Is it Sex Therapy or Couples Therapy?

I get this question a lot from people who are looking for a couples therapist. When they see “Certified Sex Therapist,” they get worried that I won’t be able to address their relationship needs, and that I only am able to address sexual problems.

I don’t blame anyone for thinking this. Our society constantly compartmentalizes sexuality across the board, pushing it out of our conscious awareness. So it’s no surprise to me that people think that sex therapy and couples therapy are completely different things. Moreover, I’ve met several other couples therapists who rarely meaningfully address sexuality in the couples work. It’s not that they’re bad at their jobs, it’s just that they fall into this common pattern that lots of people do.

Who we are

A sex therapist is a licensed mental health professional with advanced training in human sexuality. We are certified by the American Association of Sexuality Educators Counselors and Therapists (AASECT) and undergo rigorous training to achieve and maintain our certifications. All it means is that we have this additional knowledge and expertise to bring into the therapy room. 

For me, and for every other sex therapist I’ve ever met, sex therapy in relationships is couples therapy. For most committed relationships, sex is foundational. Sexual interest and attraction was part of what motivated partners to get together from the beginning. Even for many who identify as asexual, some aspect of sexuality was present in the origins of romantic relationships.

For the human species, sexuality has always primarily been about connection, and it is deeply interwoven into relationships. Therefore in my work with couples, it is impossible for me to treat one without the other. I cannot address a relationship problem that has no bearing on sexuality. Nor can I treat a sexual challenge without having ripple effects on the relationship.

I should also point out here that sex therapy can be part of individual therapy. Human sexuality has a lot of different parts that impact our overall lives. We all have bodies that feel and need to be kept healthy. We all need human connection and are influenced by sexualized social dynamics. We all have some aspect of our identities related to human sexuality (e.g. gender, biological sex, sexual orientation, etc.).

How it works

What this means for how I do therapy is that I have a wide array of tools in my toolbox, and that they are well-informed about sexuality. For individuals, I use sexuality informed Acceptance and Commitment Therapy (ACT). For couples, I use the Gottman Method and address sexuality as part of the relationship work. For couples who are dealing primarily with sexual dysfunctions, I have a variety of strategies to help improve their sexual lives.

As a sex therapist for individual clients, this means I am a safe, knowledgeable therapist to help clients who deal with sexuality and shame, trauma, mental health challenges, and their unique sexual fantasies and desires. While many clients work with me on their feelings related to fetishes like kink, BDSM, and role playing, other clients work with me on their more basic therapeutic needs. It is common for clients who identify as kinky or nonmonogamous to seek me out to work on anxiety and depression because I understand and affirm their unique sexual lives.