Is a Couples Therapist the Same as a Sex Therapist?

Jill Denton, MFT, CSAT, CCS: Definitely not. Many couples therapists are decidedly uncomfortable talking about sex. It might be as difficult for them as it is for many couples; therefore, the subject just doesn’t come up. Furthermore, some sex therapists don’t work with couples! For example, they might put their focus primarily on helping individual men with erectile problems, or individual women who are unable to orgasm.

In my own therapy practice, I encourage people struggling with sexual challenges to include their partners in conjoint therapy if they are part of a couple. But, I certainly don’t require that both people participate if this isn’t comfortable for the person who contacts me first.

When a married or partnered person contacts me individually, I’ll explain about my “three-legged stool approach” where I meet with one person by themselves, and maintain complete privacy with what they share. Then I meet with their partner alone, with the same strict confidentiality. The third leg consists of couple or conjoint counseling, with both people present (or on the phone). If one leg of a stool is knocked off, the stool topples. When all three legs are present, it makes for a safe and stable place to sit.

That’s what I do, but know that not all couples therapists are sex therapists, and not all sex therapists work with couples!

Denise Onofrey, MA, LMFTC: Sex therapy is a specialized branch of therapy. Sex therapists have additional training and expertise. A way to consider this is: a heart surgeon is a medical doctor who went to medical school, but he or she has additional and specific training to be a heart surgeon.

Though some sex therapists provide various types of therapeutic services, as does a general therapist, a general therapist should not conduct or consider themselves sex therapists unless they have had additional and specific training. Within the field of sex therapy, some therapists specialize even more beyond being a general sex therapist. For example, a sex therapist may specialize in only working with men, women, or relationships. Another sex therapist may only work with low desire issues, trauma recovery and sexuality, or enriching intimacy.

There are specific and well-respected governing bodies to ensure that sex therapists are highly qualified and well versed in the specialized field of sex therapy. One of the most renowned governing bodies which oversee the quality of education and professional development of sex therapists is the American Association of Sexuality Educators, Counselors, and Therapists (AASECT). AASECT professionals are engaged in advancing and maintaining standards for clinical and educational services in the field of human sexuality.

John Sovec, LMFT: Although some couples therapists are also trained as sex therapists, these are actually two distinctly different types of treatment. A couples therapist often focuses on assisting couples in building better communication and helping the partners build a strong relationship. A couples therapist works with issues of betrayal, infidelity, and pre-marital counseling.

What makes a sex therapist unique is that they are often a therapist who addresses the issues mentioned above, but also have training in working with sexual issues that often arise in relationships.

For some couples, there can be a mismatch in sexual needs and desires. A trained sex therapist will assist couples in building a strong, clear sexual language as well as assign exercises to support the growth of their sexual connection.

Some sex therapists also work with people dealing with issues of sexual addiction, porn addiction, sexual trauma, and sexual disorders.

If you’re looking for a therapist who can assist in sexual issues, make sure that they are licensed in your state and that they have additional certification which is often recognized as a CSAT (Certified Sex Addiction Therapist).