Introduction to Sex Therapy SexTherapy-Online, PLLC Rhiannon Beauregard, MA Licensed Marriage and Family Therapist and Supervisor Certified Sex Therapist Specialist-Problematic Sexual Behavior

About the Therapist Rhiannon Beauregard, MA, LMFT-S, CST is a Licensed Marriage and Family Therapist, AASECT Certified Sex Therapist, and Specialist- Problematic Sexual Behavior Licensed in five states: Maine, Massachusetts, New Hampshire, New York, and Texas Specializing in Sex Therapy with individuals and relationships and problematic sexual behavior

What is Sex Therapy Sex Therapy is the treatment of sexual issues through empirically proven therapeutic techniques. Sex Therapy is a specialty of traditional therapy and works directly with sex and intimacy issues within a relationship or with an individual. Sex Therapy should be conducted by a Certified Sex Therapist who is licensed as a mental health therapist and has specific training in the field of sexual health.

What Issues Does Sex Therapy Treat? Sexual Desire Issues Sexual Arousal Issues Sexual Desire Issues Low Desire No Desire Decreased Libido No Libido No Sexual Fantasies Not wanting to be sexual (with oneself and/or others) Hypoactive Sexual Desire Disorder Lack of interest or desire for sexual activity Sexual Anorexia Sexual Arousal Disorders Difficulty obtaining an erection Erectile Dysfunction Difficulty feeling aroused Dryness issues (in females) Hyper-Arousal

What Issues Does Sex Therapy Treat? Orgasm Issues Sexual Pain Issues Haven’t achieved an orgasm Aren’t able to orgasm Anorgasmia Pre-orgasmic Orgasmic Disorder Premature Ejaculation Delayed Ejaculation Early Ejaculation No feeling Sexual Pain Disorders Pain during sex Vaginismus Dyspareunia Chronic Sexual Pain

What Issues Does Sex Therapy Treat? Asexuality Sexual Aversion Disorder Post Traumatic Stress Disorder Sexual Anorexia Sexual Trauma Anhedonia Therapy to clients who identify as kink or interested/active in the BDSM community Counseling to clients who identify as non-monogamous Couples who participate in swinging activities Gender Identity Issues Questioning Sexual Orientation or Gender Identity Fertility Issues and Sexuality Sexual Issues related to parenthood Sexual issues related to disease, illness, cancer, etc. Relationship Issues Related to Sex Lack of Confidence RELATIONSHIP ISSUES

What is Sex Therapy NOT Sex therapy is not phone sex or erotic conversations. Sex therapy is not surrogate partner therapy, somatic body work, or other hands on sexual healing practices Sex therapy is not eroticized or sexual in nature. Sex therapy is not done by a counselor with little sex therapy experience. Sex therapy is not hands-on or active coaching during actual sexual experiences Sex therapy is not usually just isolated to sex, it usually is LIFE therapy in a sexual context

Compulsive Sexual Behavior This behavior can present itself in a variety of ways. Known by many names and frameworks: Problematic Sexual Behavior Out-of-Control Sexual Behavior Sex Addiction/Porn Addiction Hypersexuality As of June, 2018, the WHO has added compulsive sexual behavior disorder as an impulse control disorder to the International Classification of Diseases, Eleventh Revision.

Compulsive Sexual Behavior This is a real issue for a lot of people, spouses, partners, families, and needs careful diagnosis and treatment. Not all “unhealthy” sexual behavior is compulsive or problematic and it can be very subjective when working with these people. Problematic sexual behavior can look like chronic infidelity, inappropriate behavior on the internet, obsessions and compulsions around pornography, and a myriad of other very secretive and shame-based behaviors. Many therapists are not qualified to work with this population and can actually create a lot of turmoil in the relationship and within the individual, including increased shame, due to not handling the treatment appropriately.

Services SexTherapy-Online Offers For Clients For Professionals Sex Therapy Sex Education Sex Counseling Sex Coaching Individual Counseling Relationship  Counseling Sexual Assessment for Relationships Professional Consultation and Collaboration Supervision Case Consultation Mentoring for Online Therapy Work

Sexual Health and Medical Professionals Clients often seek out medical help for sexual issues before they seek any other consultation. Clients often don’t know what is wrong and have been guided to talk to their physicians when they have a perceived sexual dysfunction or issue. Medical professionals are an essential member of the team in treating sexual issues but are more times than not, just a piece of the puzzle towards solution.

Ideal Sexual Health Team Sex Therapist and Mental Health Therapist Often serves as care coordinator Medical Professional Trained in Sexual Health and Medical Sex Counseling (can be GP, OB/GYN, URO, NP, etc.) Sexual Health Product Specialist Physical Therapist Specializing in Sexual Health and Pelvic Floor Other allied professionals Sometimes a separate individual/couple/family therapist Attorney Financial Counselor

Medical Professional Role Assess for sexual concerns Assess for domestic violence, coercion, and relationship issues Assess for mental health concerns (often comorbid with sexual issues) Go over medication (including medication history) and discuss sexual side effects of medications*** Provide valid recommendations for medical treatment for sexual issues Provide appropriate referrals to client Use gender neutral pronouns- use partner, not husband/wife… Does your partner...?

Assessing for Female Sexual Issues

Assessing for Male Sexual Issues

When to Refer to a Sex Therapist When patient has a sexual issue that seems to be relationally, anxiety, attachment, depression, self-esteem, or other mental health area related When you feel limited by treatment options or treatment options in the past have not worked or worked for a little bit but haven’t maintained effectiveness If you aren’t sure what is happening, you can refer them for an assessment then coordinate care with the sex therapist If your instinct says there is something more going on (anxiety, emotional issues, relationship issues) and you’d like a qualified mental health professional to evaluate and weigh in

Common Patient Presentations (and what the sex therapist has to say about it) Patient comes for an appointment and shares that lack of desire for sex Assess medications- is this a common side effects? Assess anxiety and depression or other mental health issues? Assess relationship satisfaction (how are things with you and your partner or partners)? Other sexual issues (pre-orgasmic, pain, erectile issues, etc.)- what is arousal like? Offer maybe medical intervention, but referral to a sex therapist could also dive into this further.

Common Patient Presentations (and what the sex therapist has to say about it) Patient has been on avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra, Staxyn) and is still having trouble. Assess other medications- is this a common side effects? Assess anxiety and depression or other mental health issues? Lots of time this is a head thing, not a thing that can be resolved through medication Assess relationship satisfaction (how are things with you and your partner or partners, is your partner supportive, does your partner perceive failure if you don’t get an erection?) Other sexual issues (pain, ejaculatory issues, etc.) These patients are an excellent referral to pelvic physical therapist and sex therapist

Common Patient Presentations (and what the sex therapist has to say about it) Female patient is feeling a lot of pain during sex Assess hormonal concerns (perimenopause, menopause, other hormonal stuff) Internal exam to assess for any structural issues Recent traumas? Birth, Hysterectomy, Chronic UTI, psychological trauma Assess relationship satisfaction (how are things with you and your partner or partners, is your partner supportive, does your partner take adequate time for your arousal?) Educate on stimulation and arousal Other sexual issues These patients are an excellent referral to pelvic physical therapist and sex therapist

Any Questions?

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