What Happens When You Go To Sex Therapy Or Sex Coaching (A Guide For Newbies)

It’s hard enough to seek support when you are asking for help with depression or anxiety. At least with that, most people know what to expect when they arrive in a therapy session. 

But what about when you need help with sex? 

To explain what happens when you seek sex therapy, let’s start with the difference between a sex coach and a sex therapist:

Sex therapists have qualifications in therapy (or counseling) and depending on where you live can be psychologists, psychotherapists or counselors. They are experienced in particular methods of therapy and have specific training and experience in working with psychosexual issues: issues relating to gender and sexuality and sexual problems. 

Sex therapists spend a considerable time looking at the past in order to help people to resolve issues, figure out patterns and gain the tools to change the patterns. 

Some therapists, like myself, have expertise working with couples (or poly groups). Others, also like myself, have expertise working with people around trauma (or Post-Traumatic Stress Disorder) and therefore can help people to resolve sexual trauma.  

Sex coaches, on the other hand, have qualifications in coaching.  

Some are also psychologists, counselors, or therapists. They are experienced in helping clients move forward into the future so they can meet the goals they set and create the life that they desire. They do talk about the past, but spend much more time looking at the present so as to move the client into the future.

How can a sex therapist and a sex coach help?

Seeing a sex therapist can help someone to become happier with their gender identity, sexual orientation, or feel less confused in these areas. Sex therapists help individuals and couples resolve negative patterns that cause them to have sexual problems like problems with orgasm (unable to have one or having one too quickly during sex), problems with arousal and desire, shame around their desires and concerns about sexual activity.

Seeking a sex coach can help an individual or couple learn to recognize their desires, talk about their desires and get them fulfilled. The focus is on helping couples and individuals to make healthy decisions, be risk-aware, and move into action so they get their sexual needs met.  

While a therapist can also work with clients in this area, the tendency in therapy is to look backward and figure out the ‘why’ part of things —  whereas in coaching we work more to look at the ‘how’ part, to move forward into the present and future. 

Finding someone a sex therapist or sex coach who knows what they are doing is really important. 

Different areas have different requirements for training and experience. 

For example, when I was trained, there were few training courses specifically for sex therapists. I did my training in clinical psychology but I received training in sexuality and gender diversity in a variety of different places after I had already qualified and was already seeing couples and individuals for sexual issues. 

The same is true for sex coaching. There are now excellent courses and organizations that you can join specifically relating to sex therapy, and also specifically relating to sex coaching. Since there is no one organization or license for sex therapists or sex coaches, the client needs to do a bit more research to find a good practitioner.

Here are a few suggestions to help you find the right sex therapist or sex coach for you:

1. Ask what kind of training the person has had in sexuality, gender, and diversity.

Expect them to have had some training and to be able to talk about it and to talk about any qualifications, certifications or licenses they may hold. 

2. Ask how much experience the person has in working with people on sexual, gender, and relationship issues.   

For therapists, most specific courses require supervised experience before completion and some require supervised experience after completion of the course in order to gain registrations or licenses. 

For coaches, if the course was specific to sex coaching there will have been some supervised experience. Some coaching courses do not require any supervised experience.

3. Ask about supervision —  current, and during training.

Most therapists engage in some ongoing supervision and for many, it is a requirement of membership in professional organizations. 

Coaches usually engage in supervision less frequently once they have qualified.

4. Ask about the range of clients the person has seen. 

Good therapists have seen a wide range of clients, even when they specialize.

There are good coaches and good therapists who are just beginning their careers and have not had the same breadth of experience. They are happy to get additional supervision when they come across something they have not worked with before.

5. Find out if the sex therapist or sex coach is experienced with and open to supporting your particular choices or lifestyle. 

If you have a specific issue like wanting to open up your relationship, polyamory, or kink and fetishes, you want to be sure that the person has experience in that particular area.

For all types of therapists and coaches who are polyamory-friendly, check out The Open List to find someone supportive. 

For all types of professional who are kink friendly, refer to the NCSF Kink Aware Professionals List.

Once you’ve made an appointment to see a sex therapist or sex coach, you may be nervous about your appointment. This is perfectly normal!

If you are coming to an appointment with me, I won’t expect you to spell everything out in the first session. My office is cozy and looks like any other therapist or coach’s office.  

This guide is solely about my practice, but may also help you understand what happens when you see a sex therapist or sex coach in your area, too. Of course, every therapist or coach will have different procedures, but if you want their specific details, just ask them! 

Here’s what you can expect if you come to see me for help with sex:

1. I will take the time to create a safe and confidential environment.

2. Whether you come for therapy or coaching, I will ask you questions. I will start with questions about your life and your relationships now. I may ask you questions about your life and your relationships in the past.

3. I will ask you questions about sex, sexual orientation, gender, sexual interests and whether or not you have experienced any sexual trauma. I will take a detailed sexual history. But don't worry, I will not ask for a blow-by-blow (excuse the pun) account of your sexual activity.

4. I will ask about likes and dislikes when it comes to touch, affection and sex.

5. Even if you come as part of a couple (or poly group), I am likely to ask to see you once on your own. This is because in my experience, people often initially find it difficult to talk about their concerns with their partners.  A solo session can help to identify the issues the person is afraid to talk about and build a strategy so the issues can be mentioned in the couple (or poly) session.

6. Depending upon the issues you raise I may give you homework to do on your own or with your partner. That homework may be sexual in nature.

7. I may also have you do exercises in the session, and this will not be sexual in nature.

8. I will most likely give you resources (workbooks, films, books) to use to explore.

9. If you come for coaching, we will certainly be creating some goals and action plans. If you come for therapy, we may also do these at some point.

Here’s what I won’t do:

1. I won’t ask you to describe your sexual activity in moment-by-moment details, unless I am asking you to talk through something in the context of resolving a trauma.

2. I won’t ask you to take any clothing off and I won’t physically examine you.  If you have certain types of problems, I might advise you to see a medical doctor who specializes in the areas where you would have a physical exam.

3. I won’t pressure you to do anything. The work will proceed at your pace.

If the thing that has stopped you from seeking help for sexual issues is wondering what happens when you go to a sex therapist or sex coach, I hope this guide has helped you face some of your anxieties. Sex coaching and sex therapy can help people live happier, healthier lives, so if you feel like it might benefit you, it's worth reaching out and finding a sex therapist or sex coach with whom you feel comfortable. 

Dr Lori Beth is a sex & intimacy coach, registered psychologist, speaker, educator and author who works with individuals, couples and polyamorous groups to find and express their authentic sexuality and ignite their desire.  She has a special expertise healing individuals from sexual trauma and is kink knowledgeable. Book a 30-minute strategy session with her here or email her. Listen to her podcasts, The A to Z of Sexâ and Sex Spoken Here on iTunes and Stitcher.