IN THIS ARTICLE:
What sex therapy is and how it works
What a sex therapist actually does in sessions
Who sex therapy is for
What approaches sex therapists use
How to find a sex therapist and what to expect
Maybe you’ve been avoiding sex with your partner for months. Maybe desire has disappeared from your relationship, and neither of you knows how to bring it up. Maybe something happened in your past that makes intimacy feel complicated, even scary.
Those aren’t small things. And they don’t tend to get better on their own.
A sex therapist can help individuals and couples address the sexual concerns that are damaging relationships and self-worth.
What Is Sex Therapy?
Sex therapy is a form of psychotherapy that helps individuals and couples address sexual concerns, improve intimacy, and strengthen their overall relationship. It’s talk therapy. There are no physical examinations and no explicit demonstrations. Sessions are conducted in a professional, confidential, and completely non-judgmental setting.
A sex therapist is a licensed mental health professional with specialized training in human sexuality. Sex therapists are trained to address a wide range of sexual issues, including sexual dysfunction, low libido, sexual trauma, and intimacy difficulties rooted in emotional disconnection.
Who can see a sex therapist?
Sex therapy is not only for people with severe sexual dysfunction. It’s for anyone whose sex life is causing distress, conflict, or disconnection. That includes individuals working through personal concerns, and couples trying to rebuild what’s been lost.
According to research published in JAMA, 43% of women and 31% of men experience some form of sexual dysfunction in their lifetime. Most of them never seek help, not because help isn’t available, but because they don’t know where to turn.
That’s exactly what sex therapy is here for.
What Does a Sex Therapist Help With?
Sex therapists work with clients across a wide range of concerns. The role of a sex therapist is to help individuals and couples address sexual issues at the emotional and relational level, not just the physical one.
Maybe you feel like roommates more than partners. Maybe you want to want sex, but something keeps getting in the way, and you can’t figure out what it is. Maybe you’ve been carrying shame about this for so long that it’s started to feel like just a part of who you are. Do any of these feel familiar?
Low libido or low sexual desire that’s creating tension or distance in your relationship
Desire discrepancies between partners where one person wants sex more than the other, and neither of you knows how to talk about it
Sexual dysfunction, including erectile difficulties, pain during sex, or difficulty with arousal or orgasm
Intimacy avoidance rooted in anxiety, shame, or past sexual experience
Sexual trauma that’s showing up in your relationship or your body, even years later
Body image concerns that make it hard to be present during sex
Sex addiction or compulsive sexual behavior affecting your relationship
Relationship issues related to sex, including resentment, disconnection, or communication breakdown around intimacy
Recovering from infidelity and trying to rebuild trust and a shared sexual life
Working with a sex therapist also doesn’t require a crisis. Some people attend sex therapy simply to improve sexual communication, get adult sex education they never received, or deepen the intimacy they already have.
What questions about sex therapy should I ask before starting?
Good questions to ask a potential sex therapist include: What is your training and sex therapy certification? Have you worked with concerns like mine before? What does a typical session with a sex therapist look like? Do you offer online sex therapy? And what is your approach if I’m attending alone versus with a partner? Asking these questions upfront helps you feel confident you’ve found the right fit.
Sex Therapy for Couples
Sex therapy for couples is one of the most powerful tools we have for rebuilding connection. When sex and intimacy become a source of conflict, avoidance, or silence in a relationship, it rarely stays contained to the bedroom.
Couples who talk about sex openly tend to report higher relationship satisfaction. But getting there often requires a skilled guide. A sex therapist can help identify the patterns underneath the surface, whether that’s unspoken resentment, mismatched expectations, or fears that have never been named out loud.
What sex therapy for couples actually looks like
Sessions with a sex therapist are conversations. You’ll explore your sexual experiences, your histories, and your relationship dynamics together in a safe, structured space. No topic is off limits, and no judgment comes from the therapist’s side of the room.
Many couples come to us feeling like they’ve already failed. They haven’t. Sometimes, the most important step is just deciding that the connection matters enough to fight for.
Approaches Used in Sex Therapy
Sex therapists use a range of evidence-based techniques drawn from psychotherapy, human sexuality research, and relationship science. Here are the most common approaches:
Talk therapy and psychoeducation
The foundation of every sex therapy session is talk therapy. Sex therapists use conversations to help clients explore their sexual history, beliefs, and concerns. This also includes adult sex education, because misinformation about sexual function is far more common than people realize.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy helps identify and reframe the negative thought patterns that interfere with a healthy sex life. CBT is particularly effective for performance anxiety, shame-based beliefs about sexuality, and sexual trauma responses.
Sensate focus and mindfulness
Sensate focus exercises help individuals and couples slow down, reconnect with their bodies, and reduce anxiety around physical intimacy. Research shows mindfulness-based interventions are particularly effective when sexual dysfunction is driven by anxiety or negative beliefs.
Sex therapy techniques for couples
Sex therapists also assign structured homework activities for couples to practice between sessions. These reinforce what’s being discussed in therapy and help translate insight into real change at home.
