Broaching the Topic of Sex

Sexuality is a vital aspect of human life, influencing emotional, psychological, and physical well-being. Despite its importance, many mental health professionals find it challenging to discuss sexual issues with clients. This article explores supported strategies for broaching the topic of sex in the therapy session, providing practical examples to facilitate these sensitive conversations.

The Importance of Addressing Sexuality in Counseling

Research underscores the significance of discussing sexual issues in therapy. Studies indicate that clients often expect their therapists to initiate conversations about sex and feel disappointed when this does not happen (Berman et al., 2003). Moreover, unaddressed sexual issues can exacerbate mental health problems, such as anxiety and depression, and hinder therapeutic progress (Hucker & McCabe, 2014).

Strategies for Broaching the Topic

1. Create a Comfortable Environment

Establishing a safe and non-judgmental space is crucial for discussing sexual issues. Therapists should use inclusive and neutral language, demonstrating openness and acceptance.

Example: "I want you to know that this is a safe space to talk about any aspect of your life, including relationships and sexuality. Your comfort and well-being are my top priorities."

2. Normalize the Conversation

Normalizing conversations about sex can reduce stigma and anxiety. Therapists can integrate questions about sexuality into routine assessments, signaling that these topics are a natural part of therapy.

Example: "As part of getting to know you better, I ask all my clients about their relationships and sexual health. It's an important aspect of overall well-being."

3. Use Open-Ended Questions

Open-ended questions encourage clients to share their experiences without feeling pressured or judged. These questions allow clients to guide the conversation based on their comfort level.

Example: "Can you tell me about your experiences with intimacy and how you feel it impacts your life?"

4. Provide Psychoeducation

Educating clients about the connection between sexual health and mental health can validate their experiences and reduce shame. Psychoeducation helps clients understand that their concerns are legitimate and worth discussing.

Example: "Sexual health is closely linked to mental health. Many people find that their sexual well-being affects their overall happiness and stress levels."

5. Acknowledge and Address Discomfort

Therapists should acknowledge any discomfort—either their own or their clients’—and address it openly. This transparency can build trust and model healthy communication.

Example: "I notice this topic might be uncomfortable to discuss, and that's completely normal. We can take it at your pace and focus on what feels most relevant to you."

The Evidence for Integrating Sexuality Into Your Practice

Research supports these strategies as effective in encouraging open discussions about sexuality in therapy. For instance, Miller and Byers (2010) found that clients who perceived their therapists as open and non-judgmental were more likely to disclose sexual issues. Additionally, a study by Hinchliff and Gott (2004) highlighted the importance of normalizing sexual health conversations, showing that clients felt more at ease when therapists treated these topics as routine.

Broaching the topic of sex in mental health counseling is essential for comprehensive care. By creating a comfortable environment, normalizing the conversation, using open-ended questions, providing psychoeducation, and addressing discomfort, therapists can effectively engage clients in discussions about their sexual health. These strategies, supported by empirical research, help ensure that clients receive holistic and inclusive mental health care.

References

Berman, L., Berman, J., Felder, S., Pollets, D., Chhabra, S., Miles, M., & Powell, J. A. (2003). Seeking help for sexual function complaints: What gynecologists need to know about the female patient’s experience. Fertility and Sterility, 79(3), 572-576.

Hucker, A., & McCabe, M. P. (2014). Incorporating sexuality into clinical practice: Strategies for sex therapy. Routledge.

Miller, S. A., & Byers, E. S. (2010). Psychologists’ sexual education and training in graduate school. Canadian Journal of Human Sexuality, 19(1-2), 1-15.

Hinchliff, S., & Gott, M. (2004). Intimacy, commitment, and adaptation: Sexual relationships within long-term marriages. Journal of Sex Research, 41(2), 138-148.