The Rundown: What to Expect In Sex Therapy

Before services begin with our clients, we get lots of questions about what to expect in sex and relationship therapy. 

Are you going to assign us homework to have sex? 

Are we going to touch each other in session? 

Can I show you my vibrator? 

What actually goes on in sex therapy? 

We want you to know exactly what you’re signing up for, so here’s the rundown of what you can generally expect in your therapy experience at The Center for Modern Relationships.

[Image: Cat putting on sunglasses with caption reading “I’m Ready.” c/o giphy

What is sex therapy?

Sex therapy is a highly specialized form of psychotherapy in which you talk with your therapist about your experiences, feelings, and concerns related to your sexuality. Treatment encompasses a wide range of sexually-based issues, including mismatched desire, sexual functioning or sexual pain issues. You can visit our Sex Therapy page to read more about what we treat.  

At The Center for Modern Relationships, we see ourselves as sex therapists AND expert couples therapists. It’s a disappointing reality that not all couples therapists are trained to work with sexuality concerns. If sex is something you want to discuss, you can always ask a clinician about their training and comfortability with talking about sexual issues. You can be assured that a certified sex therapist (CST) or CST in training* has deeply and thoroughly explored their beliefs and values around sex, ensuring that they will take a non-judgemental approach to your sexual concerns and will offer you scientific, research-backed treatment techniques to help you express your sexuality authentically.

Okay, so what actually happens in session?

Whether you come into therapy solo or with your partner(s), you’ll be guided by your therapist through a thorough rundown of your sexual concerns and goals for therapy, as well as histories pertaining to mental and physical health, family of origin, relationship beliefs and experiences, and sexuality beliefs and experiences. If you’re a couple, you’ll be seen both together and individually, depending on the issue(s) you’re treating. Your therapist has to have a good idea of where you are, where you want to be, and the effort you’re willing to give in order to meet your goals so that they can collaborate with you. 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 help you come up with solutions to move you consensually toward where you want to be.

Michael from The Office, laying on a couch saying, “Well, the other night…” c/o giphy

Sex and relationship therapy is more directive than typical talk-therapy modalities, so you’ll likely be assigned homeplay like reading or watching videos to support therapy work, observing your feelings and behaviors over the week to identify challenges and growth, and touch or body-incorporating 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 facets 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 always a tough thing to gauge because in sex and relationship therapy, progress comes with radical honesty about your feelings and taking action. 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.

Natalie from 90 Day Fiancé saying, “yes to therapy.” c/o giphy

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

Sex and relationship therapy is most effective when you are able to engage in your work outside of sessions, as well as show up to your appointments being fully, radically honest about your feelings, wants, needs, and beliefs. The effectiveness of sex therapy for sexuality and relationship issues is proven by research time and again (Porst & Burri, 2019; Johnson et al., 2018; Montesi et al., 2011; Hogan, 1978; Zilbergeld & Kilmann, 1974). It’s important to note that different sex and relationship therapists have different styles, such as Cognitive Behavioral Therapy (CBT), Emotionally-Focused Therapy (EFT), Gottman, and somatic work. Depending on the concerns presented, your therapist may lean into one skillset heavily, or pull from multiple to help you. 

As far as attending sessions solo versus with a partner(s), we believe efficacy works both ways; however, here at The Center for Modern Relationships, we are systemic thinkers and believe change happens when the entire relationship unit – not just you solo – makes small shifts. Even if your partner isn’t physically present 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 (read: probably). Longer answer: If there is a clinically appropriate purpose for this and you and your therapist have discussed 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!

Travis from Clueless giving two thumbs up with caption reading, “Two enthusiastic thumbs up.” c/o giphy

TL;DR Sex and relationship therapy is a form of talk therapy in which your therapist will help you tend to your concerns through conversation using research-backed science, homework assignments, and other techniques. 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). Here at The Center for Modern Relationships, we consider sex and relationships as a piece of overall health that people must tend to. Sex and pleasure are human rights that you get to define for yourself. We can’t wait to consult with you and help you live your best sexual life!

*At The Center for Modern Relationships, all of our clinicians are CST's or CST's in-training with the American Association of Sexuality Educators, Counselors, and Therapists (AASECT)