A question I often get from potential clients is, what happens in couples therapy for sexual problems? They usually want to know if we will work on the entire relationship, or just focus on the couple's sex life. The answer is, it depends! If the relationship is working, but the sex isn't, then we'll focus on sex. If the entire relationship isn't working, then fixing the sexual piece won't fix everything–though sex therapy may help quite a bit in that couples will need to learn how to communicate, negotiate, trust, be open and honest, and so forth as they discuss their sexuality.
The first step in sex therapy is an evaluation. Until the evaluation is completed, no therapy actually takes place. During the evaluation, we collect information regarding the couple's complaint, including the nature of the problem, when it began, what they've tried to resolve it, as well as questions about earlier sexual and relationship history, both predating the relationship and during the relationship itself.
If the therapist determines that the couple is a good candidate for sex therapy, then a treatment plan is discussed and agreed upon. Therapy takes place minimally every other week, though weekly is better, particularly at the beginning of treatment. Because our treatment is solution-focused, during each session we try to determine what difference to the good has been made and to build upon it. By noticing what IS working and enhancing or repeating it, changes occur. In this way, the couple begins to build confidence in their ability to work through their problem, which also helps strengthen their emotional, intellectual, and, for many couples, spiritual bond.
Couples often wait a long time before they call for help. Admirably, they try to solve their problems privately, on their own. Sometimes, though, a lot of damage is done when solutions don't work or don't stick. Naturally, when they call a sex therapist, they are in a great deal of pain and want immediate relief. If only the therapist could offer such miracles! There is no shortcut to working things out, but if a couple are committed to the relationship and are willing to put faith in the process of therapy, they generally reach their desired outcome of a healthier, happier sexual relationship.
