PSYCHOSEXUAL PROBLEMS IN THE CONTRACEPTIVE CONSULTATION – FURTHER TREATMENT OR REFERRAL? (COUPLE THERAPIST)
Marital therapists, or couple therapists, work with the couple on the relationship between them. Referral for marital therapy will be more effective when there is agreement between the couple that changes in the relationship are required. Specific training in sexual difficulties is taken by selected therapists who work for Relate Marriage Guidance, or facilities may be available within a psychiatric department. The objective is to establish an emotionally secure relationship which permits normal sexual responses to occur and be enjoyed. The main emphasis is on the nature of the sexual interaction and away from the specific sexual response. It is essential for this therapy that both of the couple are willing to work at the goals set by the therapist. Based on Masters and Johnson’s work (1970), the couple are asked to carry out certain sexual homework assignments while keeping within limits such as the exclusion of genital touching or intercourse in the initial stages. The reaction of the couple to these assignments is then used to examine the interaction between them and to reveal some of the underlying problems. Modern modifications to the original Masters and Johnson techniques include a much more flexible approach using psychotherapeutic methods to identify and reduce the obstacles to the behavioural assignments (Bancroft 1989). Some therapists work as co-therapists, each working with one of a couple and conferring on how best to proceed together. Others work alone treating a couple and their relationship.
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