To become a sex therapist you need a Master’s degree, plus two years of post-degree clinical experience as a psychotherapist, or a Doctorate degree plus one year of post-degree clinical experience as a psychotherapist. Additionally, you must be licensed in an area of psychology, medicine, social work, counseling, nursing, or marriage and family therapy.
After all of this, a sex therapist must also take a wide range of courses in specialized subject matter like:
- Sexual and reproductive anatomy and physiology;
- Sexual development, relationships – marital, family, etc.;
- Factors that intersect with sexuality such as socio-cultural factors, medical factors, gender issues/identities, sexual orientation, substance abuse, sexual abuse etc.;
- Atypical sexual behavior, hyper-sexuality, and sexual dysfunction;
- Sexually transmitted infections and safer sex practices;
- History of the discipline and the most recent research and literature;
- Training in theory and methods of sex-related psychotherapy;
- Assessment and diagnosis of psychosexual disorders and medical intervention.
HOW THERAPY WORKS
There are a great many sexual behaviors that seem medical but are actually psychological in nature. As a sex therapist, that’s part of my job to determine. My job is to help individuals explore and understand the roots and causes of this behavior – sometimes it’s to help them change the behavior, and sometimes it’s to help them adapt into who they are or want to be.
There are no limitations to what I am likely to deal with when it comes to sexuality issues. Common issues that people come in with, include anything from the basics of sexual dysfunction or disorders such as erectile dysfunction or “painful sex”, desire issues, and premature ejaculation to things like transgendered identity issues, LGTBQ concerns, and alternative sexual lifestyles such as BDSM, swinging, or certain fetishes to only name a few…and there are many!
Sex therapy from a psychotherapy perspective is talk therapy, but I also include behavior therapy and psychoeducation in my practice. Typically, clients will come in for 1-hour sessions, and from time to time I will give homework for clients to do on their own. Various methods are used to explain and educate, including visual material which, predictably, can be sexually explicit, in order to make sure clients clearly understand.
Who I work with varies from case to case. Sometimes I work with an individual for couples issues, or sometimes I work with the couple to help with the individual issues. It all depends on what issues are being brought forth and what I need to do to help. Most of the time, this involves asking questions to figure out what is going on and determine how much of the activity or issue is biological in nature versus psychological in nature or what the combination of these are.
Hopefully this gives you a better understanding of sex therapy in a short snapshot on what we do. I encourage you to ask questions as much as possible, just be prepared for the answer! Sexuality is a normal, healthy, and natural part of being human and there is no need for embarrassment to seek support in overcoming challenges related to sexuality or intimacy.
By Dr. Cory Hrushka, C.S. D.S.T. NCPC, NCCE
Senior and Forensic Psychologist
AASECT Diplomate of Sex Therapy/Sex Therapist and Supervisor