What Can I Expect in a Sex Therapy Session?

In a continuation of my series about all things sex therapy I just wanted to take a brief moment to give an overview about what a person can expect when they enter into sex therapy. Of course, every person’s struggle is different and every therapist works differently and without knowing your exact situation it would be impossible for me to write out a detailed treatment plan but these are some things you could expect if you see me as your sex therapist in my virtual offices in North Carolina, Tennessee, Louisiana, Texas, Oklahoma, and Colorado.

Step One- Reach out for a free 15 minute consultation. I am not out here trying to waste anyone’s time and I am all about making sure you and I are a good fit before we begin our work. This isn’t my chance to make a sales pitch- truth be told I only want to see you if I know we would work well together and you feel that too. This is your chance to ask questions and do a “vibe check” as they say. I will also give you a brief overview of my pricing (It is here if you really want to know before the call because I am ALL about you making the most informed decision for you) and we will chat about some basic info about how I work as a therapist.

Step Two- If you decide I do feel like the right fit for you and I decide the same we will usually schedule an in depth initial assessment. This is where, I won’t lie, I am going to ask you a thousand questions. We will do some assessments for other mental health issues as well to rule out (or in) things like depression, anxiety, PTSD, OCD, and eating disorders (all things that can impact sexual functioning, btw). I will ask you about your background and family of origin. I will ask about your sexual concerns and your physical health. If I am working with you and a partner we will also do an online in depth relational assessment. I always tell clients this first session is nothing like any of our future session but I like to do a thorough job asking a lot of questions up front so that I am not surprised by something that would have changed the course of our treatment later. For example, if I was working with someone who struggled with erectile dysfunction (hate this name, more on that later) and I never asked if they enjoyed any regular exercise I might not find out they are an avid bike rider which can be a root cause of erectile dysfunction. It would be on me if I spent 6 months treating someone when the answer could have been something as simple as changing their bicycle seat! Side note: this is why sex therapists are invaluable- this is the type of information a therapist that is not trained in sex therapy might not know (bc well, that is wildly niche information)! If you are seeing someone that is not a trained sex therapist for sexual issues I would definitely encourage you seek out someone who is. If I am not the right fit, I will help you find someone that is.

Step Three- I take all the information I gather in this session and develop a tentative treatment plan and we schedule a session and decide together where to start and how often we will meet. We meet for a second session to collaborate on goals and a plan moving forward. In this session I often present you with the information that I gathered from you and tell you my clinical impression and how we will treat this issue but I also want and need your input. I may be an expert on sex but you are the expert on YOU. A big question I like to ask is- 6 months from now if we met regularly and you looked back and thought “wow! Therapy is really working!” what would you be experiencing that would make you think that? My experience with sexual concerns is that they are rarely ever “caused” by one thing. We will usually work on one thing at a time, starting where you feel most comfortable. If your sexual struggles are rooted in trauma and you don’t feel ready to address that yet but there is also a component of accurate sex education that is missing and you feel ready for that- we will start with the sex education. I hope that makes sense.

Step Four- We will meet regularly and systematically work through each of the factors that are impacting you sexually. You will also likely be given homework (assignments, podcasts, book chapters, you tube videos, etc.) to do outside of session. I GET you are super busy and will never make you feel bad for not doing these things- I always say homework is for you not for me! Of course if you do these things you will gain more from our work (I think of this stuff as like “freebie side therapy”) but I also understand you have a life and obligations!

Step Five- We check in on an ongoing basis about how our work is going. I want what we do to be helpful to you. I am super open to feedback, critique and collaboration.

I wish I could just walk you through a session and show you what it looks like, because I know reaching out is terrifying and you probably have more questions than answers now. The best thing I can say is that we will be humans together and you will know that I genuinely care and want you to have the sex life YOU want, whatever that looks like.