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The Difference Between Sex Therapy and Sex Coaching

Some of the things I am always asked when people learn about my exciting work as a sex coach:

"What type of clients do you see?"

"How can you help them and with what problems do they come to you?"

"Do you join them in their sexual activities or ... *blushes* get naked?" (Spoiler: No, I don't join them in bed and both my clients and I stay fully closed. I work talk-based.)

"I have heard of sex therapy. Are you a sex therapist? What's the difference between a sex coach and a sex therapist?"

This blog post looks at the difference between sex coaching and sex therapy.

As a clinical sexologist I empower, I enable, and I help clients learn. I strategize with my clients to define and reach their sexual goals. I am both their cheerleader and their coach. For me this means working with pathologically 'healthy' clients. A sex coach wouldn't be a fit for you, if for example, you'd experienced trauma or abuse, if you suffer from depression, burnout, anxiety, addiction or other mental health problems. Sex coaches don't diagnose and they are not trained in treating mental health problems or prescribe medication. Before you consider sex coaching, please take the time to get the support you need. (If you are in Germany, I recommend to find a qualified therapist near you.)

Sex coaching is a fit for you if you, for example, want to find more enjoyment in sex, struggle with libido or orgasm problems, want to lean how to shed feelings of guilt and shame or improve your ability to communicate your sexual wants and needs with partners. Sex coaches can guide you through sexual blockages you experience and can help you find ways to remove them.

Please note: I am not a medical professional nor am I a therapist, even though I hold a Bachelor of Psychology. I trained in human sexuality and I am an expert in solving sexual problems, I am a strategist at heart and a cheerleader by your side. You, on the other hand, are the expert in being you and so in contrast to therapy or a consultation with your doctor, we will work on eye level. It's important you are aware of both the limitations and opportunities my background brings when choosing a partner to support your individual journey.

I have to admit, though, the lines may be blurry from time to time. Some cases are very clearly falling into the 'need for therapy' vs 'need for coaching' bucket, others are less straight forward. Feel free to approach me or your therapist of choice to discuss what type of support can help you best.

What happens in real life? Both streams of professionals (therapists and doctors as well as coaches) refer-out to trusted colleagues. This means that if either a therapist, who may not be knowledgeable, comfortable or trained on aspects of human sexology, or a coach, who may see a need for classic therapy in their clients, will share their assessment with you as a client. They will be transparent about their limitations and in a best case scenario have a colleague of the appropriate discipline on hand that they can refer you to. Both coaches and therapists aim to help you in the best possible way. And sometimes that includes not starting a new client relationship, but rather introducing a more suitable professional.

What do KOLs (Key Opinion Leaders), those experts who spent decades in the field of sexology and sex coaching or therapy say about the difference between sex coaching and sex therapy? Let's start with Dr. Patty Britton, a pioneer in the field. In her book 'The Art of Sex Coaching: Expanding your Practice (2005)' she explains that sex coaching (vs. therapy) is present centred and works towards the futures, figuring out 'how the client can make it work better tomorrow' while a sex therapist would 'start in the past to find out why a client has a sexual concern'. Patti further outlines, that the coaching approach is 'client-centred' and 'dynamic', as in that the coach may 'make active suggestions, give advice or (...) accompany a client to a field trip. The coaching perspective also fosters a 'non hierarchical' dynamic and is 'empowerment- focused'.

Sandra Leiblum expressed further that sex coaching is built upon the methodologies of effective sex therapy with personal sex education at its core. While therapy investigates a client's past to help them cope with the present, coaching is focused on building on the present and creating a strong future. A coach can help a client become aware of their motivations and hurdles and can guide them in making shifts in the way they approach their problems and their goals. Coaches identify where a client is standing on a map and asks, "where shall we go next?”. AASECT distinguishes and defined sex therapists as licensed mental health professionals, trained to assess, diagnose, and provide in-depth psychotherapy, specialized in treating clients with sexual issues and concerns.

By the way: While governments regulate entry into protected professions, coaching and therefore also sex coaching is not yet a protected profession. (In Germany) you need a three year training to become a baker or a hairdresser and even more to become a barrister, teacher or accountant. However, you literally need no proof of training to work as a coach. If you wanted, you could call yourself a sex coach by tomorrow. However, certified professionals in the field of clinical sexology are typically recognized by organizations such as AASECT (in the US, the origin or the profession) or WASC. Feel free to explore those ressources for further info. I would love to see further regulation in the field of coaching to fully acknowledge the responsibility coaches take on and to help clients in their search for a trustworthy and qualified coach. The associations in the field are a starting point, of course, but I would like to see more regulation as the profession grows.

In my personal opinion, for clinically healthy clients, both sex coaching and sex therapy, are in essence two approaches or tools available to chose from based on your preferred style of working. Think about how you approach problem solving in your professional life: Are you a solution focused go-getter eager to hit the ground running? Someone who is fast at assessing the status quo and any mayor hurdles? Are you eager to smartly implement learnings from past successes and failures (both your own and your peer's) to kick-off a well thought-through action plan? Maybe then coaching is your preferred tool. Have you already experienced the support of a business coach, the access to well-working short cuts, or the releiving effect of tackling hurdles together with another expert (-coach) in your professional life? Would you consider the same approach for your sex life? After all, why would coaching, which is so incredibly wide spread and accepted as a fantastic way for improvement and success in the professional life, don't follow equal patterns in other areas of life?

For further reading/listening:

  • A very inclusive summary with links to academic research findings and international studies capturing coaching statistics: The ROI of Coaching in 2021 by Luiza Zhou


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