Adrian Scharfetter,PhD, Licensed Marriage and Family Therapist, Certified Sex Therapist

Adrian Scharfetter,PhD, Licensed Marriage and Family Therapist, Certified Sex Therapist

Telehealth Available
Professions: Marriage & Family Therapist, Sex Therapist
License Status: I'm a licensed professional.
Primary Credential: Licensed Marriage and Family Therapist - 113824
Billing and Insurance:

I don't currently accept insurance, but I can provide documentation if clients wish to submit to an insurance company for "out of network" benefit coverage

Fees: $190 per session - Individual
$230 per session - Couples
Free 10-15 min phone consult
Free Initial Consultation
Evening Availability


SACRAMENTO, California 95814

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My Approach to Helping

I am an AASECT Certified Sex Therapist. I work with low sexual desire, infidelity, mismatched desires and needs, emotional sexual pain, erectile dysfunction, delayed or impaired orgasms, ejaculation concerns, LGBTQIA health or curiosity, sexual trauma, embarrassment and anxiety in regard to sex and sexuality. Exploring types of sexual behaviors, relationship configurations and non-heteronormative expressions. Singles and couples who may be exploring or approaching issues in alternative relationships and alternative family structures, including ethical non-monogamy, polyamory, kink, living single, co-parenting, and chosen family.

My focus is in sexuality and sexual health functioning, self-esteem around sex and communicating needs in relationships, issues around sexual abuse, male sexuality and intimacy issues, PolyNon Monogamy, and Open Relationship Issues, Kink, BDSM, and LGBTQAI ally, integration of experiences around spiritual and psychedelic explorations.

I build with you a space of safety, understanding, and curiosity. My goal is to help you uncover your true potential, listen to your own wisdom, and start leading a life that is more of your own making. Struggling with the unknowns around sex, sexuality, and relationship can be challenging, and I hope to offer a safe, confidential space to help.

Specific Issue(s) I'm Skilled at Helping With

Sexuality and Sexual Health and Functioning

Self-Esteem around Sex and Communicating Needs within your Relationships

Male sexuality and intimacy issues

Poly, Non-Monogamy, and Open Relationship Issues

Kink, BDSM, and LGBTQAI ally

Work with Sexual Narcissism and Sexual Power Dynamics

Integration help around past experiences with psychedelics and other peak experiences that an individual may find difficulty processing alone

I believe therapy is one of your most critical choices in your journey, and one that could be specialized in your growth and healing. The work that I focus on allows for a greater capacity to explore:

Learning to navigate life transitions, especially around sex and sexuality

Asking for what you needwant in the bedroom

Developing the freedom to express your authentic self within intimacy and sexuality

Understanding consent and consensual sex

Recognizing barriers to romantic love and removing them

Finding your voice and becoming free to speak your mind

Connecting andor reconnecting to your creative self

Having more access to pleasure

Building self-esteem

Feeling less isolated

Replacing depression with a wider range of feelings and experiences

Developing skills to cope with anxiety

I am a part of various sex positivekink-aware communities and educational projects, and my goal is to help decrease the stigma of guiltshame that comes from how various cultures andor spiritual collectives see sex and sexuality.

I offer ally focused, inclusive, socially aware and progressive, sex positive, non-shaming therapy for all individuals regardless of race, orientation, gender, or disability.

I am also a Veteran and offer compassionate and and conscious therapy for Veterans and their family.

How Psychotherapy Can Help

Sex Therapy - Is it Right For You?
We all have to face numerous challenges that life throws at us. Whether it is difficulty with a loved one, challenges around life transitions or upsetting life circumstances, difficulty around intimacy, sexuality, and feeling ?othered? due to these circumstances and identities. My goal is to help you uncover your true potential, listen to your own wisdom, and start leading a life that is more of your own making.

Are you dealing with low sexual desire, infidelity, mismatched desires and needs, physical sexual pain, emotional sexual pain, erectile dysfunction, delayed or impaired orgasms, ejaculation concerns, LGBTIA health or curiosity, sexual trauma, embarrassment and anxiety in regard to sex and sexuality?

