According to Rosen and Wienstein (1988), sexuality counseling is a process that focuses on the following areas:
- Sex education,
- Values clarification,
- Exploration of sexual attitudes and beliefs,
- Exploration of sexual self-image,
- Sexual identity,
- Gender role development,
- Relationship issues.
The overall goal of therapeutic interventions in sexuality counseling is to improve and enhance relational and sexual functioning. (Long, Burnett & Thomas, 2006)
Sexual therapists include biological, psychological and social dimensions in the counseling process, which in principle is “dynamic interactional process between counselors and clients that facilitates exploration and understanding of connections between sexual desires, practices, attitudes, ideas, and duties” (Long, Burnett & Thomas, 2006, p.2)
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:
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:
- Female and Male Sexuality (difficulties and disorders treatment)
- Sexually Transmitted Infections and Diseases
- Minority Groups Sexuality
- Aging and Sexuality
- Disabilities, Chronic Illness
- Atypical Sexual Behavior
- Survivors of Rape and Their Partners (individual and couples issues)
- Survivors of Childhood Sexual Abuse and their Partners (individual and couples issues)