To pursue appropriate treatment, it is essential that providers assess the patient’s complete sexual functioning. This requires a thorough understanding of the nature of sexual dysfunctions, the factors involved in their development, and the means to assess sexual functioning on a variety of levels. Informing patients about treatment options, including the option of no treatment, is an important step in the assessment process. This needs to be handled very sensitively as the clinician does not want to inordinately sway the patient toward or away from treatment. Instead, the clinician should help the client or couple rationally weigh the relevant information to make a good decision for them.
It is important to note that patients with underlying psychopathology may respond poorly to sex therapy. Possible treatment plans for patients suffering from psychopathology in conjunction with a sexual dysfunction include
If the sexual dysfunction is not the primary problem, then a sexual dysfunction diagnosis is not appropriate, thus, making the fourth alternative listed above unfit.
Lobitz and Lobitz) suggest that the decision to treat the sexual dysfunction in light of observable psychopathology involves two criteria:
– This first criterion is problematic considering that the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revised (DSM-IV-TR) requires that a problem cause marked distress or interpersonal difficulty for it to be considered a mental disorder.
– The second criterion seems more relevant as it guides treatment providers in determining the severity of the psychopathology and its relevance to the sexual dysfunction (i.e., whether it is a cause or result of the other mental disorder).
For example, it has been suggested that depression affects those areas that control sexual functioning and decreased activity in these areas results in sex dysfunction.
McConaghy purports that most clinicians, regardless if they label it as such, deliver therapy that is cognitive–behavioral in nature and based on Wolpe’s conceptualization of sexual dysfunctions as resulting from anxiety about one’s sexual performance. In their review of empirical studies investigating the validity of treatments of sexual dysfunction, Heiman and Meston asserted that all of the empirically supported treatments are based on a cognitive–behavioral treatment model and the most frequent components in these treatments were sensate focus and systematic desensitization. More recently, O’Donohue et al. also conducted a critical review of empirical studies evaluating the effects of psychotherapy for male sexual dysfunction. Eighty percent of the obtained publications did not meet the reviewer’s inclusion criteria. They suggest that while clinicians maintain that treatments for male sexual dysfunction are efficacious, the lack of methodologically sound research in this area disallows claims regarding empirical validity.
Many studies examining the efficacy of sex therapy techniques have failed to employ control groups. Instead, they have compared treatment groups that have commonly integrated components from different techniques. For example, Everaerd and Dekker compared a treatment group that included sensate focus, sexual stimulation exercises, and the squeeze technique when premature ejaculation was present against a different treatment group that involved in vivo and in vitro systematic desensitization. In this study, the majority of couples in both groups showed some improvement; however, the research design makes it difficult to make any claims about what specific treatment was effective or the appropriateness of specific treatments for particular problems. Currently, difficulties in making inferences are attributable to methodological shortcomings rather than treatment inadequacies.
Despite the paucity of rigorous empirical research, clinicians continue to deliver treatments for sexual dysfunctions. Treatments ought to be tailored to the cause of the specific problem rather than to the particular diagnosis. In other words, males suffering from similar sexual dysfunctions (i.e., meeting the same DSM diagnostic criteria) may benefit from treatments that address different causes (e.g., anxiety vs. lack of ejaculatory control). The effort to deliver appropriate treatments for sexual problems is thwarted by the fact that the detection of psychological agents that cause and maintain sexual dysfunctions remains unclear; however, because normal sexual functioning affects an individual’s and couple’s quality of life, mental health providers can utilize current knowledge about possible etiological variables, the few existing psychometrically sound assessment instruments, and theore tically informed treatments that are likely efficacious for valid causal pathways. These treatments that are based on a cognitive–behavioral model will be discussed below. Or you can use Viagra New Zealand to treat ED.