The state of theory in sex therapy - The Use of Theory in Research and Scholarship on Sexuality

Studies conducted in the U.S. indicate that a substantial proportion of the adult population experiences some sort of sexual dysfunction (Laumann, Gagnon, Michael, & Michaels, 1994; Rosen, Taylor, Leiblum, & Bachman, 1993; Spector & Carey, 1990). Although many individuals do not seek professional intervention for their sexual difficulties, a great number of people do. Despite criticism from some professionals regarding its legitimacy (e.g., Szasz, 1980, 1983), a specific field, commonly referred to as sex therapy, has evolved to address sexual difficulties presented by clients.

In the past 25 years, numerous articles and books have been published on the practice of sex therapy. Indeed, periodicals such as the Journal of Sex and Marital Therapy have been established explicitly as vehicles for the publication of empirical and theoretical articles in this field. At this point, it is legitimate to reflect on the history of sex therapy. Specifically, what is the current state of theory underlying the clinical enterprise of sex therapy? Attempting to answer this question is the primary focus in the current article.

In attempting to elucidate the current state of theory in sex therapy, I first provide a brief overview of the history of contemporary sex therapy. Subsequently, I discuss some basic assumptions underlying various sex therapy approaches. In other words, the emphasis in the current article is on the implicit and explicit assumptions underlying sex therapy with regard to a few primary dimensions. For example, what assumptions do different sex-therapy approaches entail with regard to etiological factors? What is seen as the appropriate unit of treatment (individual versus couple)? Last, what is the nature of the prescribed therapeutic intervention within each theoretic approach?

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