Finding a suitable sex therapist

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One thing that always surprises me is the number of clients we see who have already seen many doctors and therapists before arriving at our door. Sadly, many experiences of seeking help and not finding a solution can give us a sense that we can’t be helped, and that the problem is ‘too big’ leading to hopelessness and sometimes even giving up. In my experience the problem being ‘too big’ is rarely the issue, and it’s more likely that the therapist who was consulted in the past (albeit very competent as a therapist) was not specially trained in sexual medicine, or in the interaction between mind and body so vital for its success, and so the intervention was ill advised and didn’t work. But say you do decide you need to see a sex therapist or such like- how do you choose the right therapist and how do you know you’re getting the best? Equally, how do you know that this therapist has enough knowledge of the warning signs of a physical cause to your difficulties to suggest you see an appropriately trained doctor if needed? Well, there’s certainly lots of choice out there, and this guide is intended to help you find the person that’s right for you.

Check their credentials

You can be sure that Sex therapists, Psychosexual Counsellors and Clinical Psychologists working in sexual medicine all have expertise in working with couples and with sexual problems, but the number of years spent training and the academic level may vary (Clinical Psychologists are trained to PhD level and usually have a broader range of therapeutic skills). Beware someone who lists sexual problems as one of a long list of other ‘problems’ that they can treat- it may be the case but it’s unlikely unless they have specific training or experience. We suggest at the very least you should only consult someone who has postgraduate training in sexual problems, such as a certification from an accredited body like COSRT (College of Sex and Relationship Therapists) or is accredited from the European Society of Sexual Medicine (ESSM) as a qualified practitioner in sexual medicine.

Check your comfort

For you to feel you can talk about things that you haven’t talked about elsewhere, you need to feel confident that you can be comfortable with that person. Check your comfort levels when you speak to them and meet them- but don’t fall into the trap of thinking they need to be just like you for it to work. If you are a gay man wanting to talk about chems, your therapist doesn’t need to inhabit the same world as you to get it. Instead, ask them- what do you know about chems? How would you work with someone struggling with them? You will quickly get a sense of whether you feel they can help you and whether they have a non judgemental manner. This is vital for everyone consulting a sex therapist, especially the case if you identify as LGBT or Q- given the world of psychiatry and psychology has a long documented dark past of problematising normal differences in lifestyle or sexual expression in the LGBTQ community. Luckily these days, therapists who marginalise or treat clients unethically are few and far between, but there are the odd few who struggle to look outside of their own narrow framework for sexual expression and may interpret your sex life as something that it’s not (this is called non gay affirmative practice). The take away message is make sure you feel comfortable, and if you don’t, raise this with them, but don’t feel obliged to carry on seeing them.

Don’t be frightened to ask how it works

Many clients I meet have had therapy before and when I ask them how their therapist worked, i.e. what therapeutic model they used, they don’t know. I always find this amazing, it’s like going to a car garage to buy a Ford, but coming away not knowing whether you’ve bought a Fiesta or a Focus. Ask them about models they use (Cognitive Behavioural Therapy? Psychodynamic? Systemic?) and the evidence base behind it- you need to know how they intend to help you resolve your issue, a brief description of what that model of therapy feels like as a client, and how it is intended to resolve your sexual problem.

Ask for their success rates

A good therapist should be able to give you direct answers about how often they work with this issue, how many sessions it may take to resolve it (bearing in mind therapy can never be an exact science) and what their outcome rates are (the number of people using their services who at the end of the work say its helped). Ask them for this information. If they don’t have it to hand, fine, but if you get a sense they’ve never even considered trying to gather this information, ask yourself why.
Ultimately, choose wisely. You are investing a great deal of your time and potentially your cash on something that’s crucially important to your wellbeing. The right help exists, but putting in the effort in finding it now is the key to ensuring it gets things where you want them to be in the future

 

Dr Karen Gurney, Clinical Psychologist – The Havelock Clinic

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