As a licensed marriage and family therapist with 20 years of experience in private practice and more than 30 years in education teaching human sexuality psychology, Dr. Jan Parker isn’t somebody who is easily shocked. “I was shocked when I was a brand new therapist — but not now,” says Parker. “Part of what I think makes a good therapist is the capacity to look beyond the behavior.”
According to Parker, learning to develop this non-judgmental attitude is a key component of the Advanced Psychology of Human Sexuality course which is part of National University’s Master of Arts in Counseling Psychology program. But why study human sexuality, and what are the goals of a human sexual behavior class?
“I want students to come out of the four-week class having been exposed to enough information so they are not totally overwhelmed or shocked with what their clients tell them,” says Parker. “They need to face that initial shock of ‘Oh my God, how do I handle this?’ first in the classroom.”
Understanding human sexuality — and the complex psychology behind it — is important because our relationship with sex often acts as a barometer of our wider health and happiness. Unfortunately, according to some research, “Sexual dysfunctions are highly prevalent, affecting about 43% of women and 31% of men.” Therapists and counselors have the opportunity to help their clients understand and treat the causes of dysfunction, leading to happier, healthier, and more fulfilling relationships — not only with their partners but with themselves.
“I’ve worked with a lot of individuals and couples who are having trouble in their relationship and that’s leading to difficulties sexually because sex is one of the places that relational issues show up fairly quickly,” says Parker. “When people don’t feel connected, or safe or loved or cared about, then sex either goes away or becomes fairly mechanical.”
If you’re considering a career as a couples’ therapist, marriage counselor, or working in a related field, it’s crucial to develop clinical skills in human sexuality psychology — skills which can also make you more marketable to employers. Read on to learn more about what constitutes healthy sexual behavior, how therapists can help clients achieve successful outcomes, some current models of sex therapy that are being used, and some of the skills and traits that make a good therapist.
What Is Healthy Sexual Behaviour?
One of the central concepts developed in the human sexuality course is the understanding of what constitutes healthy adaptive sexual behavior. This isn’t always something that can be so easily put into categories of “normal” or “atypical” behavior.
“I don’t like the word ‘normal’ because sexuality is fluid, and it’s very different for one person than it is for another,” says Parker. “There is a wide range of sexual behaviors that fall within the limits of healthy human sexuality. There are some that I would never engage in — but that doesn’t make it wrong, it just makes it wrong for me. When that happens in a loving relationship, especially in a loving and committed relationship where both people enjoy what’s happening, and engage in it willingly with each other, then we are not going to put that outside the bounds of ‘OK’ sexual behavior. Rather than asking about what is normal, the better question would be what is healthy sexuality — and that varies from person to person.”
Culture can have a big impact on a person’s understanding of what constitutes healthy sexual behavior.
“In the United States, the cultural messages about sexuality are very confusing,” says Parker. “There’s the message that sex is pleasurable and you should enjoy that. There’s the message that you should only be sexual in a marriage. There’s the message that too much sex is a problem. There’s the message that women don’t want sex as much as men, etc., etc. There are all those confusing societal messages.”
If the message is already confusing, even more so is the wider question of what constitutes “normal” human sexuality on a societal level. “The heterosexual/homosexual continuum is another example,” says Parker. “There are a lot of people who are bisexual. There are people who have mild leanings one way and major leanings in another way. None of that is outside of the boundaries of ‘normality’ — but that’s in this culture. If you were in a different culture, there would be much stricter boundaries, or there might be wider boundaries.”
While there’s a broad spectrum of opinion on what constitutes “normal” or “healthy” sexual behavior — influenced, for instance, by factors like cultural and generational values — Parker’s emphasis is on guilt-free, shame-free, consensual experiences. So what can help clients deal with feelings of guilt or shame, manage the causes and consequences of sexual dysfunction, and ultimately, achieve more successful outcomes from therapy?
Human Sexuality Psychology — Successful Outcomes
Parker believes the quality of the therapeutic relationship between the client and the therapist is key to delivering a successful outcome; because every individual is different, this can make it difficult to assign specific success rates to the field of human sexuality psychology.
