Do I Need Sex Therapy or Couples Therapy?

Written by Katie Mitchell, M.A., NCC, LPC, NCC
Certified Sex Therapist

This is a question that I hear a lot in the first few sessions of working with individuals and couples.  Client(s) are always interested to know if a specific struggle should be processed in an individual therapy setting, or if this something that should/could be addressed in couples therapy.  And, then do we need couples or sex therapy?  In short, the answer to this question is a bit more complicated than it appears!

Let me begin by explaining some of the differences between sex therapy and couples therapy.  According to the International Society for Sexual Medicine (ISSM), “Sex therapists work with simple sexual concerns also, but in addition, where appropriate, are prepared to provide comprehensive and intensive psychotherapy over an extended period of time in more complex cases.”  Sex therapy is utilized by professionals with both individuals and couples, depending on the struggles present and the presenting situation.  Couples therapy is defined by the American Counseling Association (ACA) as, addressing the most basic to the most serious concerns within a marriage/relationship in order to gain understanding (and possibly healing); “Overall, couples counseling can help couples slow down their cycles and reestablish realistic expectations and goals.”

I often like to think of this situation with the following phrase: all thumbs are fingers, but not all fingers are thumbs.  In the sense that most couples therapy is going to include sex therapy (at least for the way I therapeutically practice), but not all sex therapy is conducted in a couples setting. 

In the first couple of sessions with client(s), I usually probe about their vision of counseling and what they ultimately hope to achieve out of this experience.  Discussing counseling desires not only helps me when putting a treatment plan together, it also helps me conceptualize the type of therapy needed.  For example, if an individual is struggling with painful penetration, anxiety/shame regarding sex or sexuality, and/or erectile dysfunction, I might suggest starting with individual sex therapy.  If a couple is wanting to work on their communication and emotional connection, I would recommend beginning with couples therapy that would likely include discussions about their sexual connection. 

Each individual and couples counseling situation is unique!  Ultimately, if you are on the fence about sex therapy versus couples therapy versus individual therapy, I would highly recommend reaching out to a couple of professionals.  Most therapists offer a consultation (whether free or paid) to discuss fit-of-case experiences.  As a helpful FYI, Florida is currently the only state that requires a professional to be a Certified Sex Therapist (CST) if they are claiming to practice sex therapy.  Yes – there are plenty of qualified professionals who are not full CSTs that offer great sex therapy here in Houston; however, those individuals usually have plenty of training and research under their belt.  Again, this is where I would discuss your concerns, if you have any, with the professional you are working with or interested in working with!  Ethically, they will let you know if they are a professional fit for you or provide other referral sources that would be beneficial!

Our office does this very thing!  Reach out to us today, to discuss if individual, couples, or sex therapy is a fit for you!

Consider Couples or Sex Therapy:

If you are looking for couples or sex therapy to promote a healthy relationship, a skilled therapist can help with these goals. At Heights Family Counseling, we offer online and in-person counseling. So, you feel comfortable receiving services during the pandemic. You can work with a therapist from the comfort of your surroundings at a time that works well for you.

Begin Counseling in Houston, TX: 

Our team of skilled therapists is passionate about helping you build the life you want. We are value-driven and help people navigate life to make sense of their stories. Together, we ensure they are creating meaning and purpose in their lives. We would love to work with you. Follow these steps to begin counseling in Houston, TX, or online therapy in Texas:

1.    Contact our counseling clinic to set up a free phone consultation

2.    Meet with one of our therapists

3.    Begin couples counseling to help strengthen your relationship.