What Does Integrated Sex Therapy Mean?

Historically, sex therapy has been viewed as a practice in isolation, where intimacy issues were often considered physical issues, treated by medical professionals like urologists or gynecologists. Today, an integrated sex therapy approach means treating the whole person, physically and mentally, to address sexual health issues. 

Recent research shows that sexual dysfunction is a matter of both mind and body. According to an article in the journal "Sexual and Relationship Therapy," “knowledge about the intersections of trauma, emotional wellbeing and sexual health, respectively, have increased significantly in recent years … Sexual health professionals working with pleasure and vitality benefit from understanding brain and nervous system function through both trauma-informed and pleasure-informed lenses in order to offer the most effective approaches to working with clients experiencing sexual distress.”

Professional organizations like SSTAR (Society for Sex Therapy and Research) and AASECT (American Association of Sexuality Educators) also advocate for more holistic, integrated treatment strategies.

Because of this, sex therapists increasingly function as critical pieces of a multidisciplinary care team alongside physical therapists, physiological specialists, and other medical professionals. 

Breaking a Silent Circle

The American Psychological Association (APA) highlights that sexual dysfunction is often connected to psychological issues, including depression, anxiety and trauma. Treating a physical problem from a strictly medical perspective may only address the symptom of a deeper issue.

For example, let’s say a client is seeking help for physical pain during intimacy. They see a physical specialist, like a gynecologist or urologist, who says that everything is structurally healthy. But if the physical symptoms persist, this puts a strain on the client's relationship, self-esteem and mental health.

This can create a painful loop: emotional distress triggers physical symptoms, and those physical symptoms feed back into anxiety and relationship strain.

Clinicians need to approach the problem through a holistic lens. An effective therapist should be knowledgeable about their clients’ physical health, and a medical doctor should recognize that sexual mechanics are more than just biological. An integrated approach that includes both medical and mental health interventions is the most beneficial type of care. 

The Power of a Multidisciplinary Team

Because sexual health is so deeply related to overall health, today's sex therapists rarely practice in a vacuum. Leading institutions like the University of Minnesota’s Eli Coleman Institute for Sexual and Gender Health emphasize a collaborative approach. Their clinic offers “interdisciplinary care with medical providers to treat concerns with a physical component.”

A modern sex therapist may collaborate with a network of professionals, including pelvic floor physical therapists, endocrinologists, and general medical practitioners. A sex therapist can also provide trauma-informed care that not all medical doctors are trained in. They may even help coordinate care to make sure their client is receiving the support they need. 

It is also valuable for a therapist to have some basic medical knowledge in order to understand how illnesses, surgeries and medications can influence intimacy. For instance, a person may be taking medication for an unrelated condition that produces physical side effects that affect their sexual health. A skilled therapist knows the importance of having a complete medical picture of their client in case a specialist needs to be consulted.

The rise of somatic therapy is another indication that the field is taking a more holistic approach. Somatic therapy is a body-centered approach that focuses on the connection between the mind and the physical body that often includes using eye movement, muscle relaxation and breathing exercises. While there is limited research on the subject, somatic therapy appears to be effective in treating post-traumatic stress disorder.

A recent article in the APA’s "Monitor on Psychology" states that while many aspiring therapists’ “training gives them a strong foundation for treating sexual difficulties, sex-specific training is valuable.” Clearly, the future of sex therapy belongs to an integrated model where dual-trained mental health professionals work at the intersection of mind, body and relationship health. 

Sources

• The Interconnection of Post-Traumatic Stress Symptoms and Sexual Functioning: A Clinical Review, Journal of Sex Medicine
• Sex Therapy for the 21st Century: Five Emerging Directions, American Psychological Association 
• American Association of Sexuality Educators, Counselors and Therapists (AASECT) 
• Eli Coleman Institute for Sexual and Gender Health, UMN Medical School
• Tending to painful sex, Sexual and Relationship Therapy
• Psychological and Interpersonal Dimensions of Sexual Function and Dysfunction, The Journal of Sexual Medicine