What is sex therapy?
Experiencing sexual difficulties can feel isolating and difficult to talk about. You may feel embarrassed, anxious or unsure where to turn for support. Sexual difficulties can also affect confidence, emotional well-being, and relationships. While these experiences can feel overwhelming, they are more common than many people realise, and support is available.
Sex therapy, also known as psychosexual therapy, is a type of talking therapy that helps people explore and address difficulties relating to sex, intimacy and relationships. You can attend on your own or with a partner, and therapy can support people of all genders, sexual orientations and relationship styles.
Working with a psychosexual therapist can help you better understand what may be contributing to your difficulties and explore ways to improve communication, intimacy and sexual well-being. While some people find that talking openly with their partner helps resolve concerns, others may benefit from additional support from a trained professional.
Psychosexual therapist, Natasha Anderson-Foster, explains more about psychosexual therapy.
Sex therapists are qualified counsellors, doctors or healthcare professionals who have completed additional training to help those having sex-related difficulties.
What's the difference between psychosexual therapy and relationship therapy?
Psychosexual therapy focuses on resolving sexual difficulties. This can include performance anxiety, intimacy blocks, arousal issues, painful sex, and sexual trauma. Relationship therapy, also known as couples counselling or marriage counselling, takes a broader approach to help with a range of relationship problems. The aim of relationship therapy is to improve overall communication and trust, as well as to find new ways to resolve conflicts.
What can cause sexual difficulties?
There can be various causes for sexual difficulties. Some origins can include:
- physical (illness, disability/chronic illness, accident, surgery or medications)
- psychological (depression, anxiety or other mental health conditions)
- emotional (unhappiness in the relationship, unresolved grief)
- situational (certain situations or environments)
Common concerns discussed in psychosexual therapy include low sexual desire, erectile difficulties, vaginismus, painful sex, orgasm difficulties and intimacy concerns.
Visiting your doctor is a good first step if you think the cause may be physical. Sometimes there will be ways your doctor can help (for example, trying different medications), but if not, they may recommend psychosexual therapy. While you can see a sex therapist on your own, if the problem is affecting your partner, it can help if they attend sessions too.
Concerns around sex and intimacy can bring up a range of emotions, from frustration and anxiety to shame or disconnection. Having a safe, non-judgemental space to talk openly with a therapist can help you make sense of these feelings and work towards positive change.
What can sex therapy help with?
Sex therapy looks to help with any problem or difficulty relating to sexual relationships. This can include:
- a lack of sexual desire
- difficulty getting or maintaining an erection
- premature ejaculation, or other ejaculation problems
- difficulty climaxing
- pain during sex or being unable to have penetrative sex
- if you have stopped having sex
- mismatched sex drives
- improving communication (for example, discussing sexual needs, boundaries, and fantasies)
Talking to a stranger about your sex life may feel uncomfortable, but sex therapists are not here to judge. By being honest and talking about what you’re experiencing in this confidential setting, they will be able to help you explore the root of the problem and offer ways of helping you overcome or manage symptoms.
After various tests, scans and hospital appointments, I was diagnosed with vestibulodynia, a condition that causes pain when the inner vulva/vagina is touched. While the relationship wasn’t salvageable in the end, I was relieved to have a diagnosis. It gave me something to work with.
What to expect from sex therapy
Most therapists will arrange an initial consultation with you in the first instance. This is a chance to talk to your therapist about what you’re looking for help with and for them to explain more about how they can help. Here you should also get the chance to arrange logistics - how often your sessions will be, who will attend and how long the sessions will last.
What happens in the sessions will depend on what you’re seeking help for. Sex can often be tied up in other emotions and relationship dynamics, so you may find some sessions explore topics outside of sex.
You can attend sex therapy by yourself or with a partner or partners. Sessions will give you the chance to talk through what’s going on and understand what could be causing the problem. Your therapist will likely advise you to try various exercises outside of your sessions. You can then reflect on how well these exercises went in future sessions.
