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Hott, J.R. (1978). Principles in Sex Therapy. Am. J. Psychoanal., 38(1):41-48.

(1978). American Journal of Psychoanalysis, 38(1):41-48

Principles in Sex Therapy

Jacqueline Rose Hott, Ph.D., R.N

Sex therapy is a taskcentered form of crisis intervention whose purpose is to remove specific obstacles to sexual functioning. Based on a psychodynamic framework, it is an integrated, synergistic combination of prescribed, systematically structured sexual tasks and experiences with psychotherapeutic intervention aimed primarily at bringing about symptomatic relief of a sexual dysfunction. It includes counseling about sexual techniques, dispelling myths, and educating about the psychological and physiological aspects of sexual functioning. The focus is on the here and now of the couple's sexual interaction. Suggestions are made for specific sexual activity and then these suggestions are followed by the couple in the privacy of their own home. The sex therapy is considered completed when the couple's sexual difficulty is relieved.

Sex therapy is individualized and flexible. There is no standardized treatment routine that is applied mechanically to all sexual problems. The strategy of sex therapy, Kaplan explains, is to modify the couple's sexual transaction so as to eliminate fear, guilt, and anxiety and to maximize excitement and gratification.2 The technique combines a number of different theoretical approaches. It includes medical-physiological research, intrapsychic-dynamic psychology, interpersonal-dyadic psychology, and behavior learning theory.1

Sex therapy uses a structured, step-by-step educational experience in functional sexual behavior where the patient is the couple and not the dysfunctional individual. Both members of the couple are treated as equal partners in the problem, even if only one of them is suffering from an explicit dysfunction.4 The treatment methods are designed to modify their immediate obstacles to sexual functioning.

Masters and Johnson called for an intensive two-week daily treatment regimen conducted at their center in St. Louis, necessitating separation from family, job, and community. In other programs, such as the highly regarded ones at New York Medical College and Long Island Jewish Medical Center, these fourteen to fifteen treatment sessions, for the purposes of practicality and economics, as well as therapeutic reasons, have been spread out over about four months in a once-a-week program. A contract for a fixed number of sessions is usually agreed upon before therapy begins.

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