Psychosexual Therapist One normal sex life please Who Am I Psychology background Postgraduate counselling amp psychotherapy Psychosexual training Working for THT HIVamp Sexual Health training ID: 932994
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Slide1
Lucy Snider
Sexual Health Adviser
Psychosexual Therapist
“One normal sex life please”
Slide2Who Am I??
Psychology background
Post-graduate counselling & psychotherapy
Psychosexual training
Working for THT
HIV& Sexual Health training
Healthcare Assistant
Health Adviser
Slide3What is Psychosexual Therapy?
Sex counsellor
S
exuality counsellor
Psychosexual psychotherapist
Sexologist
Sexual therapist
Sex therapist
Sex worker?!
Slide4What is Psychosexual Therapy?
“Psychosexual therapy
is talking therapy that specialises in helping individuals and couples who experience sexual
difficulties”
http
://
www.chelwest.nhs.uk/services/hiv-sexual-health/clinics/56-dean-street/psychosexual-therapy
“
The sexual dysfunctions are characterised by a disturbance in sexual desire and in the psycho-physiological changes that characterise the sexual response cycle and cause marked distress and interpersonal difficulty
for at least six months
”
Sexual Dysfunction DSM-V
Slide5Fun Facts!
What do you think is the average length of time between
penetration
and
ejaculation
for men?
8-12
minutes
What %
of women can orgasm from
vaginal penetration
alone?
Only 20% -
approx
80
% women
cannot orgasm
during penetrative sex alone
Slide6Types of Sexual Difficulties
Erectile
difficulties
Rapid or delayed ejaculation
Difficulty to orgasm
Arousal issues
Low sexual desire
Painful intercourse
Compulsive
sexual behaviour(s)
Issues around
gender and/or sexuality
Sexual
risk taking
behaviour
Slide7Types of Sexual Difficulties
Slide8Problems Health Advisers Might See
Mental Health:
effects of depression/anxiety on sexual
function, effects
of mental health on safer
sex, disclosure of abuse
Younger Patients:
impact of mental health on sexuality and
relationships, sexuality issues, consent
Older Patients:
issues of ageing and
sexuality
Intellectual
Disabilities
:
issues of consent for sexual
relationships, stigma
and beliefs around sexuality and learning
difficulties
Physical
Health
:
effects of medication/illness on sexual functioning,
effects of HIV/STIs on sexuality
Chem
Sex:
effects of drug use on safer sex, consent, relationships, sexual function
Slide9Medical Causes of Sexual Dysfunction
These should be ruled out first
!
D
iabetes
Heart
disease
Surgery, injury
or trauma
Neurological
disorders
Medication
side effects
Hormonal changes
Fatigue!
Slide10Other Causes
of Sexual Dysfunction
Performance anxiety
Unrealistic expectations
Depression/anxiety
Unresolved sexual orientation issues
Trauma
Conflicts in the relationship
Lack of education
Religious, personal, or family values
Low self-esteem
Slide11Not For Psychosexual Therapy
T
here
is no
sexual problem (expectations)
Organic
cause
D
epression
or other mental health problems
A
lcohol
abuse/drug dependence
Domestic violence
Relationship
difficulties
S
exual assault/PTSD/trauma
Slide12The Sexual Response Cycle
Masters and Johnson “
Human Sexual Response”
(1966) – linear
model, has limitations
Helen Singer
Kaplan (1979)
-
added
psychological, emotional, and cognitive factors
Many more models
since
Slide13Break in the Cycle
Slide14How
Does
It Work?
Individuals
or
couples
Psycho-education
Focus on the behavioural aspect of
sexual
dysfunction
C
ounselling/psychotherapy
to
address any underlying
issues
Sex positive,
non-judgemental, open
space
B
roader
issues
may include:
relationship therapysexual orientation and identity
gender diversity
puberty and adolescent sexuality
older people and sexuality
sexuality
and disability
sexual and reproductive health issues (
STI/HIV/IVF)
a
ddictions
Slide15Practical Exercises
Masturbation/self-exploration
Positive body-image reinforcement
Mutual masturbation
Sensate focus
Mindfulness/relaxation techniques
Vaginal trainers
Toys/condoms/lube etc.
