Want good sex? A group may be the solution…

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When it comes to seeking psychological help for sexual difficulties, meeting one to one with a therapist is often the first thing we might consider. Although this type of work is common, there has been a considerable shift in the way psychosexual therapies are delivered in recent years. This has included a far greater variety in the type of treatments on offer, including short term therapies, online interventions and increasingly, group-based work.

Arrgh! not a group!

The thought of attending a group (for anything, let alone for something related to sexual difficulties) can often provoke a cringe inducing sense of anxiety for many of us. The popular portrayal of group therapies, particularly though TV and films, can understandably give us the impression that we will be asked to share our deepest and darkest feelings with people we don’t know.  Unsurprisingly, this can feel like a daunting prospect, and often for many years group work has been seen (both by professionals and those living with sexual difficulties) as the poor relation to more traditional one to one treatment.

What is the evidence?

In fact, the evidence of the effectiveness of group treatments for psychosexual difficulties has been building over recent years [1]. Research in this area actually started as early as the 1980s, with studies showing that group interventions could significantly reduce symptoms of a range of sexual problems; including erection difficulties, female genital pain and loss of sexual desire[2,3,4]. More recently, there have been a growing number of studies that have shown how successful group therapies can be in treating sexual problems that affect both men and women, in a relatively brief treatment model (anywhere between 5-8 sessions) [5,6]. In addition to this, there is now evidence that these can be as effective (if not more effective!) than one to one treatments [7].

So what are these groups really like?

In recent years, group treatment that have been developed for sexual difficulties are often very far away from the stereotypical images we might get about therapeutic groups. Here are some ideas about what you might expect from a modern psychosexual difficulties group:

  1. For most groups there is absolutely no obligation for you speak publicly or to share anything at all (let alone anything personal or revealing). Many group treatments will build in space for reflections, questions and comments, and of course if you feel able you can share something about your own experiences, but this is not compulsory and not sharing does not impact the quality of the treatment you receive.
  2. Psychosexual groups are typically built around a psycho-educational model. What this means if that each session will be run by a highly skilled psychologist or therapist who will disseminate information and talk though techniques and strategies relevant to the sexual difficulty being discussed. Topics will vary each week and will encompass a variety of areas designed to help you reduce symptoms and increase enjoyment in your sex life.
  3. There is generally an emphasis on you practicing at home the strategies and skills you learn about in sessions. This often includes your partner if you have one and allows you test out things and explore your body in different ways.
  4. Most groups now include designated time (either during sessions or in between sessions) for you to speak with the therapist one on one. Some group treatments even build in a few one to one sessions as part of the work. These are designed to help monitor progress and allow you to speak about anything you feel uncomfortable discussing the group setting. The aim is to ensure you are getting the most out of the treatment, to tailor it to your individual needs and help bolster the knowledge you would have gained from group sessions.

What is the feedback from those attending groups?

On the whole it seems overwhelmingly positive. Studies that have looked at the experience of those attending psychosexual groups have found that not only are participants generally very satisfied but treatments also reduce symptoms and associated distress [8]. There are several ways in which group work can benefit individuals beyond simply reducing symptoms however. These can include:

Sharing ideas and learning from others, particularly having the opportunity to get the perspectives of others that might be experiencing similar difficulties

Normalising problems, including recognising how common sexual difficulties can be, and how many (‘normal’) people experience them too

Imparting knowledge and being able to share what you know and have learnt to help others facing similar challenges.

These aspects are unique to groups and can offer something that can’t be offered in one to one work. For many it is these things that make the difference, and make psychosexual groups something that can offer the opportunity for lasting change for those living with sexual difficulties.

Making a decision about the treatment for sexual difficulties that you feel comfortable with can feel daunting at times. At the Havelock Clinic we have a team of specialist doctors and psychologists who can offer support and help you to achieve the sex life that you want, and offer treatment in a variety of ways, including one to one face to face or by Skype, and in online anonymous groups.

 

Dr Michael Yates, Clinical Psychologist, The Havelock Clinic.

 

References

  1. Kaplan, H. (2013). The New Sex Therapy: Active Treatment of Sexual Dysfunctions. Routledge: New York
  2. Kilmann, P. R., Milan, R. J., Boland, J. P., Nankin, H. R., Davidson, E., West, M. O., … & Devine, J. M. (1987). Group treatment of secondary erectile dysfunction. Journal of sex & marital therapy, 13(3), 168-182.
  3. LoPiccolo J. & LoPiccolo L. (1982). Handbook of Sex Therapy. Spinger; New York.
  4. Hurlbert DF, White LC, Powell RD, et al.(1993). Orgasm consistency training in the treatment of women reporting hypoactive sexual desire: an outcome comparison of women-only groups and couples-only groups. Journal of Behavioual Therapy and Experimental Psychiatry,24(1), 3-13.
  5. Brotto, L. A., Chivers, M. L., Millman, R. D., & Albert, A. (2016). Mindfulness-based sex therapy improves genital-subjective arousal concordance in women with sexual desire/arousal difficulties. Archives of sexual behavior, 1-15.
  6. Fruhauf, S., Gerger, H., Schmidt, H. M., Munder, T., & Barth, J. (2013). Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis. Archives of Sexual Behavior42(6), 915-933.
  7. Gurney, K., Bullemor-Day, P., Kiddy, C., van der Walt, H., White, K., Yates, M., Jamieson, R., Ashby, J., Ghosh, I. & Reichenbach, S. (2017). The evaluation of a new service model for providing effective and costs efficient sexual problems services in sexual health. In press.
  8. Brotto, L. A., & Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women.Behaviour research and therapy57, 43-54.

 

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