What’s it like to be a sex therapist?
Many sex therapists are licensed marriage and family therapists (LMFT), though not all of them. MFT is a therapy field that focuses on interpersonal relationships and viewing clients through a “systemic” lens. Sex therapists are typically educated just like other kinds of psychotherapists, and then many have additional trainings, degrees, or certifications to create their specialization.
What if I Want a Degree?
Within the last few decades, a few sex therapy graduate and doctorate level degrees have evolved across North America and Europe. There are not many of them yet, and so many therapists study marriage and family therapy, or get a masters in counseling and then specialize after school.
What is Systemic thinking?
Systems theory is a method of therapy that requires the therapist to conceptualize the client as a part of their interpersonal relationships and family dynamics. No one is an island, and systemic thinking focuses on how connected we are to one another.
Common challenges for sex therapists
Honesty– When working with couples, it is important for the couple to be completely honest with the therapist about their relationship and feelings. It can be tempting to sugarcoat or lie when you feel shame. Therapists can only work with what you tell them. They won’t judge or blame you; they need to know what is really going on.
Advice– Many clients come to therapy thinking the therapist will just tell them what to do to “fix” their sex life. But therapists don’t know everything, nor can they magically give perfect advice. Their job is to work with you to explore patterns and encourage clear communication. They aren’t wizards, but they are trained to see relationship patterns, understand relationship dynamics, and create a safe space for you to explore your feelings and build skills.
Education– Being a sex therapist means they need to understand that sexual activities are wildly diverse and be aware of any personal bias they may have regarding certain sexual relationships, customs, or behaviors. No therapist can learn in detail about every single fetish, kink, or cultural custom. But education and exposure is important so they can check any prejudice at the door. The last thing a sex therapist wants to do is embarass or judge a client.
Ethical considerations
Just like regular talk therapy, there are strict ethical codes sex therapists must follow. Most of these are for the privacy and safety of the clients. Keeping confidentiality has a lot of complex rules and structures. Remaining unbiased when a couple comes in with a fight can be difficult. Therapists remember that when working with couples the relationship unit is their clinical focus, not either individual.
False advertising can be an ethical concern for therapists. Currently, in the US, there is no specific required certification or training that qualifies a therapist as a sex therapist. Sex therapists may have all kinds of licenses or degrees within the therapy and counseling communities. Any therapist can advertise themselves as a “sex therapist” and while most are passionate about continuing education and growth, legally, any licensed therapist can give themselves the title of sex therapist.
Know your Alphabet Soup:
LMFT- licensed marriage and family therapist (specially trained in systemic thinking and relationship dynamics)
LPC- Licensed professional counselor (specially trained in individual psychology and human development)
LCSW- licensed clinical social worker (specially trained in social contexts like law, policy, and social standards regarding mental health)
LMHC- licensed mental health counselor (specially training in individual psychology and mental health)
Sex-Positive Lifestyles
Many sex therapists “practice what they preach” and are often involved in sex-positive activities ranging from sex education, to kink or queer communities, to performances like burlesque or drag. While the Code of Ethics has safety nets in place for many kinds of communities (e.g. religious, rural) there is little to no licensing board protection for a therapist who may also be living their best life in a sex-positive way.
EXAMPLE: if a therapist were to attend the same religious event as a client, and the client were to witness the therapist preach, pray, or perform religious rites, there are provisional details in the Code of Ethics on how the therapist can navigate that social situation. Yet if a therapist were to attend a kinky event and the client were to witness the therapist get tied up as part of a rope play demonstration, the therapist may be risking their license (depending on state and license specific rules) by engaging with their community.
By Ren Reed 2024
