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

2. 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

3. 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.

4. 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

5. 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

6. 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

7. 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

9. 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.

10. 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.

11. 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

12. 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.

13. 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

14. 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...?

15. Assessing for Female Sexual Issues

16. Assessing for Male Sexual Issues

17. 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

18. 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.

19. 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

20. 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

21. Any Questions?

22. Contact www.SexTherapy-Online.com Phone: 603-770-5099
Fax:
Twitter: SexTherapyOnlne
Please feel free to contact for questions and materials!