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Comparing Models of Sex Therapy

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jennifer toplak

on 1 February 2015

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Transcript of Comparing Models of Sex Therapy

Treatment Models
The Narrative Approach
The Integrative Approach
-an inter-system approach
The Solution-Focused Brief
Therapy Approach
-strength based
The Medical Approach
-treatment options are considered within various contexts.
The Relational Approach
-an interpersonal approach to problem solving.
The Integrative Approach
This approach integrates individual, couple, and marital therapy. It takes into cosideration biological, contextual, cultural and religious aspects of the client's life and beliefs ( Weeks, 2005).
The Relational Approach
Relational Sex Therapy involves working with the couple together to address thoughts, emotions, behaviors, and perceptions each hold that contribute to problems in the relationship.

Comparing Models of Sex Therapy
Sexuality is a bio-psycho-social process that entails cultural, interpersonal and physiological aspects of ones being( Lue, Giuliano, Montorsi, Rosen, Anderson, Althof, & Wagner, 2004).

Therapists need to address sexual dysfunction in relation to many inter and intra-personal aspects of an individual's history and present problems.
The Narrative Approach
Narrative therapy enable couples to work collaboratively by creating an atmosphere that foster honest and open communication ( McCoy, Stinson,Bermudez, & Gladney, 2013).
The Solution-Focused Brief Therapy Approach
Solution Focused Brief Therapy starts with possible solutions and works backwards to alliviate problems.
The Medical Approach
The Medical model is a patient-centered approach that assess the patient's complaints and wishes through examining their medical history, their mental health and when possible their partners opinions and wishes.
Similarities Between Models
Between Models
My preferred Model

I like this approach because it is eclectic, versatile and uses a systems approach to treatment in which I am most comfortable with.
Nadia and Ivan
Nadia and Ivan have been married for 13 years and have two young boys. They have come to therapy due to Nadia's loss of interest in sex and worry she will lose Ivan because of it. Ivan has threatened her with divorce if she does not get this "problem" solved (Green, Flemons, 2004).
Jennifer Toplak-Kopp
The Integrative Approach with Nadia and Ivan
Intrapsychic Components
Interactional Components
Why this Model is a Good fit for me
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Couples are
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Images of Sex
Cosgrove, L., & Daniel, K. (2002). Book Reviews: New Directions in Sex Therapy: Innovations and Alternatives. Edited by P.J. Kleinplatz. Psycotherapy:Theory/Research/Practice/Training. Vol. 39, No.4, pp381-383.
Flemons, D., & S. Green, S. (2013). Relational sex therapy.
Gender Dysphoria Fact Sheet, DSM 5.
Gender Dysphoria, DSM 5.
Interview with David Schnarch.

Lue, T. F., Giuliano, F., Montorsi, F., Rosen, R. C., Andersson, K.-E., Althof, S. . . . Wagner, G. (2004). Summary of recommendation on sexual dysfunctions in men.
McCoy, M., Stinson, M. A., & Bermudez, M. J., & Gladney, L. A. (2013). Utilizing a narrative approach to increasing intimacy after prostate cancer.
Nadia and Ivan vignette
Parry, W. (2013). Gender Dysphoria: DSM-5 reflects shift In perspective on gender identity
Schnarch, D. (1998) Passionate marriage: Keeping love & intimacy alive in committed relationships.
Trepper, T. S., Treyger, S., Yalowitz, J., & Ford, J. (2010). Solution-focused Brief Therapy for the treatment of sexual disorders.
Weeks, G. R. (2005). The emergence of a new paradigm in sex therapy: Integration.
Jennifer Toplak-Kopp
This treatment approach helps individuals increase their awareness and gain insight for working through their problems by verbalizing their strengths and problem solving skills.
Here the therapist works within a conceptual framework that informs diagnosis and treatment(Weeks, 2005)
Its structure is resiliency- based and focuses on the client' strengths by examining previous solutions and exceptions to the presenting problem , and encouraging the client(s) do more of those behaviors (Trepper, Treyger, Yalowitz & Ford, 2014).
In cases where sexual dysfunction is the main problem and assessed to be related to a health or genetic issue, hormone treatment , medication and surgery will be discussed. The goal of treatment is to restore a satisfactory sexual life, not only a rigid erection or great orgasism( Lue, Giuliano, Montorsi,Rosen, Andersson, Althof & Wagner, 2004).
Resolving sexual problems requires creating connections that are characterized by loose grip , comfortable connections that will diminish in significance and be replaced by more positive connections(Flemmons & Green, 2013).
All of the aforementioned models are client centered and believe the client is the expert in solving their problems.
Inclusion of the family's opinion is important in Narrative, Integrative and the Medical model.
All but the medical model is strength based in structure.
Solution-Focused Brief Therapy can work in conjunction with the Relational and Integrative models.
All models believe in the importance of building a trusting, and therapeutic alliance with the client(s).
Each model is based on its own theory of problem solving techniques, thus its treatment strategies will be different to obtained desired goals.
-Solution Focused Brief Therapy and Narrative Therapy do not deal much with relationship patterns and connections as Relational therapy does.

-Solution Focused Therapy looks for quick solutions.

-Narrative Therapy involves decontructing problematic narratives through insight and increased awareness of feelings, and experiences where
the Medical Model focuses on symptomatic problems.

-The Integrative model takes into account the most components encompassing truer systems approach.
I would ask each of them to define and give their interpretation of the main problem they coming to therapy for.
I would address biogenic and psychogenic issues that may play a part in Nadia's disinterest and seemingly dislike of sex.
I would address conflict, avoidance and work on improving conflict resolution skills to produce a more hopeful outlook on the future.
As a therapist using the Integrative approach with this couple I would work within a conceptual framework of defining love, commitment, and passion. I would address sexual problems from biological, psychological perspective. I would strive to improve the couple relationship by addressing communication issues, fears, and conflict resolution abilities. I would ask about beliefs and feelings carried over form their families of origin and learn how cultural and social and religious factors may influence beliefs and meanings about gender roles and performance.
I would then work on creating positive experiences and connections for this couple working within the framework of Relational Therapy.
I would assess congruence and attribution each give about each other and use interventions from SFBT, such as scaling and "instead" questions.
I would initiate a discussion about Nadia's and Ivan's individual needs for intimacy and love and ask each of them where they stand in believing their spouse can fulfill these needs, possibly needing to address commitment issues withing the relationship.
I chose the Integrative model because it gives me a structured framework which makes me feel secure, and the freedom to adapt techniques I feel comfortable using and believe work for self discovery and helping create change.
I am insight oriented so working within this model helps bring together my beliefs about why people think the way they do, and helps me understand and learn about how behavior changes and the importance of semantics using questioning to promote change agents through SBFT and Narrative techniques.
A relational and contextual understanding of sexuality needs to be incorporated in our clinical work (Kleinplatz, 2002).Because we are all so different in our attitudes, beliefs, self-confidence and perceptions of others, we have developed strong and unique personalities.
Our images of sexuality, what we think is sexy and what is normal are vastly different from each other. As a sex therapist it would be important to understand a client's beliefs about sex and to help them discover their "own identity", in perspective to their mates. If the goal is Differentiation, as David Scnarch (1997)describes, than the goal of therapy should strive towards helping couples balance their need for individuality and togetherness using therapeutic techniques and tools that "best fit" that couple.
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