What Does a Couples Sex Therapist Do? A Guide
If you’ve ever wondered whether a sex therapist could help you (or you and your partner), you’re not alone. Many people are curious about what sex therapy involves but aren’t sure what to expect or whether it’s “for them.”
Let’s clear that up.
As a sex therapist, my goal is simple: to help individuals and couples work through emotional, relational, or mental blocks that are getting in the way of a healthy, satisfying sex life. That could mean anything from working through shame and anxiety to navigating mismatched desires, communication breakdowns, or past sexual trauma.
It’s not about judgment. It’s not about performance. It’s about helping you understand your experience and build a sex life that feels safe, connected, and aligned with your values.
So… What Is Sex Therapy?
Sex therapy is a form of talk therapy (also known as psychotherapy) focused on sexual concerns. It’s grounded in evidence-based approaches like:
Cognitive Behavioral Therapy (CBT)
Emotionally Focused Therapy (EFT)
Mindfulness-based practices
Couples communication tools
Therapists like me are trained in both mental health and human sexuality. Some of us come from backgrounds in counseling, psychology, social work, or medicine, but all reputable sex therapists have specialized training in sexual wellness.
Sex therapy can be done individually or with a partner. Sessions are always private, supportive, and tailored to your needs and goals.
What Sex Therapy Helps With
Sexual challenges don’t exist in a vacuum. They’re connected to how we feel about ourselves, how we relate to our partners, and how we were taught to think about sex.
Some of the reasons people seek sex therapy include:
Low or absent desire
Difficulty getting aroused
Trouble reaching orgasm
Painful sex (such as vaginismus or dyspareunia)
Erectile concerns
Premature or delayed ejaculation
Sexual shame or anxiety
Healing after sexual trauma
Mismatched libidos
Body image concerns
Hypersexuality or out-of-control sexual behavior
Concerns around porn use or sexual compulsivity
STI stigma or disclosure issues
Exploring new forms of intimacy
It’s also a space to unpack messages you’ve internalized from religion, culture, or upbringing—and rewrite your relationship to intimacy in an empowering way.
What Happens in a Session?
The idea of talking about sex with a therapist can feel daunting. I get it. But here’s the thing—therapy isn’t about making you uncomfortable. It’s about helping you feel understood, validated, and safe enough to get curious.
During a typical session, we might explore:
Your sexual history and beliefs
What sex means to you emotionally and relationally
What’s been hard—and what you wish felt different
What turns you on (or off), and why that might be
Communication struggles with your partner
You can come alone or with a partner, depending on your goals. Either way, our work is collaborative, not prescriptive. We’ll go at your pace.
Homework may include:
Reflective journaling or conversations
Sensate focus exercises
Mindfulness or relaxation techniques
Communication skill-building
And just to be crystal clear: there is never any sexual activity during therapy. Sex therapy is talk-based, respectful, and held to strict ethical guidelines.
What If There’s a Physical Issue, Too?
If your concerns have a possible medical cause (like hormone imbalances, pelvic pain, or erectile dysfunction), I may recommend consulting with a medical provider such as a urologist, OB-GYN, or primary care physician.
Sex therapists and medical professionals often work as part of a team. I can help with the mental and emotional aspects, and your doctor can assess any physical contributors.
What’s the Difference Between a Sex Therapist and a Sex Counselor?
It’s a good question—and the difference comes down to training and approach.
Both sex therapists and sex counselors are educated in human sexuality and may be certified by organizations like the American Association of Sexuality Educators, Counselors, and Therapists (AASECT).
The key distinction?
Sex therapists use psychotherapy to explore deeper emotional or psychological patterns.
Sex counselors often focus more on education, tips, and short-term solutions.
If you’re looking for a safe space to explore how past experiences, emotions, and beliefs are shaping your sex life, a sex therapist is the right fit.
Ready to Learn More?
Whether you’re struggling with desire, recovering from an experience, or just want to feel more connected in your relationship, sex therapy can be a powerful step toward healing and intimacy.
You don’t need to be in crisis. You don’t need to have all the answers. And you certainly don’t need to feel ashamed.
Let’s talk.
I work with individuals and couples all across Texas through secure, private virtual sessions. Book a free 15-minute consultation to see if this work fits you.
Because your relationship with your sexuality matters and you don’t have to figure it out alone.