Are you exploring types of sexual behaviors, relationship configurations and non heteronormative expressions? Are you a single or a couple who may be exploring or approaching issues in alternative relationships and alternative family structures, including ethical non-monogamy, polyamory, kink, living single, co-parenting, and chosen family?

Maybe you are not satisfied with what?s happening (or not happening) in your bedroom. You would like more sexual intimacy in your relationship with your partner but every time you ask for it, it blows up in your face. You are struggling with performance anxiety or sexual pain and you?ve been avoiding having sex all together. Is low libido or a sexual dysfunction keeping you from enjoying your sex life? Let?s explore these questions together!

My Role as a Therapist

What to Expect?
In session, a sex therapist will work to help a person or couple seeking help achieve an improved mental and emotional state in order for them to enjoy a more satisfying sexual experience andor relationships. Sessions are strictly instructive and verbal, and all exercises and that involve physical contact are performed outside of the session. Sex therapy does not involve having sex with the therapist or being forced to have sexual contact with anyone else. Therapists may, as part of the process, encourage those in treatment to consider participating in certain intimate activities or exercises with their partner, but a person is never made to do so as part of therapy. Sex therapy is largely a mental and emotional reflection of one?s own internal conflicts, concerns, andor questions about sex.

My Guiding Ethical Principles

Throughout our life our ability to adapt to change and shift into new ways of being and thinking are a key aspect of growth. This principle is no different sexually. If we are too ridged in our ways, inflexible and determined to stay within strict parameters we can miss out on a wide, colorful spectrum of experiences and fantasies. I explore here a few items that can usher in our adaptability in our sexual lives.

Life has a way of tossing us the unexpected at times. Stress from work, going back to school, a new child in the family (or even pet), and even taking on major projects can have a drastic decrease in sex and sexuality. Being aware that these sudden shifts can put a damper on sexy time helps, as awareness is one of the first steps towards resolution. If you are not having as much sensualsexual connection as you would like, start by observing what has changed in your life or those of your partners world.

Sex and sexuality evolve throughout our lives. For some people, the experience of decrease in sex drive happens with age. People who are in long-term relationships often find that their sexual activities, as well as interests and capabilities, change over time. You might get curious and see or read about something that you want to experiment with so the change can positive. On the flip-side, the realities of medical conditions have an impact of your sexual expression that is less desirable, both with yourself and with others. Are you open to these changes? Are you willing to step into the unknown and explore? Is facing grief and loss of what was preventing space from developing into what may be? Adaptability requires facing the current reality just as it is and deciding from there what will or won?t work for you in a relationship, and this requires remarkable courage.

Adaptability is about recognizing and accepting that the people that I have connection with will necessarily evoke different things in us, and this may look different from another partner or partners. Once acknowledged, we can adapt to the reality of our loved ones by letting ourselves discern what this partner can bring out of us, by taking personal responsibility for staying in tune with the aspects of our sexuality that are central to us regardless of our partner, or by deciding that we need to move on to what it is we are seeking out in our connections, both intimately and sexually.

What I Say to People Concerned about the Therapy Process

Many times couples may consider if couples therapy is right for them. Improving relationships, discovering rue meanings of how and why two individuals fall in love, and how love changes over the course of time is rewarding and beautiful to witness. Having said this, there is a few instances that need to be noted that couples therapy doesn?t always work.

When there is domestic violence as a part of the negative relationship patterns conducting therapy with safety and emotional honesty is not likely to be possible due to various reasons. Safety, trust, honesty, and respect are the vital cornerstones I hold as critical when moving into this work. While sometimes there are situations where the partner violence is infrequent or minor enough for me to work with the couple, I may recommend that they seek individual therapy (which I could provide to one member) to help stop the pattern of violence. This would be a high consideration before couples therapy and may be the critical piece to acknowledge if couples work will be effective or not.

I also seek to inquire about alcohol and drug use that may be present in the relationship. When one or more people in a relationship are having a hard time regulating their use of any substances (in other words, is there addictive patterns, or compulsive patterns that are present), that person?s relationship with the substance, shame, and the emotional and mental consequences of being under the influence have a high chance of getting in the way.

