Psychosexual therapy

Written by Katherine Nicholls
Katherine Nicholls
Counselling Directory Content Team

Reviewed by Laura Duester
Last updated 17th January 2023 | Next update due 16th January 2026

The aim of psychosexual or sex therapy is to help you improve the physical intimacy between you and your partner and overcome or manage any sexual difficulties you’re having. Whatever your gender, sexual orientation or relationship status, sex therapy can support you to feel more comfortable about getting intimate.

What is sex therapy?

Having sexual difficulties can feel very isolating. You may feel self-conscious and unable to speak up about them, whether that’s having an honest conversation with your partner or reaching out to a professional. The truth is, sexual problems are very common and the best way to tackle them is to talk about them.

If the problem is affecting your relationship, being honest and open with your partner about what’s happening is a great first step. For some, this alone is enough to help work through the problem. For others, more support is needed.

This is where psychosexual therapy comes in. Sex therapists are qualified counsellors, doctors or healthcare professionals who have completed extra training to help those having sex-related difficulties.

Psychosexual therapist, Natasha Anderson-Foster, explains more about the approach.

What causes sexual difficulties?

There can be various causes for sexual difficulties and their origins may be:

  • physical (illness, disability/chronic illness, accident, surgery or medications)
  • psychological (depression, anxiety or other mental health conditions)
  • emotional (unhappiness in the relationship, unresolved grief)
  • situational (certain situations or environments)

Visiting your doctor is a good first step if you think the cause may be physical. Sometimes there will be ways your doctor can help (for example, trying different medications), but if not, they may recommend psychosexual therapy. While you can see a sex therapist on your own, if the problem is affecting your partner it helps if they can attend sessions too.

Sex is loaded with emotion and often, talking it through together with an impartial therapist can help ease tension and bring you closer together.  

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What can sex therapy help with?

Sex therapy looks to help with any problem or difficulty relating to sexual relationships. This can include:

  • a lack of sexual desire
  • difficulty getting or maintaining an erection
  • premature ejaculation, or other ejaculation problems
  • difficulty climaxing
  • pain during sex or being unable to have penetrative sex

Talking to a stranger about your sex life may feel uncomfortable, but sex therapists are not here to judge. By being honest and talking about what you’re experiencing in this confidential setting, they will be able to help you explore the root of the problem and offer ways of helping you overcome or manage symptoms.

After various tests, scans and hospital appointments, I was diagnosed with vestibulodynia, a condition that causes pain when the inner vulva/vagina is touched. While the relationship wasn’t salvageable in the end, I was relieved to have a diagnosis. It gave me something to work with.

- Painful sex: it's time to speak up

What to expect from sex therapy

Most therapists will arrange an initial consultation with you in the first instance. This is a chance to talk to your therapist about what you’re looking for help with and for them to explain more about how they can help. Here you should also get the chance to arrange logistics - how often your sessions will be, who will attend and how long the sessions will last.

What will happen in the sessions will depend on what it is you’re seeking help for. Sex can often be tied up in other emotions and relationship dynamics, so you may find some sessions explore topics outside of sex.

Your sessions will give you and your partner (if they join you) the chance to talk through what’s going on and understand what could be causing the problem. Your therapist will likely advise you to try various exercises outside of your sessions. You can then reflect on how well these exercises went in future sessions.

Once you get through the initial nervousness of talking about sex, you’ll be able to explore how sex affects your relationship and what it is you need to feel fulfilled. If sex is important in your relationship and is causing problems, sex therapy is an option to help you overcome these problems and enjoy physical intimacy again.

What qualifications should a sex therapist have? 

In the UK, practising psychosexual therapists should be trained with a minimum of two years in a post-graduate diploma in psychosexual therapy, plus a minimum of 200 supervised clinical hours. Although it's not a legal obligation, some psychosexual therapists will be registered with the College of Sexual and Relationship Therapists (COSRT), the UK's leading membership organisation for therapists specialising in sexual and relationship issues. 

Bear in mind that other (non-psychosexual) counsellors may have undertaken CPD or similar training to help with treating psychosexual difficulties in case these come up during the course of general/non-specialist therapy.

How to find a psychosexual therapist

If you're ready to work with a sex therapist, you can use our search tool to find the right therapist for you. Take your time to browse profiles and see who stands out to you. When talking about vulnerable topics, being able to build a sense of trust and rapport with your therapist is key.

Try to get to know the therapist and more about the way they work, so you feel more comfortable getting started and if anything doesn't feel right, you can look for a different therapist that suits your needs. 

I have worked with many couples that have gone through a psychosexual programme. It is more than going back to their sex life before. It is about finding a new way to really connect physically, learn to communicate about sex, and to explore and develop together to create something that really works for both of the couple. 

- Counsellor, Nicola Buchanan, COSRT(Acc), MA, PST PgDip, PCSA

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