Sex therapy: Types, common issues, and what to expect

Reviewed by Stephanie Steinman, PhD, CSAC

Written by

Last updated: 09/06/2024

A couple sit on a couch talking to a therapist

What is sex therapy?

Sex therapy focuses on helping individuals and couples manage and overcome any sexual concerns affecting their relationships and overall well-being. It involves working with a sex therapist who offers a safe space to discuss and address challenges related to sex and intimacy.

Sex therapists vs. sexologists

Sex therapists are licensed mental health professionals who specialize in addressing sexual issues, while sexologists study human sexuality from a scientific perspective.¹

Sex therapists typically have advanced degrees in psychology, counseling, or social work, along with specialized training in sexual health. Sexologists, on the other hand, may come from various academic backgrounds. They focus more on research, education, and advocacy related to sexuality.

While both professions deal with sexual topics, sex therapists work with clients to resolve sexual concerns and improve intimacy.

Types of sex therapy

Sex therapists have a variety of therapeutic approaches they can use to address issues related to sex and intimacy. Therapy modalities commonly used in sex therapy include:

Cognitive behavioral therapy (CBT), which helps people identify and change negative thought patterns and behaviors affecting sexual function.
Psychodynamic therapy, which explores unconscious motivations and past experiences influencing current sexual issues.
Mindfulness-based therapies that teach present-moment awareness to reduce anxiety and enhance sexual experiences.
Couples therapy that focuses on improving communication and intimacy between partners.
Eye movement desensitization and reprocessing (EMDR), which may help people process traumatic experiences affecting sexual function.
Sensate focus therapy, which uses structured touch activities to reduce performance anxiety and increase sensual awareness.
Psychoeducation thatprovides accurate information about sexual anatomy, function, and health.

These approaches may be used separately or in a combination, depending on the client’s needs. Visit our directory to find a therapist in your area who can help address your specific concerns.

Common issues addressed in sex therapy

Sex therapy can help with a wide range of concerns individuals may face, including:

Low libido
Erectile dysfunction or premature ejaculation
Difficulty achieving orgasm
Pain during intercourse
Body image issues affecting sexual confidence
Sexual anxiety or performance anxiety
Gender identity or sexual orientation concerns
Challenges related to aging and sexuality
Sexual side effects of medications or medical conditions
Concerns about sexual addiction or compulsive behaviors
Sexual concerns related to chronic illness or disability
Sexual side effects of hormonal changes (such as menopause or andropause)

Another concern sometimes addressed within sex therapy is sexual trauma. Sexual trauma can interfere with a person’s interest in, and ability to engage in, intimacy and sex. Some people may need individualized trauma therapy before they are ready to explore sexual concerns. It’s always the individual’s choice if they want to pursue sex therapy.

Sex therapy can also address issues that present within relationships, including:

Navigating non-traditional relationship structures (such as polyamory or open relationships)
Rebuilding intimacy after childbirth, surgery, or major life changes
Improving sexual communication skills
Overcoming differences in religious or cultural barriers to sexual expression
Developing strategies for maintaining long-term sexual satisfaction in relationships
Differences in desire levels between partners
Intimacy problems or trust issues following infidelity
Mismatched sexual preferences

Sex therapy helps individuals and couples explore and enhance their sexual experiences, fostering a more fulfilling and satisfying intimate life. Treatment may include learning new techniques for pleasure, expanding sexual repertoires, or addressing specific fantasies and desires.

What to expect from sex therapy

In sex therapy, clients can expect a confidential and non-judgmental environment. The therapist will begin with a thorough assessment of the individual’s or couple’s concerns, sexual history, and relationship dynamics.

Sessions typically involve open discussions, practical education, and homework assignments to practice new skills or techniques outside of therapy. The duration of treatment varies depending on the specific issues being addressed. When it comes to specific sex therapy techniques, the approach will likely be shaped by the therapist you choose to work with and the issues you’re facing.

For instance, in some cases an eight-week mindfulness-based cognitive therapy intervention has been successfully tailored to address sexual dysfunction.² Other research suggests art therapy, sex therapy, and emotionally focused therapy could be most beneficial when paired with each other.³ There’s no one-size-fits-all approach.

It’s important to note that sex therapy doesn’t involve any physical contact between the therapist and client. All physical exercises are performed privately by the client or couple. The therapist will not instruct client to undress or instruct sexual intimacy in the moment.

Additionally, sex therapists do not “choose sides” when working with a couple. They will also not try to convince or manipulate a client into doing anything they do not want to do.

Sex therapy for individuals vs. couples

Sex therapy can be beneficial for both individuals and couples, but the approach may differ. For individuals, therapy may focus on personal sexual concerns, self-exploration, and building confidence. Couples sex therapy may address relationship dynamics, communication issues, and mutual sexual satisfaction. In both cases, the therapist tailors treatment to clients’ specific needs.

Individual therapy may involve more introspective work, while sex therapy for couples emphasizes joint problem-solving and improving intimacy. Some couples may choose to attend both individual and joint sessions. This allows each person to address personal issues alongside relationship concerns.

Is sex therapy awkward?

Many people feel uncomfortable discussing intimate details of their sex lives. But experienced sex therapists are skilled at creating a safe and non-judgmental space for their clients. They approach sensitive topics professionally and compassionately, helping clients feel more at ease over time.

It’s normal to feel some awkwardness at first, but this usually diminishes as therapy progresses. Therapists may use humor and normalizing language to reduce tension and help clients open up.⁴ Keep in mind that sex therapists are trained professionals who have heard a wide range of concerns and are there to help, not judge.

Is sex therapy effective?

Research indicates that sex therapy can be highly effective for many sexual concerns. Cognitive behavioral sex therapy, for instance, may be as effective as medication for treating nonorganic erectile dysfunction in men.⁵ For women, mindfulness-based sex therapy has been shown to help with sexual desire and arousal.⁶

Success rates vary depending on the issue being addressed and individual circumstances. Factors that can contribute to effectiveness include client motivation, therapist expertise, and the willingness of partners to participate fully in treatment.

Finding a sex therapist

Many people don’t seek help for their sexual issues. Stigma, cost, and accessibility are some of the major obstacles to seeking sex therapy.⁷ Misconceptions about what sex therapy entails can also deter people from seeking help.

When selecting a therapist, it’s important to consider their credentials, experience, and approach to ensure a good fit. Look for therapists certified by reputable organizations, such as the American Association of Sexuality Educators, Counselors, and Therapists (AASECT), and those specializing in your specific concerns.

Many therapists offer initial consultations, allowing you to ask questions and gauge your comfort level before committing to therapy. Don’t hesitate to interview multiple therapists to find the best match for your needs.

To find qualified sex therapists in your area, visit our directory.

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