There can be a variety of other minor issues that can be present inside the relationship. This can get in the way of positive and healing treatment, and I am very honest about the limitations that are present in our work. My goal is not waste your valuable time, though acknowledging that treatment my take a while and may not look like much at first. Trusting in the process is critical at this point, but there are limits and I am happy to offer suggestions to individual therapists, or another couples therapist that may specialize in specific items you are seeking help in.

There are a few critical items that can highlight the success of the therapy for all members of the relationship. One of the key items I seek to understand first and foremost is the reason that you love and respect each other. If you can answer this question with ease and connection, then the therapy has a very good chance of being effective. This base of respect and mutual appreciation, helps become the cornerstone for experiences of empathy, respect, honesty, and kindness that can help replace the old patterns.

Another key element that I look for is a capacity for emotional self-regulation that is present in the relationship and the individuals. That is, the ability to slow reactions, to be curious about your partner?s meaning, and to acknowledge when you are too upset to be productive. Speaking is a skill. Listening is even more of a skill. My hope is to slow the process down and engage on a ?speaking and listening? space, hearing not only what is being said, but how, and even why. It is these pauses and slowing processes that the biggest change and awareness takes place.

Finally, another key element for couples therapy is when both members of the couple are willing to make their own changes as well as acknowledge the changes that are being made. I seek to help couples to turn complaints about their partner?s behaviors into opportunities for the complaining partner to change. Once you are willing to make changes, I then open the door to introduce the communication tools and skills to help you make the changes you want to make to become the partner you want to be. This is usually done by helping each member redefine the pieces of their relationship in a way that they can both understand. It is vital that this part of the work is grounded and respected.

A final note: couples therapy does not always work out, even if everything is aligned properly and the individuals in the relationship are engaged and present. I offer a space for vulnerability and honesty, and sometimes that brings forth truths on where each individual is in their own reality as well as the relationships. Clarity and understanding can illuminate parts of the connection between lovers that are strong and supportive or bring forth an understanding that the time is now for moving apart. My hope is that whichever direction we go, it id done with love and compassion, as well as curiosity and understanding.

Services I Provide

  • Coaching
  • Creative Arts Therapy
  • Individual Therapy & Counseling
  • Marriage, Couples, or Relationship Counseling
  • Telehealth

Ages I Work With

  • Adults
  • Elders


  • English

Groups I Work With

    Bisexual Allied
    Body Positivity
    Gay Allied
    HIV AIDS Allied
    Intersex Allied
    Lesbian Allied
    Non-Binary Allied
    Open Relationships Non-Monogamy Family and relationship Dynamics
    Queer Allied
    Racial Justice Allied
    Sex Worker Allied
    Sex-Positive, Kink Allied
    Transgender Allied

Industries & Communities Served

  • First Responder/Medical Professionals
  • LGBTQ+
  • Military/Law Enforcement
  • Self-Employed and Freelance Professionals

Client Concerns I Treat

  • Attachment Issues
  • Breakup
  • Codependency / Dependency
  • Emotional Intelligence
  • First Responders
  • Identity Issues
  • Infidelity / Affair Recovery
  • Jealousy
  • LGBT (Lesbian, Gay, Bisexual, and Transgender) Issues
  • Men's Issues
  • Military and Veterans Issues
  • Polyamory / Nonmonogamous Relationships
  • Power
  • Rejection
  • Relationships and Marriage
  • Self-Love
  • Sex Addiction
  • Sexuality / Sex Therapy
  • Trust Issues

Types of Therapy

  • Depth Therapy
  • Depth-Oriented Brief Therapy
  • Dreamwork
  • Emotion Focused Couples Therapy
  • Expressive Arts Therapy
  • Hakomi
  • Humanistic Psychology (humanism)
  • Internal Family Systems (IFS)
  • Jungian Psychotherapy
  • Mindfulness-Based Cognitive Therapy (MBCT)
  • Narrative Therapy
  • Person-Centered Therapy (Rogerian Therapy)
  • Transpersonal Psychotherapy

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