Reading/education
Slide16Medications & Tools
Slide17Medications & Tools
Slide18Medications & Tools
Slide19Medications & Tools
Slide20Role Play
Turn to the person next you and discuss the last time you had difficulty having sex and how that made you feel
JUST KIDDING!!!!
Slide21Case Study 1
Su Yin
is a19 year old student. She has
asked her GP for a referral
to psychosexual therapy after
reading an article about ‘sex addiction’ in a magazine. She reports spending most of her time thinking about
sex and says she has
had
lots of sex with
men and women she
meets out in clubs or via
the
internet. She often takes
cocaine
during sex.
Su Yin
says
she is
“never satisfied”
and wonders if she has a “hormonal problem”. She says she would like to “stop being a
slut” and
settle down with
someone but
quickly gets bored whenever she has a regular sexual partner.
Slide22Case Study 2
Jeremy is 32 years old and identifies as MSM. He comes to the clinic complaining of erectile dysfunction. He tells you he can’t last as long as he used to and is asking about Viagra. He says this is really upsetting him and he wants to “get back to normal”. After further discussion, Jeremy tells you he was using Crystal Meth for the past year, but he is now sober and has a new regular boyfriend.
Slide23Case Study 3
Melanie is a 26 year old heterosexual female. 2 years ago she was diagnosed with HSV 2. Her first outbreak was very painful and
t
raumatic but she has not had any recurrent outbreaks since. Melanie states its very painful in her vagina when she tries to have penetrative sex. The last time she tried was 18 months ago with a casual male partner.
Slide24Merging My Two Roles
Idea
There is already
a psychosexual clinic in
place
I already have the qualifications
I have protected time to see patients
Can I see psychosexual patients?
Implementation
Discussion with manager and psychosexual service
Agree time off floor for supervision etc.
Secure place for notes
Appointments added to system etc.
Secretarial
assistance/running
my own
clinic
Maintenance
Supervision
CPD training
Slide25Benefits - Me
Maintain my skills
CPD
Variety to my role
Cross-directorate working
Increased job satisfaction
Access to resources
Work in an NHS setting
Wide range of patients
Experience
Slide26Benefits - Patients
“Sexual health”
does not simply mean free from sexual infections, it involves obtaining emotional and physical pleasure from
sex
All
treatment
options/services available at their
local
clinic - not
be referred to somewhere
else (anxiety, lost to follow-up, immediate access)
Sex positive environment, non-judgemental service
Space to be open -
helps to show that we prioritise emotional as well as physical
issues
I’m used to talking about all sexual problems
Able to “dig a bit deeper”
Wide range of knowledge
Access to onward referrals
Offer of an additional service – in high demand, complete “sexual health” service
Slide27Benefits – My Team
We begin to be considered as a specialised team
I can share psychosexual/counselling
expertise within the
team - experience
, knowledge, training, links with other psychosexual
counsellors/services etc.
Boosts the professional standing of the JHC HA Team within the wider MDT
Provides a link between JHC and the
trust’s
p
sychosexual
s
ervice
(run from 56
Dean Street)
Slide28Benefits – Health Advising
Broaden Health Adviser role
More specialised clinics & services
Scope for further training and qualifications - “Health Adviser” becomes a recognised and qualified role
Improves the professional standing of
HA’s
in sexual
health
HA’s
providing a psychosexual service provide a focussed and supported (via
supervision
) expert service for patients
Meets
a demand from patients
Slide29In Conclusion
Sex
is more exciting on the screen and between the pages than between the
sheets
-
Andy
Warhol
Slide30Resources
www.cosrt.org.uk
www.psychosexualtraining.org.uk
www.tccr.org.uk
The New Male
Sexuality
-
B.
Zilbergeld
Becoming
Orgasmic: A
Sexual
and
Personal Growth
P
rogramme
for
Women
-
Julia
R.
Heiman, Joseph
& Leslie Lo Piccolo
Ending Female Pain
– Isa
Herrera
How To Overcome Premature Ejaculation
-
Helen
Singer
Kaplan
Human Sexuality and its
Problems
-
John
Bancroft
Slide31Questions
Thank you for listening, I am happy to receive any questions
Contact me:
l
ucy.snider@chelwest.nhs.uk
0203 315 6155