Understanding the Different Kinds of Sex Therapy

Sex therapy is a richly diverse field, with practitioners drawing on a variety of philosophical perspectives, specialized training, and accreditation bodies. Below is an exploration of the main schools of thought, key certification pathways, and emerging perspectives in the field.

Schools of Thought and Philosophical Perspectives

Sex therapy approaches vary widely, reflecting the complexity of human sexuality. Each perspective brings a unique lens to understanding and addressing sexual health concerns.

Biological/Biomedical Perspective
Grounded in medical science, this perspective focuses on the physiological aspects of sexual function. Therapists or medical professionals using this approach may address issues such as hormonal imbalances, erectile dysfunction, or neurological conditions. Treatment often involves interventions like hormonal therapy, medications, or physical therapies.

Psychodynamic Perspective
Drawing on the work of Freud, Jung, and other psychoanalytic pioneers, the psychodynamic approach examines how unconscious conflicts and early childhood experiences shape sexual behavior and identity. This method often involves deep exploration of past relationships and emotional patterns to uncover the roots of present-day sexual concerns.

Behavioral and Cognitive-Behavioral (CBT) Perspective
Evidence-based and practical, CBT focuses on identifying and changing maladaptive thoughts and behaviors related to sexuality. Techniques such as exposure therapy and cognitive restructuring are used to address issues like performance anxiety, negative self-beliefs, and phobias around intimacy.

Humanistic and Client-Centered Perspective
Inspired by Carl Rogers and Abraham Maslow, this approach emphasizes individual autonomy, personal growth, and the fulfillment of human potential. Humanistic therapists foster a supportive environment where clients can explore their sexuality in a nonjudgmental, empowering way.

Feminist and LGBTQ+ Affirmative Perspective
This inclusive framework addresses the influence of societal power dynamics, gender roles, and cultural narratives on sexual health. It advocates for the rights and representation of marginalized groups, ensuring therapy is a safe space for all identities and orientations.

Relational and Attachment-Based Perspective
Focusing on the dynamics of relationships, this approach examines how attachment styles and interpersonal interactions influence sexual health. Building on the work of theorists like John Bowlby and Sue Johnson, it emphasizes creating secure connections to enhance intimacy and satisfaction.

Integrative and Holistic Perspective
Blending techniques from multiple modalities, the integrative approach seeks to address the mind, body, and spirit as interconnected facets of sexual well-being. Popular in contemporary practice, this approach often includes elements of mindfulness, somatic therapy, and energy work.

Perspectives and Specializations

The field of sex therapy continues to evolve, with practitioners embracing innovative approaches to address diverse client needs.

Trauma-Informed Approaches
This perspective prioritizes the resolution of sexual trauma using techniques such as Eye Movement Desensitization and Reprocessing (EMDR) and somatic experiencing. The goal is to create safety and restore a healthy relationship with one’s body and sexuality.

Sex-Positive and Pleasure-Centered Approaches
Celebrating the diversity of sexual expression, this framework emphasizes normalizing various sexual identities, orientations, and preferences while enhancing individual and relational pleasure.

Cultural and Religious Sensitivity
Acknowledging the profound impact of cultural and religious values on sexuality, therapists using this perspective adapt their approaches to align with clients’ unique backgrounds and beliefs.

Emerging Areas

The field of sex therapy is expanding into new domains, such as:

• Intersectionality: Exploring how overlapping identities (e.g., race, gender, socioeconomic status) affect sexual experiences.

• Neuropsychology: Examining the brain’s role in sexual function and satisfaction.

• Technology’s Impact: Addressing how digital innovations like pornography, dating apps, and AI companions influence sexual health.

Understanding these frameworks and credentials can help individuals seeking therapy make informed decisions, ensuring their journey toward sexual wellness is guided by competent, compassionate, and culturally attuned professionals.

More Detail on Training and Focus

Clinical Psychologists and Counselors

• Training: Degrees in psychology, counseling, or social work (e.g., PhD, PsyD, LMFT, LCSW).

• Focus: Emotional and psychological aspects of sexual health, including desire issues, performance anxiety, trauma, and relationship dynamics.

• Perspective: Psychodynamic, cognitive-behavioral, or humanistic approaches often applied to sexual concerns.

Medical Professionals (Sexologists)

• Training: Medical degrees (MD, DO) with specializations in urology, gynecology, or endocrinology, often supplemented with sexology certifications.

• Focus: Physical or biological causes of sexual dysfunction, such as hormonal imbalances, erectile dysfunction, or pelvic pain.

• Perspective: Biomedical focus, often combining medical treatment with counseling.

Certified Sex Therapists

• Training: Licensed therapists with additional certification in sex therapy (e.g., AASECT certification in the U.S.).

• Focus: Broad range of sexual concerns, including intimacy issues, sexual identity, and trauma.

• Perspective: Integrative, blending psychological, relational, and sometimes medical perspectives.

Couples and Relationship Therapists

• Training: Degrees in counseling or marriage and family therapy with additional training in sex therapy.

• Focus: Interpersonal dynamics and how they affect sexual satisfaction.

• Perspective: Systems theory and attachment-based approaches are common.

Somatic Sexologists and Bodyworkers

• Training: Certifications in somatic sexology or bodywork (e.g., training from organizations like the International Society for the Study of Women’s Sexual Health or Body Electric).

• Focus: Body-based approaches to sexual healing, such as breathwork, movement, and touch.

• Perspective: Focus on embodiment, sensation, and somatic trauma release.

Coaches and Educators

• Training: Certifications from organizations like the Somatica Institute or Sexual Health Alliance.

• Focus: Practical skills for improving intimacy, communication, and sexual satisfaction.

• Perspective: Focus on empowerment, communication, and pleasure rather than therapeutic treatment of dysfunction.

Spiritual and Tantric Sex Therapists

• Training: Varied; may include tantra certifications or training in specific spiritual traditions (e.g., Kashmiri Shaivism, Neo-Tantra).

• Focus: Integration of sexuality with spiritual growth and energy work.

• Perspective: Holistic, often incorporating rituals, meditation, and breathwork.

Visit these Accreditation and Certification Bodies to Find People That Fit Your Style

• AASECT (American Association of Sexuality Educators, Counselors, and Therapists): Gold standard for sex therapist certification.

• American Board of Sexology (ABS): Certification for professionals in the field.

• International Society for Sexual Medicine (ISSM): Training for medical professionals.

• World Association for Sexual Health (WAS): Promotes global standards in sexual health.

• College of Sexual and Relationship Therapists (COSRT, UK): Certification for therapists in the UK.

• International Society for the Study of Women’s Sexual Health (ISSWSH): Training for addressing women’s sexual health.

• Somatica Institute: Training in somatic sexology.

• Body Electric School: Training in body-based sexual healing.

• Institute for the Advanced Study of Human Sexuality: Certification in sexology.