What to Expect in a First Session With a Sex Therapist
For most people, a visit to someone you have never met to talk about the most intimate part of your life is – to say the least – stressful.
Surprise!
It’s utterly normal to imagine the worst – embarrassment on your side, scary or intrusive questioning on the side of the therapist. And potentially judgement and shame.
However, luckily for us all, my clients tell me that their experiences are more positive. With the opportunity to unload and share stories (sometimes ones that have been held close for a life-time because of fear and shame) they typically say how much relief they feel.
In your first sex therapy session, you can expect
a professional, talk-only process designed to build trust and assess your needs. In therapy (sexual or otherwise), there is no physical contact, or sexual activity between client and therapist.
Every therapist has their own methods but here below is the broad outline of what might be covered.
Initial Assessment and History
The therapist will conduct a comprehensive assessment of your concerns, focusing on the biological, psychological, and social factors of your life.
- Presenting Concerns: You will discuss what brought you to therapy and what changes you hope to see.
- Sexual History: Expect questions about your past sexual experiences, habits, and any history of trauma.
- Medical/Mental Health History: They will ask about medications, physical health conditions, and any history of anxiety or depression.
- Beliefs and Values: You may explore how your family, culture, or religion influenced your views on sex.
Openness and honesty will work best even if it’s not easy at first.
Establishing the Therapeutic Relationship
- Confidentiality: The therapist will explain the strict ethical and legal boundaries that protect your privacy.
- Rapport Building: The goal is to create a judgment-free zone where you feel safe discussing sensitive topics.
- Sessions typically last 45–60 minutes.
- Couple sessions are often longer. I recommend 1.5 – 2 hours and I also suggest individual sessions for each of you to gain a full perspective.
Goal Setting and Treatment Plan
- Identifying Goals: You will work together to set specific, achievable objectives, such as improving communication, addressing dysfunction, or enhancing pleasure.
- Homework Assignments: While not always assigned in the very first session, you may be given “homework” to practice at home, such as communication exercises or specific types of touch.
- Education: Therapists often provide psychoeducation about anatomy and sexual functioning to correct myths or misconceptions.
How to Prepare
- Confirm Credentials: Ensure your therapist is a qualified mental health professional with additional training in sexual health. I have a Masters in Sexual Health from Sydney University, a degree in counselling and many years of additional specialised training.
- Reflect on Goals: Think about what success would look like for you. Be hopeful but realistic.
- Gather History: Have a list of your current medications and any relevant medical history.
- Bring Questions: Write down any topics or concerns you specifically want to address.
2. Legal and Ethical Exceptions
In all forms of therapy, confidentiality is not absolute. By law, a therapist must break confidentiality in the following scenarios:
- Imminent Danger: If you are a clear and immediate threat to yourself (suicide) or to an identifiable other person (homicide).
- Abuse Reporting: In Australia, your therapist is a “mandatory reporter” so must report suspected or confirmed abuse of a child (and others in some cases).
- Court Orders: Information may be subpoenaed if you are involved in certain legal or criminal proceedings.
- Supervision: Therapists may discuss cases with a clinical supervisor to ensure quality care, but they must remove all personally identifying information.
Do remember that your therapist is there to help and support your personal growth and change. An experienced sex therapist will understand your difficult feelings around coming to sex therapy for the first time.
It’s very normal and even healthy to protect the most personal parts of your life experience but, as you and the therapist grow in understanding your story, you can become less guarded and allow yourself to explore the complexity of your experiences with the therapist’s support and guidance.
Best of luck with your journey.
