Lights. Camera. Action.

LET’S TALK ABOUT SEXStarring: ANDREA KHOURY AND VINISHA RANA

Scene 1: Do we really need to learn about sexuality?Scene 2: What’s the worse that could happen?Scene 3: Its all about the DialogueScene 4: Educate yourselfScene 5: Our role in this movieScene 6: Let’s practice the scenes

Movie Layout

Do you think our program’s absence of sexuality courses limits your competency as a

counselor?

Yes B/C research says:

★ Counselor comfort with sexual issues directly correlates with the client’s comfort with discussing sexual issues with their counselor (Ayers & Haddock, 2009; Berman,

1996)

★ Counselor comfort with sexual issues directly correlates with Sexual education in Graduate School (Fife, Weeks, & Gambescia, 2008; Miller & Byers, 2008, Miller & Byers, 2009).

★ Counselor comfort level has shown to have a more significant impact on a client’s comfort than amount of training and clinical experience (Ayers & Haddock,

2009; Berman, 1996)

★ Counselors may be inadvertently harming their clients if they are embarrassed or uncomfortable discussing sexual topics (Harris & Hays, 2008; McCarthy &

McDonald, 2009)

Statistically speaking...

★ Think about when you do an intake or assessment for clients, are there typically any questions or items on these forms or in these procedures that allow you to address the internet sexual activities your clients may be engaged in? 81% Say NO

★ Have you ever had a client discuss their internet sexual activities with you? 71% Say YES

★ In my opinion, the expression of sexuality is an acceptable topic for everyday conversation. 54% said Agree or Strongly Agree

■ In Dr. Hinman’s opinion this is dismal and shows that they are not comfortable at all

The WORST that could happen

Safety Incorrect or no Information

on how to protect themselves may result in

unwanted pregnancies, STDs or risky behavior

ConfusionClient could become even more confused regarding their sexual orientation

and identity as an individual

JudgementClient could feel hurt or judged due to what they have shared and thus respond by losing their

trust in you.

“

”

...the reality that many counseling training programs virtually ignore sexual issues, and that clients frequently perceive mental health care providers as being uncomfortable with sexual issues and lacking clinical skills when discussing sexual issues, including Internet pornography addiction.

Dr. Bradly K. Hinman

Our lovely Dr. Hinman conducted his research to help address...

Why the dialogue is important

★ Counselors should be familiar with terminology used with LGBT clients.

★ Counselors should use identity-affirming language to avoid negative stereotypes and shaming our clients.

★ Depending on a person’s age or cultural experience they would describe their sexuality differently Ex. Homosexual vs. Gay vs. Lesbian.

★ Therefore counselors should always ASK their client how they define their sexuality and refer to it in the same way their client refers to it.

Terminology of Sexual Orientation

See your informative handout :)

Activity Time

Educate Yourself

★ AASECT (American Association of Sexuality for Educators Counselors and Therapists) provides ongoing training and continuing education in sexual education, counseling, and therapy. [Sex Therapist; 90 hours of coursework, 300 supervised clinical hours]

★ The Sexual Health Network has an informative site that is helpful for learning more about sexual health, relationships, sexual education, and health concerns

★ Yuan, Koss, and Stone include definitions and considerations for working with sexual trauma survivors. (Yuan, N. P., Koss, M. P., & Stone, M. (2006). The psychological consequences of sexual trauma)

★ Bidell discusses important issues for competent counseling with gays, lesbians, and bisexuals (Bidell, M. P. (2005). The sexual orientation counselor competency scale: Assessing attitudes, skills, and knowledge of counselors working with lesbian, gay, and bisexual clients. Counselor Education & Supervision, 44, 267-279. )

★ Respond openly and confidently when sexual values are challenged★ Communicate effectively about sexuality★ Use sexual vocabulary which is appropriate to the situation★ Be sensitive to and respectful of others’ feelings and anxieties towards sexual

matters★ Be confident in knowledge about sexulaity★ Be posed in session when addressing sexual matters★ Encourage clients to explore their own sexual values★ Have respect and tolerance of others sexual values and practices

Competent Counselors Should:

