性心理療法 (セックスセラピー)

Rosen, Wiensrein (1991)によると、性心理療法は以下の領域に焦点を当てる必要性があると指摘されています。

  • 性教育
  • 価値の明確化
  • 性に対する態度と信念の探求
  • 性に関するアイデンティティ
  • 性役割の発達
  • 対人関係の問題

以上のような領域への治療的介入により、関係性や性機能を改善・向上させることが性心理療法における目標となります(Long, Burnett & Thomas, 2006).

性心理療法においては、生物学的、心理学的、社会学的側面が含まれており、それらがカウンセラーとクライアントの間において影響しあい、性的な欲求、態度、考え、目的などの関連性に関する理解が深まると言われています(Long, Burnet & Thomas, 2006, p2)。

The principles of sexual counselling may be described by referring to Jack Annon’s PLISSIT Model, which is a counselling tool used in sexuality assessment and therapy.

PLISSIT is an acronym for the following:

P: Permission

LI: Limited information

SS: Specific suggestions

IT: Intensive therapy

Permission – helping a client to explore and normalize his/her sexual dreams, fantasies, desires feelings, thoughts, and behaviors, and communicate them freely and in a non-judgmental manner. The major role of permission is to normalize internal sexuality related thoughts and emotions and create guilt-free and shame-free sexual behaviors and experiences. Normalizing in many cases is sufficient to reduce negative connotations and barriers and it helps to produce positive attitudes toward sex issues.

Limited information – aims to correct false beliefs, sexual myths and incorrect information, and provides factual knowledge about realistic sexual expressions and behaviors.

Specific suggestions – direct interventions which help the client change his/her sexual behaviours and expressions in order to reach desired goals.

Intensive therapy – when more complex and in-depth analysis and interventions are needed. Usually it is a combination of cognitive-behavioural techniques and other therapeutic approaches, including psychodynamic therapy, family therapy, PTSD treatment and others.

Sex therapists offer a variety of interventions, based on client’s needs and desired outcome. Some of them are rooted in different psychological theories, often related to behavioural, psychodynamic, and cognitive-behavioural approaches, while other interventions are more specific to sexuality field.

Some of the common strategies include:

  • Developing realistic and appropriate goals
  • Dealing with emotional traumas which block free sexual expressions
  • Enhancing sexual communication skill
  • Exploration of sexual fantasies
  • Reviving boring sexual repertoire
  • Identifying contextual triggers and catalysts for sexual activity
  • Cueing exercises
  • Behavioural techniques including Sensate Focus exercises
  • Relaxation and mindfulness exercises
  • Exploring alternate forms of sexual expression

Long, Burnett  and Thomas (Long, Burnett & Thomas, 2006) the specific therapeutic areas in sexuality counseling describe as follows:

  1. Female and Male Sexuality (difficulties and disorders treatment)
  2. Sexually Transmitted Infections and Diseases
  3. Minority Groups Sexuality
  4. Aging and Sexuality
  5. Disabilities, Chronic Illness
  6. Atypical Sexual Behavior
  7. Survivors of Rape and Their Partners (individual and couples issues)
  8. Survivors of Childhood Sexual Abuse and their Partners (individual and couples issues)