How To Know If You Need A Sex Therapist Or A Sex Coach To Help Your Relationship

13 minute read

If you’re at the stage where you want support to improve or make sense of your sex life; there’s one key question to ask yourself: do you need a sex therapist or a sex coach?

Why, you may ask? 

Because they’re different – and both have their own set of pros. Take it from a sex therapist and sex coach herself, their approaches aren’t one and the same. And this matters for the results you’re looking to achieve.

Perhaps you’re experiencing low or no sex drive. With accompanying pressure and stress surrounding sex.

Or maybe you’re struggling with your mental health and this, in turn, is affecting your interest in sex in ways you’d like to understand better. 

You might also be experiencing sexual anxiety and relationship insecurity at the same time, and you’re not sure what’s what and how to get past it and onto the other side. The side where sex is plentiful and enjoyable – and you relish emotional intimacy with your partner. 

This article will empower you with the information needed in order to know who or what kind of support best matches your unique needs. 

The truth is – when it comes to the differences between sex coaching and sex therapy they’re often far too simplistic. Coaching is usually described as looking forward and being solution-focused, whereas therapy is thought of as focusing on the past in order to understand it and feel better in the present

While these differences may ring true in some sense – it’s way too shallow of an answer. And depending on the style of sex coaching and the type of psychotherapy your sex therapist specializes in – more often than not this is a faulty statement altogether.

Let’s get into the nitty-gritty and make sense of the true differences, once and for all!

What is sex therapy?

Sex therapy is treatment for all kinds of sexual difficulties. Typically the sexual difficulties that a sex therapist will help you with are actual diagnoses in the DSM. The DSM (The Diagnostic and Statistical Manual of Mental Disorders) is the official manual of mental health disorders and symptoms that lead to a particular diagnosis. 

These diagnoses range from the sexual (such as sexual desire disorder or genito-pelvic pain) to the non-sexual (such as depression and anxiety). 

If you see a therapist they will use the DSM as a tool to help discover the severity of what you’re experiencing and what diagnosis best matches your symptoms. For instance, has this been an ongoing problem for more than six months, and is it something that comes up during solo sex too, or only during partnered sex?

What do sex therapists focus on?

Sex therapy can look very different, depending on the therapeutic modality your therapist is trained in. For instance, if you see a therapist that specializes in CBT (Cognitive Behavioural Therapy) they’ll likely focus on your thoughts and give you concrete tools to help you reframe those thoughts. 

If you see a psychodynamic therapist, they’re likely to focus on the broader picture; not just your thoughts in the present day but what your childhood was like and the possible ramifications of that on your present-day sexuality. 

Generally speaking though, therapists use a “top-down” approach – which means they assess:

• What’s going on in your mind to make sense of how you’re feeling, 
• Why this is happening, 
• And what can be done about it to improve your situation. 

One of the positives of seeing a sex therapist is that they’re formally trained and have to follow a strict code of ethics in order to keep practising. Another positive is that they can help you with other difficulties you might be experiencing at the same time. 

For instance, if you have low desire and simultaneously feel depressed – your therapist might want to treat both your depression and low desire at the same time. This is because our sexuality and sex life are closely linked to our mental and physical health. 

Because of this link, we need to address it all in order for you to get your sex drive back. This is why sex therapists look at the whole picture of your experience to help suss out which problem area needs support first.  

When you experience sexual difficulties such as pain during sex or orgasm problems this might also have negative effects on your relationship. Perhaps the mere mention of sex from your partner shuts you down and leads to arguments or a lack of general closeness. 

You might even find yourselves struggling to put into words the wall that your sexual difficulties are building between you and your partner. Because the enmeshment is too tricky for you to unravel on your own.

In order to get a sense of what needs tending to your sex therapist will look at the big picture and see what is causing the difficulties. From this wide lens, your therapist will assess your mental health, the dynamic of your relationship, communication patterns, perhaps even your attachment style – all in order to help you move forward and create the sex life you still want deep down.

My free resource The Desire Test helps you take that first step towards an increased sex drive, by understanding your decreased desire. 

Take the 10-page assessment quiz, get the answers you need to understand what’s standing in the way of your desire, and get free sex and relationship tips directly to your inbox. You can unsubscribe at any time.

What is sex coaching?

The biggest difference between sex coaching and sex therapy is that sex coaching, unlike therapy, isn’t treatment. 

This doesn’t mean sex coaching can’t still help you with a wide variety of sexual difficulties. It’s just that the approach and the goals differ from that of a therapist.