“The treatment outcome is going to vary, ” says Parker. “The client must want to change, the client must believe that the therapist believes that they can change, and the therapist must believe the client can change. The quality of the therapeutic relationship varies from therapist to therapist. There are therapists who are excellent at forming solid, good, empathic, warm, caring, therapeutic relationships and there are some that are not so good at that.”
Advances in technology and medical science, particularly in the field of neuropsychology, has also brought about huge changes to the way clients are assessed and offered treatment.
“With the development of PET scans you can see how the brain is working and having some kind of stimulus,” says Parker. “This has contributed to the understanding of the interaction between the frontal lobe which controls the decision-making thought process — oh-that’s-not-a-good-idea-to-yell-at-the-boss kind of stuff — and the pleasure center which is in the limbic system which deals with emotion, behavior, and motivation. In people with compulsivity of one kind or another, that communication process between those two parts of the brain is different than it is with people who don’t have that compulsivity. While this doesn’t change anything immediately, it does offer an explanation to the client and their family or loved ones for their behavior and really makes a difference to the way a client engages with treatment.”
Five Sexual Therapies and Interventions
Virginia Johnson and William Masters pioneered the field of research into human sexuality and sexual dysfunction in 1957. More than 60 years have passed since their groundbreaking early research — and as cultural values and mainstream attitudes around topics like gender, sexuality, marriage, and divorce have evolved, approaches to sexual therapy have likewise evolved to keep pace.
Below, we’ll take a closer look at some of the most significant shifts in the field of sex therapy — for example, the growing emphasis on inclusivity and diversity — as identified by the American Psychological Association (APA). We’ll also explore some of the most common approaches and techniques used by marriage and family therapists, such as engaging in mindfulness-based interventions with clients.
1. Mindfulness-based interventions
From Silicon Valley programs to proliferating meditation apps, the concept of mindfulness — originally a Buddhist tenet that embraces being fully present in the current moment, instead of worrying about the past or fantasizing about the future — has exploded onto the Western mainstream in recent years, with the mindfulness meditation industry carving a billion-dollar niche into the $4.5 trillion wellness industry. It’s no surprise that, with such widespread appeal — and the ever-growing body of research behind them — mindfulness-based interventions are also being utilized in the field of sex, marriage, and family therapy, where these techniques have already shown promise in controlled trials and studies.
For example, one pilot study published in The Journal of Sex Research, which involved “26 women [ranging in age from 25 to 63] with a diagnosis of sexual interest/arousal disorder,” who “participated in eight weekly group sessions” and “completed… at-home mindfulness exercises,” found that “mindfulness… significantly improved and mediated increases in sexual function,” with results that included “significant improvements in sexual desire, overall sexual function, and sex-related distress” — not to mention “significant improvements” to depressed mood in participants. Other studies have also shown that mindfulness can alleviate the symptoms of anxiety and depression, which frequently lie behind and/or result from sexual dysfunction, in groups of male patients.
2. Psychotherapy interventions over medications
There are a variety of medications intended to treat sexual dysfunction in men and women, the best-known example of which is undoubtedly the Pfizer drug Viagra. While medications like Viagra are effective for many people, there are many others for whom a strictly pharmaceutical approach falls short — for instance, individuals who experience sexual dysfunction as the result of a mood disorder or psychological trauma, such as depression, anxiety, PTSD, or having a history of sexual abuse. Issues such as having low self-esteem, feeling undervalued by a partner, suffering from chronic stress, or being dissatisfied with one’s physical appearance can also contribute to sexual dysfunction. In these and other situations, it’s essential to treat the emotional pain behind the behavior or disorder — not just medicate its physical symptoms or manifestations.
3. Expanding inclusivity
Unfortunately, there’s a long history of inequality and exclusion in healthcare and medicine, which extends to areas like family counseling and sex therapy — services that are often costly to access and/or have been chiefly geared toward heterosexual, monogamous, married couples. The good news is that, like other fields of therapy and counseling, marriage and family counseling are becoming more equitable, more accessible, and more inclusive.
