While lack of desire -- which can take many forms -- is one of the most common reasons to seek sexual counseling, it is far from the only one. If you think you have a sexual problem or are seriously dissatisfied with your intimate experiences, a therapist who specializes in sexuality can serve as a shortcut to the heart of the matter.
There are a number of ways to find a good sex therapist.
First ask those in the counseling business whose professional ethics usually guarantee confidentiality: a pastor, for instance, or a current or former general therapist, or a physician.
A physician may be the best place to start, because a sexual problem could stem from a physical condition or a drug side effect. Having a medical evaluation first to rule out physical causes for your sexual problems can save you time and minimize angst.
Other sources for sex-therapist recommendations include medical and psychological organizations, such as county medical associations. Or, if you really want privacy, go on the Internet and type in "sex therapist'' to find one via a search engine. There are private, legitimate counselors who conduct online sexual therapy.
It's important to ascertain whether a sex therapist has appropriate credentials. One way to do this is to get a referral from an established sex-therapy organization, such as the American Association of Sex Educators, Counselors, and Therapists (AASECT) or the American Academy of Sexologists.
In most states anyone can call himself or herself a sex therapist, but chances are if a practitioner is referred by a professional organization he or she has already met the certification requirements of that group.
For example, the AASECT's requirements for certification as a sex therapist include a master's degree plus three years (1,000 hours a year) of clinical experience as a psychotherapist or a doctorate plus two years of clinical experience as a psychotherapist. The AASECT also requires a state regulator license or certificate in psychology, medicine, nursing, social work, or marriage and family therapy; an alternative requirement exists for states that don't have regulations. Therapists thus certified must also complete at least 90 hours of training in gender-related issues, marital dynamics, psychosexual disorders, and medical factors influencing sexuality. (The remaining requirements are posted on the AASECT web site, listed below.)
Once you find a therapist, make only one appointment for a consultation. Don't sign up for a series of treatments before meeting at least once.
During the consultation, don't be shy about asking questions, advises AASECT Executive Director Howard Rupple, Ph.D., Ed.D. He suggests the following questions:
- What is your educational background?
- Are you involved in professional education work or training?
- What is your approach to therapy? What will happen during the session? What kind of time commitment is necessary?
- What are your fees?
- Have you had experience treating the problem I have?
- What do you require of me? (For example, some therapists will only see a person who is in a committed relationship.)
If a therapist doesn't fully answer your questions, if you don't agree with a therapist's approach or demands, or if you simply don't feel comfortable, go to the next professional on your list, Rupple suggests.
For sex therapy to work, you must have a degree of trust and comfort with the therapist, agrees Roseline Meadow, PhD, a psychologist, a sex therapist, and the author of Women's Conflicts About Eating and Sex. She advises asking how long the person has been a therapist. "It takes years to develop skill in sex therapy," she says. "You learn by doing in this profession."
What about academic titles and publications? "Kindness and empathy are more important," Meadow says.
Keep evaluating once you begin therapy. According to Meadow, ongoing self-evaluation of therapy is important: "If after eight or 10 sessions you're not making progress, then get a second opinion."