Are they qualified? In most states, any person can claim to be a sex coach, sex educator, or even a sex therapist with no training. Many have had no formal certification or degree in sexuality or sexual health but believe the topic is interesting so they address topics with no more than their opinion. As a consumer, you end up with a therapist who speaks only from personal experience alone rather than treatment based on education, training and research in the field.
You want to know first, does the psychotherapist you are seeing has a Master’s degree or higher in a mental health field? Are they a licensed therapist in one of the mental health fields? Therapists may be psychologists (PhD. or PsyD). They may have a MSW and if licensed, will be listed as a licensed clinical social worker (LCSW). They may have a Master’s in Counseling and be listed as a Licensed Professional Counselor (LPC), or they could have a Master’s degree in Marriage and Family therapy (MA or MFT). A psychiatrist is a person who has gone through Medical School and then has specialty training in Mental Health. These MDs assess and prescribe medicines for mental health related issues, but over the last 30 years, refer people out for therapy and focus on adjusting people’s medicines for depression, anxiety and other mental health issues.
Q: WHAT IS A CERTIFIED AASECT THERAPIST? HOW HAVE THEY BEEN TRAINED?
A: AASECT is the American Association of Sex Educators, Counselors and Therapists and it assures the highest level of expertise. The training is rigorous and they have specialized training and experience in sexuality, and in sexual health and dysfunctions. To become a Certified Sex Therapist with AASECT, all of the following credentials and training are required:
–a minimum of a Master’s Degree in one of the mental health areas listed above plus clinical experience in mental health.
–a minimum of 300 clinical hours of treatment of patients that present with sexual concerns as the primary presenting problem.
–a minimum of 50 hours of supervision/consultation with a Certified AASECT Sex Therapist to discuss these Sex Therapy cases listed above.
-a minimum of 90 hours in Human Sexuality.
-a minimum of 60 hours in Specialty Training in Sex Therapy.
-a minimum of 10 hours in a Sexual Attitude Reassessment Seminar to examine one’s feelings, attitudes and beliefs regarding sexuality and sexual behavior.
-ongoing AASECT membership, continuing education and adherence to the standards of AASECT Code of Ethics.
Q: WHAT TOPICS ARE COVERED IN THE 90 and 60 HOURS OF AASECT REQUIRED SEX THERAPY TRAINING?
90 Hours of Human Sexuality Education
A minimum of ninety (90) clock hours of academic coursework in sexuality education, covering general knowledge in the Core Knowledge areas listed below.
1. Ethics and ethical behavior.
2. Developmental sexuality from a bio-psycho-social perspective across the life course.
3. Socio-cultural, familial factors (e.g., ethnicity, culture, religion, spirituality, socioeconomic status, family values) in relation to sexual values and behaviors.
4. Issues related to Sexual Orientation and/or Gender Identity: heterosexuality; issues and themes impacting lesbian, gay, bisexual, pansexual, asexual people; gender identity and expression.
5. Intimacy skills (e.g., social, emotional, sexual), intimate relationships, interpersonal, relationship and family dynamics.
6. Diversities in sexual expression and lifestyles, including, but not limited to polyamory, swinging, BDSM, tantra.
7. Sexual and reproductive anatomy/physiology.
8. Health/medical factors that may influence sexuality including, but not limited to illness, disability, drugs, mental health, conception, pregnancy, childbirth & pregnancy termination, contraception, fertility, HIV/AIDS, sexually transmitted infection, other infections, sexual trauma, injury, and safer sex practices.
9. Range of sexual functioning and behavior, from optimal to problematic, including but not limited to common issues such as: desire discrepancy, lack of desire, difficulty achieving or maintaining arousal, sexual pain and penetration problems, difficulty with orgasm.
10. Sexual exploitation, including sexual abuse, sexual harassment, and sexual assault.
11. Cyber sexuality and social media.
60 Hours of Specific Sex Therapy Skills and Training
A minimum of sixty (60) clock hours of training in how to do therapy with patients/clients whose diagnoses include the Psychosexual Disorders described in the current edition of the DSM. Sex therapy training must include:
1. Theory and methods of sex-related psychotherapy, including several different models.
2. Techniques of sex-related assessment and diagnosis of the Psychosexual Disorders described in the current edition of the DSM.
3. Theory and methods of approach to intervention in relationship systems experiencing sex and intimacy problems.
4. Theory and method of approach to medical intervention in the evaluation and treatment of psychosexual disorders.
5. Principles of consultation, collaboration, and referral.
6. Ethical decision-making and best practice.
7. Practicum experience, i.e. exposure to treatment of clinical cases through observation, demonstration, case review, role-playing, etc.
WHAT QUESTIONS SHOULD I ASK THE AASECT THERAPIST- ASIDE FROM THOSE ABOUT MY PARTICULAR DIFFICULTY (erectile dysfunction, premature ejaculation, low drive, etc.)
- Do they believe masturbation is healthy or unhealthy?
- What percentage of their practice identify as having a fetish, kinky, polygamous, or have open relationships?
- What is their stance on porn?
- Are they familiar with Gay-Affirmative Therapy for gay and transgender patients, or do they just consider themselves “gay friendly”, OR do they believe people should eliminate gay thoughts and/or behaviors because these things are sinful and unnatural.
- Do they believe any of the areas listed above make the patient a “sex addict?”
A note about sex addiction: While out of control sexual behaviors can be addressed, be careful not to label the lower desire partner as dysfunctional and the higher drive partner as an addict. Desire discrepancies are common and “sex addict” is an overused term by the general population and addiction therapists. Sex Addiction is not listed in the DSM (Diagnostic and Statistical Manuel) or recognized by the medical community. Interestingly, however, many treatment facilities have capitalized on this sex addiction “diagnosis” as a money maker, offering sex addiction programs. While 12-step methods of treatment are hugely helpful for addressing substance use such as heroine and alcohol, for sex, the addiction model comes from a place of shame, framing the partner as the enabler, and labels any “outside the box” erotic interest as pathological. It uses shame to treat the “addict” with 12 step philosophies. From addiction therapists you will hear, “No sex for 90 days” and “Once an addict, always an addict.” This “sex addict” label and treatment for “sex addiction” also conveniently provides a get-out-of-jail-free card for the behaviors since they believe the person has a disease. A desire to use substances is different than having out of control sexual behaviors, as every person is born a sexual person and dies a sexual person.
Instead, core issues causing out of control sexual behaviors can be addressed and treated with first comprehensively understanding and addressing the reason for the person’s behaviors, rather than just glossing over these. Then important is working on triggers for the behaviors, setting up strategies around the areas that are causing the person to make decisions that cause difficulty, understanding the concepts of mutual respect if they have partners, understanding that their behaviors impact others, understanding boundaries, learning to value themselves rather than finding validation from others, along with addressing many, many more areas that can contribute to sexually engaging in situations that produce anxiety afterward.