The approach of a sex coach isn’t based on diagnoses but rather on helping you get past difficulties (that might not exist in the DSM) and create a truly satisfying sex life. 

This means coaching goes beyond simply removing of the negatives (which is what we do in therapy), and also takes into account what would make sex more fun, more pleasurable, and more exciting. 

This might involve talking about sexual techniques or activities that increase pleasure in the bedroom. But there’s also the opportunity to explore how your relationship affects your sex life – and vice versa. And if areas such as communication and emotional closeness need tending to, your sex coach might also be able to help you in those areas too. 

From body-based to thought-based sex coaching

Many sex coaches have a more somatic or body-based approach than therapists. This means they address the body itself in order to understand what’s going on in the mind and in turn, what’s creating your sexual difficulties.

The focus here is not on your coach touching your body – rather your coach helping you understand how your body is acting and why, when it comes to sex.  

The clues may lie in how your heart races as soon as you think of sex, or how your shoulders tense when your partner tries to initiate sex. 

Other sex coaches use a more “top-down” approach: they address thoughts patterns and beliefs that are causing sexual difficulties. Similar to a therapist they work from the perspective of our mind holding power over our emotions, and how addressing thoughts can make us feel better and help us enjoy sex more.

Why would you need a sex therapist?

One of the fundamental differences to consider when choosing a sex therapist or a sex coach is that a sex therapist is required if what you’re seeking help for needs treatment. This is especially important to consider if you’re experiencing sexual trauma or are carrying trauma from the past. 

This trauma needs to be processed in order for you to move on properly. 

As a sex coach is not a mental health professional, they cannot help you with diagnoses such as PTSD or CPTSD. Moreover, a sex therapist should always be your professional of choice if you need simultaneous help with your mental health as well as your sex life and sexuality. 

What about a sex coach who is also a sex therapist?

If you’re looking to reduce the negatives surrounding sex and also want to explore how to increase pleasure and create a fulfilling sex life – a sex coach who’s also a sex therapist is your best bet. 

This way you’re getting a clinician who is both professionally trained and qualified, and who has diversified the way they work to ensure they’re coming at your problem from all angles. 

They bring a really varied set of tools to help you

They draw from psychotherapeutic to coaching modalities which means their methods are therefore often eclectic. They use their years of training, experience, and a mixed skillset in order to tailor their help to your specific needs. 

All therapists have training in specific forms of psychotherapy.

These range from CBT (Cognitive Behavioural Therapy), Relational Therapy, Psychodynamic Therapy, or various trauma therapy modalities such as EMDR (Eye Movement Desensitization and Reprocessing). This means the will instantly know whether their specific background will be helpful for you your specific situation. 

This also means all therapists honour any possible limitations and refer to other clinicians when a specific problem is beyond their level of expertise, or when it’ otherwise appropriate. 

A sex coach, who often has less formal training, might not always know where the lines are drawn between problems that require treatment and those which are suited to coaching

The important thing to know here is that this isn’t because they’re not good at their job. In fact, sex coaches who have received professional training in both the science of coaching and the science of sexology can be brilliant.

However, the coaching space in general isn’t regulated. This means anyone can call themselves a sex coach without having any training whatsoever.

And this can, for obvious reasons, lead to coaching that is potentially harmful. Especially if the coach doesn’t have the skills needed to know when referring out is important, or how to deal with a particularly complex situation. 

A sex therapist who’s also a sex coach also knows when certain tools aren’t appropriate for coaching clients. 

Even innocuous modalities that might be used in sex coaching such as breathwork, can be potentially harmful if they’re not used in the right way. They might also cause damage if they’re used with someone who doesn’t have the capacity for all the things that breathwork can bring to the surface.

For all these reasons and more, a sex therapist who is also a sex coach is usually the best option in order to receive professional help from someone with extensive training, a code of ethics, and a diverse skillset. 

Common areas in your sex life that a sex therapist can help you with

A sex therapist can help you with a whole range of difficulties. Here’s a list to consider if you’re looking specifically for a therapist:

• Erectile difficulties
• Lubrication difficulties
• Low libidos or mismatched libidos in your relationship
• Compulsive desires or difficult controlling sexual urges so much so that it impacts your work life or school
• Painful sex or genital pain
• Sexual trauma
• Gender dysphoria
• Sexual identity
• Sexual anxiety
• Depression around sex
• Communication and self-expression

All of the difficulties above can be addressed through in-person therapy appointments but also via online sessions. Depending on the therapist you seek they might even offer you homework assignments such as exploring communicating about sex with your partner, guided touch exercises, learning how to turn yourself on, or even things such as mindfulness and getting in contact with your body. 