If you intend to become a marriage and family therapist, a sex therapist, or a related type of therapist or counselor, it’s important to understand the needs of — and challenges facing — nonmonogamous individuals, nonbinary and transgender individuals, gay, lesbian, and bisexual individuals, and other individuals who face marginalization and discrimination. Training to counsel a diverse client population will enable you to provide more people with better support.
4. The couple’s perspective
Historically, sexual dysfunction such as pain or lack of arousal has been viewed — and treated — as an individual problem specific to the patient. But in most cases, the dysfunction or disorder is actually an issue that impacts not only the individual but also their partner or partners.
Fortunately, according to the APA, “[M]ore researchers are [now] beginning to look at both individual and relational data in studies of sexual dysfunction,” such as this study published in The Journal of Sexual Medicine. By taking a broader, more couple- or partner-oriented perspective on sexual dysfunction, therapists and counselors hope to help their clients achieve better outcomes like decreased pain, increased emotional intimacy, and increased sexual desire between partners.
5. Changing attitudes toward sex
Social attitudes and values are in a constant state of flux, shifting with each new generation while being molded by political and cultural events — for example, the Sexual Revolution of the 1960s and changing attitudes around birth control, or the shift in public opinion around same-sex relationships and marriages that has occurred over the past several decades. Attitudes around sex, gender, and relationships are constantly evolving — but even as taboos relax, many people still feel uncomfortable discussing their sexual issues candidly.
Embracing online therapy or teletherapy — for example, offering services through an app or website — is a way to reach and support patients who might not feel comfortable discussing their issues in a face-to-face setting. The APA noted that, while “more research is needed… early studies have shown cybertherapy to be effective for treating a variety of sexual problems in men and women.”
What Makes a Good Therapist?
It’s crucial for aspiring therapists to actively develop — and maintain — the skills that are needed to understand and communicate with their clients. According to Parker, a good therapist needs to have the ability to look beyond their client’s behavior and tackle the root causes of issues — a process that requires patience, self-reflection, and critical thinking, among numerous other skills.
“People act out types of behaviors because they are in some kind of pain,” says Parker. “It’s the ability to look at what the pain is and not get caught up in the details of the behavior that I believe is part of what makes a person a good therapist.”
So what are some of the soft skills you’ll need in order to become an effective therapist? Here are a few examples.
- Active listening and clear communication, both verbally and in writing
- Critical thinking and the ability to remain analytical — even when the situation gets heated or emotionally intense
- Adaptability and flexibility, which will help you tailor your approach to each client as their needs evolve
- Strong interpersonal skills, such as patience, dependability, and demonstrating respect for others
- Time management and organizational skills
- Self-awareness and the capacity for reflection
Learn more about the traits and skills you’ll need to become a successful psychologist — or, dig deeper into the essential skills for specific areas of therapy, such as Applied Behavior Analysis (ABA) and child psychology.
Therapy and Psychological Fitness Requirements
Parker believes that many students are drawn toward a career in therapy because they have a desire to help others — which is often based on their personal experiences of specific issues. As such, students in the Counseling Psychology program are required to engage in 25 hours of personal psychotherapy.
“Helping other people heal is sometimes an unconscious desire to heal themselves,” says Parker. “That’s why it’s so important for the therapist to do their own work because they need to work through their issues outside of the therapy room where they are the therapist.”
A student’s “physiological fitness” is also screened before they are accepted into the Counseling Psychology program.
“We have a two-stage process,” says Parker. “The students have to submit a written application which includes two essays, one which asks about how the important relationships in their life have contributed to how they have become who they are today. The second question is for them to define two positive aspects about themselves and two aspects of growth about themselves. We are looking for people who are able to be self-reflective and who can own the parts of them that still need work. Then, if the students pass the written screening, we have an in-person interview, and in that interview, we ask many personal questions. Again we are looking for the capacity for self-reflection and the capacity to own the part that is theirs.”
Taking an Online Class in Human Sexuality Psychology
Want to gain a deeper understanding of the psychology of human sexuality? Consider taking an online course.
