What Sex Therapists Do and Don’t Do For Your Sex Life

Going to therapy for any reason still carries stigma and confusion for many people, unfortunately. It’s even worse for sex therapy. There are a lot of misconceptions about who needs to go, what happens during an appointment, and what it says about you if you decide to see a sex therapist.

Jack and Jill Adult talked to two sex therapists who explained what they do — and what they don’t do — in their practice.

Sex Therapy is a Form of Talk Therapy

Sex Therapy is a Form of Talk Therapy“We only engage in talk therapy with our clients and receive training on common sexual concerns and how to treat them,” states Praia Westerband-Otero, licensed mental health counselor at Remote Mental Health. “The types of topics which can be discussed in sex therapy are amazingly varied. Many clients are looking to discuss sexual concerns such as delayed orgasm, libido disparities with their partner(s), and premature ejaculation. Other common conversations tend to be around the topics of masturbation and pornography, fantasies, and curiosity about kink and BDSM.”

It’s Not Always Just About Sex

“The first job of a sex therapist is to get an accurate differential diagnosis,” says Nicole Prause, Ph.D., founder of Liberos. “People with depression often notice a lower sex drive early in depression. People who believe they are addicted to porn usually are not; they are just experiencing shame or using porn to cope with depression. Specializing in sex still means having a solid understanding of psychological processes. A “sex” problem may not really be a sex problem.”

You Can Go Alone or With Your Partner(s)

You Can Go Alone or With Your Partner(s)“Some people come to sessions individually and others come with one or more of their partners,” says Westerband-Otero. “Some clients come in alone at first because they want help with having conversations with their partner(s) or family that they believe will be difficult. This can include introducing their partner(s) to a new sexual activity that they feel may be rejected, discussing the opening of their relationship, or discussing their sexual orientation or gender identity.”

Be Ready for Homework When You Go

“Sex therapy differs from other empirically-supported therapies primarily in that in-session practice is very limited,” states Dr. Prause. “Sensate focus exercises, vaginal dilator exercises, and so on are all done with some level of nudity (and sometimes a partner) that would not be appropriate in a therapists’ office. It can be difficult to understand what a client is experiencing in their at-home practice. As a result, we usually have books like Femalia that have explicit, but non-aroused, images of the vulva to help us communicate appropriately about sexual issues.”

Westerband-Otero gives very specific “assignments” to her patients. “Sometimes sex therapy involves homework assignments such as reading, watching videos on certain topics, or doing exercises alone or with your partner(s) that were agreed upon in session to help you move towards your goals.”

Sex Therapy Can Help You Deal with Shame and Fear

Sex Therapy Can Help You Deal with Shame and Fear“Many clients come in wanting to reduce the amount of fear, shame, or guilt they experience when thinking about or engaging in certain activities,” says Westerband-Otero. “Often, I ask my clients where they learned that sex was bad or dirty. We work towards disputing any irrational beliefs they may hold about sex, their body, and what excites them. Sex therapy is a safe place to begin the process of exploring a wide variety of sexual concerns with a professional that is sex-positive, non-judgmental, and knowledgeable of human sexuality. Many times this is the first time these clients have been able to discuss these parts of their lives with someone and that process itself can be very therapeutic.”

Don’t Expect Sex

“The most common misconception is that sex therapists are going to engage in some kind of sexual activity with their clients,” states Westerband-Otero. “We often have discussions with our clients about the sexual activity they engage in or want to engage in that can be a bit more detailed than what you may encounter in an average therapy session. However we do not engage in any physical contact with any of our clients, and our conversations are not meant to be arousing.”

“Every once in a while I get calls from people who seem to believe sex therapists are like phone sex operators and the callers engage in inappropriate behavior,” continues Westerband-Otero. “Unfortunately, this is very common in the field, but it will hopefully diminish as more and more people know what a session with a sex therapist is actually like.”


Just like anyone can benefit from general therapy sessions, anyone can benefit from sex therapy. You don’t need to have a scary or massive problem before you go. And you don’t even need a partner. If you know you carry some shame or fear about sex or you don’t know how to deal with or think about your sexual needs or feelings, a sex therapist can help.

Have you ever been to a sex therapist or considered going? Feel free to share your experience in the comments below!

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