Here's What Actually Happens During Sex Therapy (Hint: No One Gets Naked)

Plus, where to find your own sex therapist.
Sex therapy
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Dina Cheney - The Knot Contributor.
Dina Cheney
Dina Cheney - The Knot Contributor.
Dina Cheney
The Knot Contributor
  • Dina writes for The Knot Worldwide, specializing in food, travel and relationships.
  • With more than 20 years of experience in service journalism, she also pens articles and recipes for publications, such as Good Housekeeping, Parents, SELF, Health, Men’s Health, Men’s Journal, Prevention, Fine Cooking, Weight Watchers and Diabetic Living.
  • Dina graduated from Columbia College, Columbia University and The Institute of Cul...
Updated Jul 01, 2023

Whether it's mismatched sex drives or one partner's inability to orgasm, issues with sexual compatibility can leave you feeling frustrated and hopeless. Enter sex therapy—a specific type of talk therapy that focuses on sexual well-being and relationship satisfaction. Sounds intriguing, no?

To understand what sex therapy really is and how to find the right specialist, we spoke with three experts:

  • Dr. Stephanie Buehler is a licensed psychologist and AASECT-certified sex therapist, director of The Buehler Institute and author of Enliven Your Sex Life.
  • Amanda Pasciucco, PhD is an AASECT-certified sex therapist, licensed marriage and family therapist and the owner and founder of Life Coaching and Therapy
  • Lonnie Barbach, PhD. is a couple's therapist and one of the first co-directors of clinical training at the University of California San Francisco, Human Sexuality Program.

What Is Sex Therapy?

Sex therapy is essentially talk therapy, but with a focus on sexuality and relationships, explains Dr. Buehler. "It can help to treat sexual issues and problems in and out of the bedroom," she says.

Sex therapy can be used to facilitate communication if you're simply looking to take your sexual satisfaction to the next level, as well as help with issues that include:

  • Low sexual desire
  • Mismatched sexual desire
  • Differing physical abilities
  • Sex after illness or cancer
  • Premature ejaculation
  • Consensual nonmonogamy

What Actually Happens in Sex Therapy?

First, the therapist takes a history to get a sense of the problem and how to best solve it, explains Dr. Buehler. Usually, the solution will take the form of education, suggestions of strategies to try, or—if the problem is long-standing—additional psychotherapy plus educational tips.

The psychotherapy piece involves exploring patients' past emotions, relationships and core beliefs about themselves and the world around them. After all, according to Dr. Barbach, many sexual problems (such as lack of desire) are really relationship problems. "People come to work on the sex, but have to work on the relationship—so they're feeling connected enough to work on the sex," she says.

One of the most common issues, low sexual desire or drive, can often be remedied by focusing on self-care, says Dr. Buehler, who urges her patients to ensure they're getting proper sleep, nutrition, exercise and stress management.

For couples to make progress between sessions, sex therapists will also often give homework assignments, like touching activities or gratitude practices, to report back on during their next appointment.

How to Find a Sex Therapist

When looking for a licensed sex therapist, it's important that your specialist has a background in psychology, stresses Dr. Buehler, since many physical sexual problems have a psychological aspect to them as well. This way, they can diagnose non-physical issues affecting sexual function, like trauma, depression and anxiety. Ideally, they should be certified by AASECT, the oldest and largest association for sex therapists.

Find a Sex Therapist Near You

To find a local specialist, Dr. Buehler recommends searching the directory on the AASECT site and inputting your zip code. You can also ask your OBYGN, urologist or primary care doctor for a referral.

Dr. Pasciucco also recommends reading online reviews, as well as exploring any professional social media the specialist may have. By looking specialists up on YouTube and reading their blogs, you can get a sense of their approach, she explains.

Online Sex Therapy

Many practitioners also offer their services virtually, so you and your partner can attend online sessions without leaving home. Just make sure to choose a sex therapist licensed to practice in your state, says Dr. Barbach.

Additionally, there are therapy services that exist solely online, such Talkspace and Regain. Both popular online treatment providers offer relationship-centered couples therapy, where you can discuss topics surrounding sex and intimacy. While price quotes vary, Talkspace typically charges around $110 a week for a 30-minute couples therapy video session, plus text and audio messaging with a licensed marriage and family therapist.

How to Get a Resistant Partner to Go for Sex Therapy

Unfortunately, couples tend to wait a while before seeking a sex therapist. "Things usually have to get very bad first," says Dr. Barbach. To encourage a resistant partner, she suggests explaining that sex is very important to your relationship satisfaction, and that your issue is likely common and solvable.

If your partner is hesitant out of embarrassment, reassure them that therapy is completely confidential. Ultimately, sex therapy provides a safe space for you to grow and thrive as both sexual beings and as a couple.

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