Sex TherapyWhat I need to know about Sex Therapy

Prepared by: Bestco (The Board of Examiners in Sex Therapy and Counselling in Ontario)

What is Sex Therapy?

Sex therapy is a method of treatment used with individuals or couples who have sexual problems and concerns. It is based on the belief that sexuality can be a positive part of life, that relationships can be rewarding and that emotional and physical intimacy is a desirable goal. Sex therapy provides a supportive atmosphere in which individuals or couples can talk about sexual and relationship issues with a professional who is knowledgeable and comfortable with this area of life.

Why is Sex Therapy necessary?

Self-esteem and feeling comfortable about sexuality are often closely related. “When I can’t feel good about my sexuality, how can I feel good about myself?” The reverse is often also true. Reliable information about sexuality is still difficult to find and many people feel uninformed about sexual response and enjoyment. Knowing about our body and feeling at ease with the range of emotions associated with our sexuality can contribute to a sense of well-being.

Sexual intimacy is important for most couples as it can strengthen closeness and caring between partners. This is particularly important in today’s society where there are many pressures on couples. Dissatisfaction with the sexual aspect of the relationship and the loss of shared intimacy may lead to feelings which threaten the total relationship. Relationships may even end because of unresolved sexual difficulties.

Who seeks Sex Therapy?

The qualified sex therapist counsels people with a variety of sexual concerns which may be a consequence of many factors of personal or social origin. They may be the result of illness or surgery, physical difficulties, or sexual trauma such as incest or sexual assault. Concerns may be about such things as levels of sexual desire, painful intercourse, absence of orgasm, erection problems or timing of ejaculation. Sex Therapists will also facilitate clients sexual potential enabling them to enhance and enrich a creative form of sexual expression.

In addition, sex therapists work with couples who want to be able to talk more comfortably about sexual and intimacy issues. Sexual problems may be closely associated with other relationship issues which interfere with the desire to be intimate and close with one another.

The sex therapist also helps individuals who have inhibitions they wish to change, and questions to explore regarding sexual identity and orientation.

What can I expect in Sex Therapy?

You have a right to expect your sex therapist to be:

– knowledgeable
– at ease talking about sexuality and relationships
– sensitive
– non-judgmental
– respectful of your feelings, values and privacy

Your therapist will probably begin to assess your concerns by asking you a number of direct questions about your personal history, sexual feelings and behaviour. This is to help you and your therapist to clearly understand your issues. If you do not feel ready to talk about something, you can say so and your wish will be respected.

A medical examination may or may not be a part of the assessment. This should only be done by a physician. You should be fully informed and comfortable with the reasons for the examination.

Treatment plans vary with different therapists and the approach taken depends on the problem. As well as being supportive, the therapist may challenge or confront you on important issues but this but this will be done with respect for your feelings and values. You may be offered the opportunity to read books designed for use in sex therapy. Between appointments you, or you and your partner, may be asked to do some exercises at home to help both your communication and comfort with sex. The format of these exercises is usually negotiated with your therapist so that you feel comfortable with the treatment plan. Ask questions about anything that you do not understand and talk with your therapist about anything that you do not want to do.

You should not be asked:

-to take your clothes off unless it is for a medical examination by a physician and you are comfortable with and understand the reasons of the examination

-to engage in any form of sexual activity in front of your therapist, either alone or with your partner

-to engage in any form of sexual contact or activity with your therapist

What training or certification do Sex therapists have?

People who become sex therapists usually have at least one professional degree in a field such as marital and family therapy, medicine, nursing, psychology, pastoral counselling or social work plus further specialized educations and training in sex therapy. Most sex therapists will work under a code of ethics prescribed by their professional association. (Ex. The American Association for Marriage and Family Therapy, (AAMFT) – marriage and family therapists; The College of Physicians and Surgeons of Ontario – physicians; The College of Nurses of Ontario – nurses; The Ontario Board of Examiners in Psychology – psychologists; The Canadian Association for Pastoral Practice and Education – pastoral counsellors; The College of Certified Social Workers – social workers.

In Ontario, some sex therapists are accredited by the Board of Examiners in Sex Therapy and Counselling in Ontario (BESTCO). Applicants must have received certification in marital and family therapy or its equivalent from a professional association such as The American Association for Marriage and Family Therapy (AAMFT).

It is important that the sex therapist be responsible to an organization with a strict ethical code and that practitioners be answerable to a statutory body which accepts complaints from the public and which has the power to discipline its members.

No single professional degree qualifies a person to do sex therapy. Sex therapists may come from a variety of professional backgrounds. Knowledge of sexual anatomy and function, relationship issues, sex roles and expectations, and problems resulting from sexual abuse are just some of the areas a sex therapist needs to understand.

Before becoming registered, a sex therapist will be supervised by a more experienced sex therapist for up to three years as one part of the certification process.


Sex therapy is an approach to very real human problems. It is based on the assumption that sexuality is good, that relationships can be meaningful and that interpersonal intimacy is a desired goal. Sex therapy is by its nature a very sensitive treatment modality and will include respect for the client’s values and cultural beliefs. Registered sex therapists should be non-judgmental, gender sensitive and supportive of the equal rights of men and women to full expression and enjoyment of healthy sexual function. Registered sex therapists should be members of professional organizations or licensing bodies which govern practitioners’ conduct and practice.