What is psychosexual therapy?

The College of Sexual and Relationship Therapists (COSRT) defines psychosexual therapy as “The use of targeted counselling or longer term psychotherapy to help address sexual problems…a highly specialised work that involves an in-depth knowledge of anatomy, physiology as well as pharmacology.”


Psychosexual therapy is a form of therapy for couples and individuals who have ongoing issues with their sex lives that cause continuing distress. It’s a talking therapy that combines dynamic relationship therapy alongside more behaviourally focused work. No one takes their clothes off. The behavioural element sometimes involves specialised tasks done in the privacy of your own home.

Who can benefit from psychosexual therapy?

Psychosexual therapy is for people over 18, from any cultural background, religion, sexual orientation or gender/gender identity. It’s a therapy done either alone or with a partner. Typical issues include mismatched or lost desire, sexual anxiety perhaps trauma-related, orgasm difficulties, ejaculation or erection issues or problems with pain.

What happens in psychosexual therapy? 

Your therapist will listen carefully to each individual’s or partner’s view of the problem. Time is spent finding out how the issue developed and how it affects them. Couples can have different ideas about how they each experience their struggles. It is really important to understand these different viewpoints. Both are valid.

A careful history of all aspects of the relationship is taken, with a specific focus on the sexual relationship. Experiences of trauma, early family disruption and how adolescence was navigated are all explored. These can play important roles in the growth of current sexual difficulties.

Medical conditions/medications, and psychiatric issues are considered. Referrals to GPs are made if needed. After a detailed and careful assessment, a treatment plan is collaboratively put together.

Ongoing sessions involve talk, education about bodies/biology, targeted work on specific difficulties and some focused behavioural touching tasks. Myth-busting is ongoing!

What training do psychosexual therapists have?

A psychosexual therapist is an already trained therapist with additional specialist psychosexual training. Ideally, this additional training is to Master's level.

Psychosexual therapy training involves: 

  • the study of anatomy and the physiology of sexual response, psychosexual dysfunctions and desire disorders
  • assessment processes and treatment planning
  • specific behavioural and education work, mindfulness and other behavioural treatments
  • an understanding and experience working with diversity and different clinical, cultural and religious groups, survivors of trauma and sexual abuse

A psychosexual therapist is trained to:

  • create a safe space where gentle exploration of issues can happen at the client’s own pace
  • recognise when appropriate medical referrals are needed
  • have a detailed understanding of sex through the life span, following illness, mental health issues, disability, pharmacology and its impact on sexual and emotional function

What specific skills to look out for when choosing a trained therapist?

Your therapist: 

  • will be a skilled communicator, rapport and confidence builder
  • holds hope and optimism, validates, educates and lets you know you’re not alone
  • challenges myths and communicates that all sexual struggles can be understood and made sense of
  • understands that sexual experience is highly variable and “good enough” can be OK
  • will help you find the right language and confidence to communicate about sex and feelings effectively and creatively
  • will help you reconnect with your body
  • will help you improve/rebuild trust and physical/emotional intimacy together

It takes courage to talk but contact me and find out how I can help you.

The views expressed in this article are those of the author. All articles published on Counselling Directory are reviewed by our editorial team.

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London SW7 & W6
Written by Elisabeth Marriner, MSc Individual/Couple Counsellor+Sex Therapist
London SW7 & W6

Elisabeth Marriner MSc, is a highly qualified, experienced psychodynamic and psychosexual Individual and couple therapist offering online sessions. She works in private practice in West London and as a Visiting Clinician at Tavistock Relationships.
0207 361 0067

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