Common areas in your sex life that sex coaching or a program like Re:Desire can help you with

When it comes to sex coaching, you can definitely get help for things like low desire, loss of attraction to your partner, stress and pressure surrounding sex, a loss of pleasure during sex, or even erectile and lubrication difficulties. Sexual worries and anxieties can also be tended to with the help of a sex coach.

Depending on your sex coach’s scope of expertise, they may be able to help you with relationship struggles, too. 

Perhaps you’re experiencing an emotional disconnect within your relationship or your marriage. One that is connected to the sexual but also tied to problematic dynamics that have been built up over time. 

Struggles surrounding communication in relationships in general, and specifically about sex, can usually be addressed within the realm of coaching, too. A sex coach that works with couples can help you resolve challenges that are interlinked so you can revel in pleasure and deep emotional closeness once again.

When a sex therapist is also a sex coach

The great part about working with a sex coach (especially if that sex coach has sex therapy training), or joining a 1:1 online program like ReDesire, is that they have such a broad, all-encompassing toolbox. 

This enables them to not only solve the problem at hand – but to also create the sex life and relationship you’re secretly still dreaming about and hoping you can create. One that can be maintained long after the program has ended – and that fills you with love, life and energy.

Re:Desire is a 1:1 online program that helps you with a broad range of difficulties. The focus lies on helping those with low desire (or couples with mismatched libidos), have more and better sex. Sex that is pressure-free, shame-free, guilt-free and toe-curling good! It addresses:

• Pressure and stress surrounding sex
• Difficulties dealing with mismatched libidos in your relationship
• Low or non-existent desire for sex
• Sex that isn’t pleasurable and/or boring
• Worries about sex 
• Difficulties staying present during sex
• Erectile difficulties
• Relationship insecurity as a result of mismatched libidos or low desire
• Troubles communicating about sex
• Difficulties communicating in general
• Decreased emotional intimacy in your relationship

How to decide what solution is best for you

So – if you’ve got this far you might be thinking “but how know if I need a sex therapist or a sex coach for my unique situation?” Well – here’s a list of questions to help you field offers before taking action to improve your situation.

1. Does the service provider have any professional qualifications specifically regarding Sexology and human sexuality?
   
   It may seem obvious that people working in this area do – but unfortunately, a lot of therapists don’t have any credentials in these areas. 
   
   Truth be told, not even all couples therapists have training in Sexology. And, as previously mentioned, not even all sex coaches have any training in Sexology or coaching.
   
   If you opt for a professional who doesn’t have credentials in Sexology, you run the risk of them using their own personal morals and values as guiding light in your sessions which can be harmful. You want a professional who bases their approach on science and best practices. 

2. Does the service provider have experience in this area and have they dealt with the specific kinds of problems you’re currently experiencing?
   
   While it’s not always necessary, it can feel reassuring knowing the professional you choose has dealt with these difficulties before.
   
   
3. If you’re looking to seek help from a sex coach, what are their credentials?
   
   As previously mentioned, not all sex coaches have formal training in coaching or sexology, so you’ll want to make sure you do your due diligence to make sure that this is someone who will be professional.
   

4. Next, ask yourself if there is a mental health component that also needs addressing.
   
   If your primary symptom is anxiety or depression, this lends itself to therapy more than sex coaching, at least to begin with. You can always change or pivot to a new provider once your most acute symptoms have been managed.
   

5. Finally, is there a physical component that needs addressing?
   
   Would a visit to your urologist or a gynaecologist be helpful?  Perhaps a pelvic floor expert? Sometimes sexual difficulties need both medical and psychological intervention.

Moving forward with your decision on sex therapy vs sex coaching

At the end of the day, it’s important to have a look at what you want help with and why.  Sex therapy is an invaluable service for those dealing with mental health difficulties and their sexual side effects such as depression, anger, anxiety or addiction. 

But sex coaching with a coach who is also a sex therapist, can be a wonderful alternative that addresses your difficulties from a non-pathological lens.

This means you can get help with both removing the negatives and layering the positives back in. So that sex can become your safe space again.

A place where you can retreat and relish in the connection with your partner.

Where you can finally experience true, unabashed pleasure and let go of all the performance and pressure.