Comfort in Treating Sexual Problems: Current Training and Counselor Self-Efficacy

Abstract

Counselor discomfort with sex can impede couple growth during the therapeutic process. As couples address multifaceted problems during therapy, counselors should be prepared to professionally discuss a couple’s sexuality during the therapeutic process. As such, the continued taboo surrounding the discussion of sex may illicit embarrassment or nondisclosure of the sexual difficulties by the individual or couple, or worse, be ignored completely by the counselor. Therefore, counselor self-efficacy of sexual topics requires continued analysis within the literature and clinical practice. Thus, the focus of this article is to bridge the gap between counselor sexual discomfort and building self-efficacy of sexual topics through the use of practical strategies (i.e., assessments and interventions) to use in treatment by (a) presenting an overview of literature on sexual perspectives of counselors that inhibit therapeutic discussion of sexuality in the counseling environment, (b) highlighting therapeutic lenses of sexuality that assist in understanding how sexual problems positively and/or negatively impact clients while promoting healthy communication between the counselor and client, (c) providing evidence for the use of sexually based assessments to assist counselors in the development of sexual conversations in treatment, and (d) presenting a brief overview of treatment methods for sexual problems. Implications for practice and research are discussed.

What Does It Mean to Be Responsive to a Partner’s Sexual Needs? Toward a Definition of Sexual Need Responsiveness

“…Given conflicts about sex are among the most difficult problems to solve (Geiss & O’Leary, 1981 ; Sanford, 2003 ) but are also more predictive of interpersonal vulnerability (Rehman et al, 2017 , 2019 ) and relationship quality (Rehman et al, 2017 ) than non-sexual conflicts in relationships, it is important for clinicians to address sexual need responsiveness in therapy. While some therapists are likely to already address this issue in therapy, many couples therapists feel ill-equipped to discuss sexuality with couples (Hipp & Carlson, 2019 ). Based on the findings, we advise clinicians to have a conversation about how partners can accommodate each other’s needs in a sexual scenario, help couples communicate and listen to each other’s needs, and to be mindful of respecting each other’s boundaries.…”

Sexual Wellness and Rare Disease Considerations: A Behavioral Case Conceptualization and Approach to Counseling Treatment

“…One of the first overall implications for counseling practice involves counselors increasing their competency on issues pertaining to sexual wellness in counseling, as well as their comfort in discussing these sorts of issues in counseling. Hipp and Carlson (2019) speak to this important need in their recent article in The Family Journal. Without competency in discussing sexual issues with clients, counselors may lead treatment from their own potential countertransference or personal value system, instead of working collaboratively with clients toward validating their experience of sexual and intimacy difficulties while living with a serious medical illness and offering appropriate treatment approaches.…”

“…Even when clients perceive that counselors might be receptive to discussing relevant sexual issues, counselors and other types of mental health providers often do not directly ask clients about their sexual concerns (Hipp & Carlson, 2019;Miller & Byers, 2009). Levine, Risen, and Althof (2016) identified numerous primary concerns counselors may have in addressing client sexual issues: (a) being unaccustomed to talking about sex, (b) not knowing what sexual information is necessary to ask about, (c) not understanding something the client shares, (d) being uncertain how to respond to clients disclosing sexual concerns, and (e) embarrassing the client.…”

“…Unless a counselor attended a CACREP-accredited marriage, couple, and family counseling program, in which Standard 5.F.2.e -human sexuality and its effect on couple and family functioning -is required within the specialty area's contextual dimension curricular standards, it is possible for counselors to have no formal education in addressing client sexuality or sexual wellness issues. Furthermore, even if counselors have had formal training as a part of their educational background, they may still experience discomfort or hesi-tancy in discussing sexual issues with individual clients or couples (Hipp & Carlson, 2019;Levine et al, 2016).…”