Sexual Health Q&A

What happens during sex therapy?

Sex therapy is a form of counseling intended to help individuals and couples resolve sexual difficulties, such as performance anxiety or relationship problems.

Clients generally meet in the therapist’s office. Some choose to attend sessions alone; others bring their partner with them. Session frequency and length usually depend on the client and the type of problem being addressed.

It’s normal for clients to feel anxious when seeing a sex therapist, especially for the first time. Many people have trouble talking about sex at all, so discussing it with a stranger may feel awkward. However, most sex therapists recognize this and try to make their clients feel comfortable. Often, they start with questions about the client’s health and sexual background, sex education, beliefs about sex, and the client’s specific sexual concerns.

It’s important to know that sex therapy sessions do not involve any physical contact or sexual activity among clients and therapists. Clients who feel uncomfortable with any aspect of therapy should speak up or stop seeing that particular therapist.

Sex therapists usually assign “homework”—practical activities that clients are expected to complete in the privacy of their own home.

Such homework might include the following:

Experimentation. Couples who feel they’re in a sexual rut may try different activities, such as role playing or using sex toys, to increase their desire. Other couples may need to adjust their sexual routine or positions, especially if one partner has a health condition that requires such changes.

Sensate focus. This technique for couples is designed to build trust and intimacy while reducing anxiety. Couples progress through three stages, starting with nonsexual touching, progressing to genital touching, and, usually, ending with penetration.

Education. Sometimes, clients do not receive adequate sex education while they are growing up. As a result, they may not be aware of anatomy and how the body functions during sexual activity. Therapists might assign books or web content to read or videos to watch. They might also suggest that clients use a mirror to learn more about their body.

Communication strategies. Clients may practice asking for what they want or need sexually or emotionally in a relationship.

Success with sex therapy often depends on how committed clients are to the process. If clients are willing to put in the effort, either alone or with a partner, they may reach their sexual goals.