Sexual Counseling Approach Theoretical Overview:

Sexual Counseling Approach

Theoretical Overview:

Depending on the therapist, and their prescribed philosophies, a number of counseling related therapies tend to alleviate symptoms. Standard cognitive therapy often shows positive results; talking with the therapist and sharing issues, attending group therapy to reduce isolation and social stigma, variations of exposure therapy and stress inoculation training. Cognitive Behavior Therapy (CBT) which is an approach that attempts to change the patterns of thinking or behavior that are responsible for an individual's negative emotions, thus changing the way they feel about themselves and present to the external world. Essentially, behavioral therapy is an approach to psychological interaction that reinforces desired and eliminates undesired, behaviors in the subject. This theory focuses on the behaviors, not the thoughts that produce them and is broken down into therapy and modification. Of course, there are overlaps in the manner in which the therapy is conducted, but all are designed specifically to address the quality of the event (or overt behavior) exhibited. In general, CBT patients learn to identify thoughts that might trigger feelings of fear or anxiety and replace them with different thoughts -- simply replacing the memories of the trauma with new, more positive ones (SOURCE, YEAR, p. 22; Follette and Ruzek, eds., 2007).

CBT originated with classical conditioning and operant learning, combined with social learning theory and the role of cognitive experiences in determining behavior, CBT merges into a model that assumes most psychological and psycho-social problems derive from a fault coping or thinking process. This approach, though, also recognizes latent or observable factors that contribute to the individual's dysfunction. CBT tends to be more valuable because it uses an integrated approach that takes a more realistic and multidimensional approach. This also allows for a broader range of therapeutic interventions -- self-efficacy, individual thought and meditation about events, etc. (SOURCE, pp. 22-3; Wright, 2004).

Because CBT addresses the dysfunction or maladaptation, the therapist can focus on behavior, not the personality of the client. This makes CBT attractive for compulsive sexual behaviors, or addictions like excessive masturbation, addictions to pornography, etc. Focusing on changing the behavior, whether that is from a bad experience, an addiction, or simply the way one approaches family during stressful issues is a way to help the client get back on track more quickly, and help them function again. CBT is also appropriate as a first therpeutical intervention in that it focuses on fixing a behavioral problem, but leaves room for additional work with other theoretical approaches (Fong, 2006).

Analysis:

CBT can be effectively used in a variety of stressful or tense situations. Depending on the nature of the issue, focusing on changing behaviors often aids the individual in reducing an addiction, changing their approach to a situation, or focusing on interaction and dialog issues. CBT may be used, for example, with:

Severe anxiety from a recent sexual assault -- CBT may be used to unearth the issues surround the assault and resulting anxiety by helping the client focus on adaptation. The therapist should help the client understand that they were a victim, did not choose the issue, and the fault of the issue is with the perpetrator. Anxious feelings are a rational response to trauma, but by practicing assertion training, the client can take charge of their own emotions and begin to heal (SOURCE, p. 23).

A Gay/Bisexual person struggling to come out to friends and family -- CBT will help the client understand communication patterns, self-sabotage patterns, and again assertiveness to help family and friends understand that being Gay or Bisexual is not a choice, but just as much a part of the client as their hair color, body shape, and/or personality. Cognitive restricting can help the client evaluate and change any shame or negative feelings about themselves, and translate that into first self-acceptance, then honesty with family and friends (SOURCE, p. 23).