Sexual Dysfunction and Couple Dysfunction

Couple sex therapy is best understood as a subspecialty of couple therapy. Couple sex therapy may focus on problems in desire, pleasure, eroticism, and/or satisfaction. Although arousal and orgasm problems need to be carefully assessed and treated, problems related to desire represent the primary concern that brings couples to sex therapy. There is a great need for more research on sex therapy models, therapeutic processes, and outcome. The authors describe in detail the psychobiosocial model of assessment, treatment, and relapse prevention. A particularly important component is the four-session assessment, which features individual psychological, relational, and sexual histories. This comprehensive, multidimensional treatment model focuses on the use of psychosexual skill exercises practiced at home by the couple. Therapy interventions are directed at factors that subvert sexual desire and function as well as interventions to promote desire, pleasure, eroticism, and satisfaction. Clients are urged to develop a couple sexual style that balances each person’s sexual voice, thus becoming an intimate sexual team. The goal for all couples, straight or gay, married or unmarried, is to integrate intimacy and eroticism into their relationship. An individualized relapse prevention plan is also discussed as an integral component of comprehensive couple sex therapy.