DSM-5: Sexual Dysfunctions

“Clinically significant disturbance n a person’s ability to respond sexually or to experience sexual pleasure”★ Delayed Ejaculation: marked delay in or inability to achieve ejaculation.★ Erectile Disorder: marked difficulty in obtaining, maintaining an erection during sexual activity; marked

decrease in erectile rigidity.★ Female Orgasmic Disorder: marked delay in or infrequency of or absence of orgasam; reduced intensity

of orgasmic sensations.★ Female sexual interest/arousal disorder: Absent/reduced interest in sexual activities/thoughts/excitement

or genital or nongenital sensations★ Male Hypoactive Sexual Desire Disorder: deficient or absent sexual thoughts and desire for sexual activity.★ Genito-Pelvic Pain/Penetration Disorder: Recurrent difficulties with vaginal penetration, vulvovaginal or

pelvic pain during penetration, fear or anxiety about vulvovaginal or pelvic pain in anticipation of, during or as a result of penetration.,

★ Premature Ejaculation: recurrent pattern of ejaculation occurring during sexual activity within approximately 1 minute following vaginal penetration and before individual wishes it to occur.

Scene 1

Lola, a 25-year old laboratory technician has been in a domestic partnership to a 32-year old cabdriver for 5 years. The couple has adopted a 2-year-old son, and the marriage appears harmonious.

The presenting complaint is Lola’s lifelong inability to experience orgasm. She has never achieved orgasm, although during sexual activity she has received what should have been sufficient stimulation. She has tried to masturbate, and on many occasions her partner has manually stimulated her patiently for lengthy periods of time. Although she does not reach climax, she is strongly attached to her partner, feels erotic pleasure during lovemaking and lubricates copiously. According to both of the them, the partner has no sexual difficulty. Exploration of her thoughts as she nears orgasm reveals a vague sense of dread of some undefined disaster. More generally, she is anxious about losing control over her emotion, which she normally keeps closely in check. She is particularly uncomfortable about expressing any anger or hostility. Physical examination revealed no abnormality.

Scene 1 Discussion★ What are your thoughts about Lola’s presenting concerns?

★ As Lola’s clinician, what would you do to explore with her?

★ Are there any diagnoses you would want to consider or rule out?

★ Do you feel that there are any potential biases you may have as a counselor that would prevent you from competently treating Lola?

Scene 1 Feedback

★ Lola’s sexual difficulties are limited to the orgasm phase of the sexual response cycle (she has no difficulty in desiring sex or in becoming excited). During lovemaking there is what would ordinarily be an adequate amount of stimulation. The report of a “vague sense of dread of some undefined disaster” as she approaches orgasm is evidence that her inability to have orgasms represents a pathological inhibition.

★ Female Orgasmic Disorder due to Psychological Factors

Ayres, M. M., & Haddock, S. A. (2009). Therapists’ approaches in working with heterosexual couples struggling with male partners’ online sexual behavior. Sexual Addiction & Compulsivity. 16, 55-78

Berman, L. A. (1996). A study of the influence of sexuality education experiences, sexual comfort and agency support on social workers willingness to address client sexual concerns (Doctoral dissertation)

Diagnostic and Statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.

Fife, S. T., Weeks, G. R., & Gambescia, N. (2008). Treating infidelity: An integrative approach. The Family Journal: Counseling and Therapy for Couples and Families, 16, 336-323.

Harris, S.M., & Hays, K.W. (2008). Family Therapist Comfort With and Willingness to Discuss Client Sexuality. Journal of Marital and Family Therapy, 34, 239-250.

Hinman, B.K. (2013). Mixed Methods Analysis of Counselor Views, Attitudes and Perceived Competencies Regarding the Treatment of Internet Pornography Addiction.

Spitzer, R. (2002). DSM-IV-TR casebook: A learning companion to the Diagnostic and statistical manual of mental disorders, Fourth edition, text revision. Washington, DC: American Psychiatric Pub.

Van Den Berg, N., & Crisp, C. (2004). DEFINING CULTURALLY COMPETENT PRACTICE WITH SEXUAL MINORITIES: IMPLICATIONS FOR SOCIAL WORK EDUCATION AND PRACTICE. Journal Of Social Work Education, 40(2), 221-238.

http://itspronouncedmetrosexual.com/2013/01/a-comprehensive-list-of-lgbtq-term-definitions/

www.assect.org

http://ced.uncg.edu/wp-content/uploads/2012/06/Sexuality_Counseling_Guidebook-Volume_IV-Fall_2009.pdf

KEEP TALKING ABOUT

SEX

WEWANT

YOU TO