A sex therapist’s approach to diversity
Sex therapists are trained to work with diverse populations, including LGBTQ+ individuals and couples, survivors of sexual trauma, people with disabilities, older adults, and people from different cultural backgrounds. The goal is always culturally sensitive, inclusive care. Everyone deserves a space where their sexual experience is treated with respect.
Can individuals attend sex therapy, or is it only for couples?
Sex therapists work with both individuals and couples. Many people attend sex therapy on their own to address personal sexual concerns, past sexual trauma, body image issues, or low sexual desire. You don’t need to be in a relationship to benefit from sex therapy.
What Happens in a Sex Therapy Session?
A session with a sex therapist might feel different from what you’re imagining. Here’s what you can actually expect:
Open, confidential conversations about your sexual concerns, history, and relationship dynamics
Education about sexual health, anatomy, and realistic expectations around sexual function and desire
Exploration of emotions, past experiences, and how they’re showing up in your current sex life
Exercises or strategies to improve sex and intimacy, both in sessions and at home
Guidance on communication so couples can talk about sex more openly between sessions
Sex therapy is entirely talk-based. There is no physical contact, no observation of sexual activity, and no surrogate partner therapy involved in standard clinical sex therapy practice.
According to AASECT (the American Association of Sexuality Educators, Counselors and Therapists), certified sex therapists complete rigorous specialized training in human sexuality, clinical ethics, and sex therapy certification requirements. Working with an AASECT-certified sex therapist can help you feel more confident that your provider has specialized training.
Does Sex Therapy Work?
Yes, sex therapy can be effective, and many approaches used in sex therapy are supported by research. Sex therapy techniques like CBT, sensate focus, and couples-based interventions have strong evidence behind them for addressing sexual dysfunction, low sexual desire, and intimacy difficulties.
That said, the outcomes depend on showing up consistently and being willing to be honest in sessions. Sex therapy isn’t a passive process. But for people who engage with it genuinely, the changes tend to be lasting.
What sex therapy can help with specifically
Research supports sex therapy’s effectiveness for:
Erectile dysfunction and other forms of sexual dysfunction
Low libido and desire discrepancies in couples
Vaginismus and pain during sex
Sexual anxiety and performance concerns
Recovering sexual intimacy after trauma or infidelity
Improving overall relationship satisfaction and emotional connection
Online sex therapy has expanded access significantly. If in-person sessions aren’t possible, many licensed sex therapists offer telehealth options with the same quality of care.
Is Sex Therapy Covered by Insurance?
It depends on your insurance plan and how the sessions are billed. Sex therapy delivered by a licensed mental health professional is often billed under standard mental health codes, which many insurance plans cover. However, coverage varies significantly by provider.
What to check before your first session
Ask your therapist if they accept your insurance or provide superbills for reimbursement
Contact your insurance provider to ask about mental health benefits and out-of-network coverage
Check if telehealth sessions are covered, as many plans now include online therapy
At our practice, we provide superbills to clients so you can submit for reimbursement through your insurance. We want cost to be as little a barrier as possible.
How long does sex therapy take?
The length of sex therapy depends on what you’re working through. Some people see meaningful improvement in 8 to 12 sessions. Others work with their therapist over a longer period, especially when sexual trauma or complex relationship issues are involved. Your therapist will give you a realistic sense of the timeline after your first session.
How to Find a Sex Therapist
Finding a sex therapist who is the right fit matters. Here’s where to start:
Search the AASECT referral directory to find a certified sex therapist near you
Look for a licensed mental health professional with sex therapy certification, not just general counseling experience. Sex therapists are licensed mental health professionals first, including licensed clinical social workers (LCSW), marriage and family therapists (LMFT), professional counselors (LPC), and psychologists
Ask about their approach to working with your specific concerns before committing
Consider online sex therapy if in-person options are limited in your area
The help of a sex therapist is most effective when you feel genuinely comfortable with the person. Don’t hesitate to have a consultation before committing to ongoing sessions.
Looking to Start Sex Therapy? Get in Touch with Our Sex Therapists
We know it can take a lot to reach this point. Searching for answers about sex and intimacy often means you’ve already been sitting with something painful for a while, maybe in silence.
At our practice, we help individuals and couples address the sexual concerns and relationship issues that are quietly getting in the way of closeness. We work from an emotionally focused, attachment-based approach. That means we’re not just looking at behavior or techniques. We’re looking at what’s happening underneath, the fears, the disconnection, the moments where you couldn’t reach each other, and helping you find your way back.
If you’re ready to take the first step, we’d love to hear from you. Book a consultation today, and let’s figure out together what’s possible.
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About Author
Elizabeth Polinsky is a Certified Emotionally Focused Couple Therapist (EFT) providing EFT marriage counseling in the states of Virginia, Maryland, North Carolina, South Carolina, Arkansas, and Nevada. She also provides EFT training and supervision to therapists looking to become certified in EFT Couple Therapy. As a military spouse, she has a special passion for working with military and veteran couples, and is also the host of The Communicate & Connect Podcast for Military Relationships.
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My podcast, blogs, videos, newsletters, and products are general information for educational purposes only; they are not psychotherapy and not a replacement for therapy. The information provided is not intended to be therapy or psychological advice; and nothing I post should be considered professional advice. The information provided does not constitute the formation of a therapist-patient relationship.
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