While National University pioneered many of the online learning techniques which are now commonplace at universities around the world, it has only recently launched the counseling psychology program online.
“We had our first online cohort start in May,” says Parker. “We resisted going online for years because therapy is a relational process. How do you teach somebody to be relational online?” Two things changed the faculty’s mind.
“Technology has advanced to the point where students can make videos and show them through web conferencing tools like Zoom,” says Parker. “It’s not quite the same as doing it in person, but you can see a lot to help the student recognize what works and what doesn’t. The other thing was because of work or family commitments, many of our potential students were unable to get to campus by 5.30 pm to take the program; so by not offering an online class, we were eliminating a whole group of students.”
Video plays a huge role in the delivery of online classes. “I developed a counseling techniques class,” says Parker. “I did a whole bunch of videos where I demonstrated the techniques. The students then have to submit their own videos where they also demonstrate the techniques.”
However, even students in the online course must come together and practice the techniques in a “real world” environment. “We’ve also added two in-person intensives where students meet for three days, eight hours a day, and do a lot of role play,” says Parker. “They practice all the different ways in which they meet a client for the first time and do an assessment session, do basic counseling skills, practice running group therapy, working with children and adolescents, and working with couples and families. That allows them to have that in-person aspect that we worried we might be missing online.”
Where Can These Skills Be Applied?
Students who earn a degree in counseling psychology, such as a Master of Arts in Counseling Psychology, can explore careers like a social worker, school counselor, group therapist, or health psychologist. A formal specialization in sex therapy — or, at minimum, an understanding of the fundamentals in diagnosis and treatment — enables counselors and psychologists to better understand and serve their patients.
The Master of Arts degree in Counseling Psychology at National University is an accredited program, available both online and in a traditional on-campus format, that offers students two specialization tracks: the MFT Specialization or the Combined MFT/LPCC Specialization. While different in scope and focus, both specializations provide students with the foundational skills necessary to become Marriage and Family Therapists (MFTs) in California. Students who graduate with an MA in Counseling Psychology at National University will be prepared to advance to the next step of their post-graduate associateship and licensing exam.
Let’s take a closer look at each of these specializations and some of the objectives they emphasize.
The Marriage and Family Therapy (MFT) Specialization
“California is where marriage and family therapists (MFTs) first began back in the late 1960s and early 1970s,” says Parker. “The MFT license here in California is a broad license. It means that people can work with anyone where there is a relational aspect to the therapy. That can be the relationship they have with themselves or with others, for instance, family members, romantic partners, co-workers, or friends.”
The MFT specialization within our MA in Counseling Psychology program is designed for students who wish to focus their careers upon serving populations like children, families, couples, and teenagers. The MFT Specialization prepares students with the skills necessary to assess and treat couples and individuals with a variety of disorders and impairments, in addition to patients whose relationships are being impacted by stress or other life events and situations.
Learn more about the MFT Specialization by contacting our admissions office and requesting information about our MA in Counseling Psychology program.
The Combined MFT/Licensed Professional Clinical Counselor (LPCC) Specialization
“The LPCC license is relatively new in California, and it allows people to work with unrelated adults, unless they take specific training in working with children, couples and families,” says Parker. “In our program, if someone takes the LPCC program, they actually take the combined program because it’s much better that they have training in working with children, couples, and families because that is a large part of the population of people who are seeking therapy.”
Like its name suggests, the Combined MFT/LPCC Specialization merges aspects of the MFT Specialization with an additional component, the Licensed Professional Clinical Counselor (LPCC) Specialization. While most states use the title “Licensed Professional Counselor,” or LPC, California adds a clinical element, demanding rigorous training and extensive qualifications that include passing a clinical exam. The combined specialization satisfies the academic criteria for both LPCCs and MFTs, providing a versatile and flexible degree option for students who are interested in pursuing both paths.
Learn more about the Combined MFT/LPCC Specialization — and whether this option is right for you — by exploring the accredited MA in Counseling Psychology program at National University.