As you become more comfortable discussing your experiences of talking about sex, you’ll be able to explore how sex affects your relationship and what it is you need to feel fulfilled. If sex is important in your relationship and is causing problems, sex therapy is an option to help you overcome these problems and enjoy physical intimacy again.
Sex therapy does not include sexual activity, nudity, or physical contact with your therapist. A psychosexual therapist uses discussion-based approaches to explore areas you may be experiencing an issue with. They may also suggest tasks, exercises, or homework to complete between sessions.
What qualifications should a sex therapist have?
In the UK, practising psychosexual therapists should be trained with a minimum of two years in a post-graduate diploma in psychosexual therapy, plus a minimum of 200 supervised clinical hours. Although it's not a legal obligation, some psychosexual therapists will be registered with the College of Sexual and Relationship Therapists (COSRT), the UK's leading membership organisation for therapists specialising in sexual and relationship issues.
Bear in mind that other (non-psychosexual) counsellors may have undertaken CPD or similar training to help with treating psychosexual difficulties in case these come up during the course of general therapy or non-specialist counselling.
Frequently asked questions about sex therapy
Can I get sex therapy on the NHS?
Different areas offer different kinds of therapy. Some areas offer a set number of sessions of psychosexual therapy sessions. You may need to ask your GP for a referral. To find out more, ask your GP or search for your local area to find out what services are available.
How long does sex therapy take?
Sex therapy is typically a short-term form of therapy, focused on specific goals. How many sessions are needed can vary from person to person; there is no set number. Typically, anywhere from five to 20 sessions may be recommended, with sessions lasting anywhere from 45 to 60 minutes, depending on your therapist.
What does a sex therapist do?
A sex therapist uses talk therapy to help individuals and couples work through emotional, psychological, or relationship-based challenges that are affecting their sexual health and intimacy. Creating a non-judgemental space, they may look at identifying the root causes, providing more information, and assigning practical exercises and techniques.
Is sex therapy for couples?
Yes. Sex therapy is for both couples and individuals experiencing sexual difficulties. You can attend alone or with a partner, depending on your circumstances and what feels right for you.
Is psychosexual therapy confidential?
Yes, psychosexual therapy is confidential. What you discuss in your sessions will usually remain private between you and your therapist. There are some exceptions, such as if there are concerns about your safety or the safety of others. Your therapist will explain their confidentiality policy before you begin working together.
Who can benefit from sex therapy?
Sex therapy can support anyone experiencing difficulties relating to sex, intimacy or relationships. This includes individuals, couples, people of all genders and sexual orientations, and those in different types of relationships. It may also help people experiencing changes that affect their sex life, such as illness, disability, ageing, menopause, medication side effects, or major life transitions. Whatever the cause, therapy can provide a safe space to explore your experiences and find ways to move forward.
Is psychosexual therapy evidence-based?
Sex therapy is considered to be an evidence-based form of talking therapy. It integrates psychological techniques and behavioural exercises to help with sexual dysfunction and improve intimacy.
How to find a psychosexual therapist
If you're ready to work with a sex therapist, you can use our search tool to find the right therapist for you online or in-person, or check out the links below to find psychosexual therapists in your area.
It can be helpful to take your time to browse profiles and see who stands out to you. When talking about vulnerable topics, being able to build a sense of trust and rapport with your therapist is key.
I have worked with many couples that have gone through a psychosexual programme. It is more than going back to their sex life before. It is about finding a new way to really connect physically, learn to communicate about sex, and to explore and develop together to create something that really works for both of the couple.
- Counsellor, Nicola Buchanan, COSRT(Acc), MA, PST PgDip, PCSA
Taking time to learn more about a therapist and their approach can help you feel more comfortable getting started. Building trust and rapport is an important part of the therapeutic relationship, so it's important to find someone you feel at ease talking to.
