Enhancing Sexuality: A Problem-Solving Approach to Treating Dysfunction - Therapist Guide, 2nd Edition (Treatments that work)

145 Pages·2009·0.74 MB·English

by  John Wincze

Enhancing Sexuality
EDITOR-IN-CHIEF
DavidH.Barlow,PhD
SCIENTIFIC
ADVISORY BOARD
AnneMarieAlbano,PhD
GillianButler,PhD
DavidM.Clark,PhD
EdnaB.Foa,PhD
PaulJ.Frick,PhD
JackM.Gorman,MD
KirkHeilbrun,PhD
RobertJ.McMahon,PhD
PeterE.Nathan,PhD
ChristineMaguthNezu,PhD
MatthewK.Nock,PhD
PaulSalkovskis,PhD
BonnieSpring,PhD
GailSteketee,PhD
JohnR.Weisz,PhD
G.TerenceWilson,PhD
Enhancing Sexuality
A PROBLEM-SOLVING APPROACH TO
TREATING DYSFUNCTION
SECOND EDITION
T h e r a p i s t G u i d e
John P. Wincze
1
2009
1
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LibraryofCongressCataloging-in-PublicationData
Wincze,JohnP.,1943–
Enhancingsexuality:aproblem-solvingapproachtotreating
dysfunction:therapistguide/JohnP.Wincze.—2nded.
p. ; cm.—(TreatmentsThatWork)
Includesbibliographicalreferences.
ISBN978-0-19-531507-3
1.Sextherapy. I.Title. II.Series:Treatmentsthatwork.
[DNLM:1.SexualDysfunctions,Psychological—psychology.
2.SexualDysfunction,Physiological—therapy. 3.Sexuality. WM611W758e2009]
RC557.W5552009
616.85(cid:2)8306—dc22
2008038440
9 8 7 6 5 4 3 2 1
PrintedintheUnitedStatesofAmerica
onacid-freepaper
About TreatmentsThatWork™
Stunning developments in healthcare have taken place over the last
severalyears,butmanyofourwidelyacceptedinterventionsandstrate-
gies in mental health and behavioral medicine have been brought into
questionbyresearchevidenceasnotonlylackingbenefit,butperhaps,
inducing harm. Other strategies have been proven effective using the
bestcurrentstandardsofevidence,resultinginbroad-basedrecommen-
dations to make these practices more available to the public. Several
recent developments are behind this revolution. First, we have arrived
at a much deeper understanding of pathology, both psychological and
physical, which has led to the development of new, more precisely tar-
getedinterventions.Second,ourresearchmethodologieshaveimproved
substantially,suchthatwehavereducedthreatstointernalandexternal
validity, making the outcomes more directly applicable to clinical sit-
uations. Third, governments around the world and healthcare systems
andpolicymakershavedecidedthatthequalityofcareshouldimprove,
thatitshouldbeevidencebased,andthatitisinthepublic’sinterestto
ensurethatthishappens(Barlow,2004;InstituteofMedicine,2001).
Of course, the major stumbling block for clinicians everywhere is the
accessibility of newly developed evidence-based psychological inter-
ventions. Workshops and books can go only so far in acquainting
responsible and conscientious practitioners with the latest behavioral
healthcare practices and their applicability to individual patients. This
newseries,TreatmentsThatWork™,isdevotedtocommunicatingthese
excitingnewinterventionstocliniciansonthefrontlinesofpractice.
Themanualsandworkbooksinthisseriescontainstep-by-stepdetailed
procedures for assessing and treating specific problems and diagnoses.
But this series also goes beyond the books and manuals by providing
v
ancillary materials that will approximate the supervisory process in
assistingpractitionersintheimplementationoftheseproceduresintheir
practice.
In our emerging healthcare system, the growing consensus is that
evidence-based practice offers the most responsible course of action
for the mental health professional. All behavioral healthcare clinicians
deeplydesiretoprovidethebestpossiblecarefortheirpatients.Inthis
series, our aim is to close the dissemination and information gap and
makethatpossible.
Thistherapistguideisdesignedtogivementalhealthprofessionalsthe
necessary tools to assess and treat sexual dysfunction. It focuses on the
treatment of couples, but may also apply to the treatment of single
clients.Thiscomprehensiveguidecoversawiderangeofsexualdysfunc-
tion in men and women, including problems with desire and arousal,
problems with ejaculation and orgasm, and problems with pain and
discomfortduringsexualrelations.Eachtopic-specificchaptergivesan
overviewofprinciplesunderlyingtreatmentandmainconceptstocon-
veytoclients.Casevignettesprovideexcellentillustrationsofkeypoints.
Atypicalorproblematicresponsesarealsoaddressedindetail.Thecor-
respondingworkbookprovidesinformationtocorrectmisbeliefsabout
sex and offers practical suggestions for improving sexual relations. It
includesexercisesforcouples,chapterreviewquizzes,anduser-friendly
worksheetstoincreaseclientunderstanding.Clinicianswillfindthisan
invaluableresourcetohelpclientsenhancetheirsexualfunctioningand
theirrelationships.
DavidH.Barlow,Editor-in-Chief,
TreatmentsThatWork™
Boston,MA
References
Barlow, D. H. (2004). Psychological treatments. American Psychologist, 59,
869–878.
InstituteofMedicine.(2001).Crossingthequalitychasm:Anewhealthsystem
forthe21stcentury.Washington,DC:NationalAcademyPress.
vi
Acknowledgments
IamverygratefulforthemedicalconsultationthatMartinMiner,MD,
and Mark Sigman, MD, gave to me to help put this book together.
TheirenergyandintelligentguidanceinestablishingtheMen’sHealth
Center at Miriam Hospital has been an inspiration to me. I am also
thankful for the support of my wonderful family and lifelong friends
of Sweat 67. Finally, sincere thanks are in order to Oxford University
Press,especiallytoCristinaWojdyloforherpersistenceandguidancein
bringingthisbookthroughallstagesofproduction.
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Contents
Chapter1 IntroductoryInformationforTherapists 1
Chapter2 PathwaysforTherapy 9
Chapter3 AssessmentandTreatmentPlanning 17
Chapter4 BuildingBlockstoUnderstand
andAssessSexualProblems 23
Chapter5 ProblemsWithDesireandArousal 37
Chapter6 ProblemsWithEjaculationandOrgasm 53
Chapter7 ProblemsWithPainandDiscomfort
DuringSexualRelations 65
Chapter8 ImportanceoftheSexualPartner 73
Chapter9 WorkingWithaPartnertoMaster
SexualProblems 83
Chapter10 MasteringtheSexualProblem 89
Chapter11 ContinuingProgressandPreventingRelapse 115
Chapter12 MaintainingGainsandPreventingRelapse 121
References 129
ix