Here’s What Happens in Sex Therapy

By Helen Wyatt, LMFT, Senior Clinician at Dalliance Sexual Wellness

TL;DR Sex therapy is a form of talk-therapy in which your therapist will help you tend to your concerns about sexuality through conversations informed by peer-reviewed, rigorous research. You’ll have to reflect, do your homework assignments, and actively participate in the techniques your therapist assigns. Sex therapy is effective for treating both sexual functioning concerns, as well as emotionally based problems relating to sexual expression for you and your partner(s). Dalliance therapists consider sex, consent, and pleasure to be human rights. We can’t wait to talk with you and help you live your best sexual life!

Before therapy services begin, we get lots of questions from our clients: What happens in sex therapy? Do I need to be partnered? Do we touch each other? Do you watch us have sex? Can I show you my vibrator? What actually goes on in session?

We want you to have a great experience in therapy and know exactly what you’re signing up for during your dalliance at Dalliance. 

What is sex therapy?

Sex therapy is a type of counseling that helps individuals and people in relationships address challenges related to their sexual relationships. It generally involves talking to a therapist who specializes in sexuality issues about your experiences, feelings, and concerns related to your sexuality, both in how you express yourself and in who you are as a sexual person. It’s notable that our therapists are both expertly trained sex therapists AND couples therapists; it’s a sad reality that not all therapists work with sexuality but here at Dalliance, we’ve got you!

Okay, so what happens in our sex therapy sessions?

First, you’ll have a consultation to get a clear understanding of the concerns you’re here to address and what you’d like to get out of sex therapy. We’ll collaborate to create goals that address your concerns to keep us on track throughout the work (we’re fans of SMART goals!). It’s essential that your therapist gets to know YOU – where you’ve been, where you are, where you want to be. They’ll spend multiple sessions in the beginning of therapy asking you questions about your physical and mental health, your sexual health and relationship experiences, and your life growing up with your family and friends. 

We aren’t here to change who you authentically are, and we won’t ever persuade partners into having more or different sex together. We are here to help you explore the challenges getting in the way of your desired sexual expression and experience, and to help you come up with solutions to move you consensually toward where you want to be.

Sex and relationship therapy is more directive than other types of therapy, so you’ll likely be assigned “homework.” Therapy homework generally looks like: reflection over what you’ve discussed or been challenged on in session; observing your feelings and behaviors over the week to identify challenges and changes; reading or watching videos to support therapy work; and touch- or body-based activities to do with yourself or with a partner(s) in the privacy of your own home. You will always remain fully clothed in therapy and you can expect that there is no physical touch happening between therapist and client (it’s against our ethical code!). You will never be asked to touch your partner in an NSFW (not safe for work) manner in a session.

It’s also important to note that in sex therapy, you’ll likely find yourself talking about a lot of different things outside of sexuality. The truth is, everything in your life outside the bedroom has the potential to follow you into the bedroom - that fight you had with your partner earlier in the week, the stress that came with getting your kids out the door to school this morning, and so on. Often in sex and relationship therapy, we find ourselves talking about the intersection of sex and other parts of life: boundaries, communication issues, learned beliefs and behaviors in our family of origin, attachment, body image and self-esteem, how you learned to express your sexuality, how you learned to be in a romantic partnership… the list goes on. All of these conversations will lead to you living differently, in a holistic and complete way. Sex and relationship work has potential to benefit much more than just your sex life!

How long is this going to take?

This is a tough thing to gauge because in sex and relationship therapy, progress comes with radical honesty about your feelings and taking action. Change takes time (it takes 12 weeks neurologically to wire a habit). It can be difficult to talk about sex – most of us aren’t at all used to sharing such private, vulnerable information aloud. But believe us… the more you do it, the easier it becomes. We look at this work as an 80/20 ratio; twenty percent of our work happens in the therapy room, eighty percent is dependent on how you choose to engage in the work as you go about your days with your partner. Remember, the key to adult learning is repetition – creating change takes the time it takes, depending on how motivated you are.

Is sex and relationship therapy effective? Do I have to come with my partner?

Yes, sex and relationship therapy can be very effective - we’re happy to share a myriad of scientific articles with you for your particular sexual problem that show sex therapy can lead to repair and lasting results. That said, the success of therapy depends on the willingness of the individuals involved to engage honestly and openly in the process, receiving feedback, and making change. Through guided discussions, practical exercises, and personalized strategies, many individuals and couples find significant improvements in their sexual satisfaction and overall relationship health. 

You do not necessarily have to come to therapy with a/your partner; therapy can be beneficial whether you attend sessions individually or as partners. Even if your partner isn’t physically here in the therapy room they are still very much considered as part of the therapeutic conversations you have with your therapist. We also try to be straightforward when we believe your concerns would be better addressed with your partner along for the ride.

Can I show you my vibrator collection?

Short answer: maybe (*probably. eventually*). Longer answer: If there is a clinically appropriate purpose for this *and* you and your therapist have discussed doing so ahead of time, we are definitely happy to have show and tell, as well as talk about all things sex toys, pleasure, relationships, and connection. We truly want to validate you in your journey of learning to express yourself and your sexuality comfortably and genuinely!