Online Sex Therapy: What To Expect And How To Make The Most Of It

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15-minute read

Knowing whether a therapist will be a good fit to support you and your specific needs, whether they’ll be on your wavelength and align with your preferred style, goals and values, and actually picking someone who you like can feel like an impossible task. Therapist offering online support can simplify this process.

Figuring Out If A Therapist Is Right For You

Therapists and counsellors are beginning to offer short (15-30mins), free, non-obligation consultations to make these decisions easier for the people they’re looking to support. These brief consults are often conducted via phone or online and give you an opportunity to officially meet, decide whether you feel comfortable and connected, to briefly discuss what’s going on and learn about that therapists particular approach. These consults can help you to make an informed decision when seeking support. Go ahead and book a few initial consults and make notes to assist your future self when it comes to deciding. 

Check out the Therapy for Black Girls Guide to Getting Started with Therapy for a Therapist Tracking Sheet and Lived Experience Counselling’s Free Digital Guide to Finding the Right Therapist.

What To Look Out For

Pay attention to whether the therapist responds to your questions with respect and empathy. Do you like their approach and style? Do you feel safe and comfortable talking to them? Do you enjoy their vibe and feel a connection with them? 

One of the most important factors in predicting a positive therapy outcome is the relationship between you and the therapist, a.k.a. the therapeutic alliance. A strong therapeutic alliance depends on whether you feel heard, seen, understood, respected and valued, and is even more important that the therapists training, approach and experience.

Not every person you connect with will be a good fit and that’s ok. In my practice, I have niche areas that I work best within; exploring pleasure, desire and arousal differences, supporting disabled people and those with chronic illnesses to navigate their sex lives and pleasure and supporting those who experience pain or pain conditions that makes sex challenging. I only work with people whose experiences fit within my main areas of practice because I know I can support those folx best. I work within my niche area as a way to prevent myself from getting burnt out by trying to take on too many different cases. None of us can be good at everything and it’s the same for therapists. If you see a sex therapist who specialises in 20+ different areas, then its likely their skill level isn’t equal across the board. They’ll be better at some things than others and you won’t find out until you’re deep into your work together. 

What To Expect In A session

Therapy, both in-person and online doesn’t have to be serious or formal. It can feel very much like an easy going, relaxed and casual conversation where you can laugh and talk about anything with someone who truly hears you and can understand what you’re going through. As each therapist has their own style, sessions will look a little different depending on who you decide to work with. Sex therapy with me often looks like a combination of taking a deep dive into subjects or unpacking experiences, valuing and making space to feel and interpret your feelings and it may involve more practical strategies and learning new skills.

One of my most important skills as a sex therapist is creating a safe, non-judgmental space for you to talk openly about topics that you might not be comfortable talking with anyone else. With others, you might worry about the possibility of being judged or shamed. With a therapist, there is a higher chance they won’t discriminate against you or judge you for sharing vulnerable parts of yourself. Most therapists have undergone years of training, supervision and self-reflection to hold a candle to their blind spots and work through their biases and misbeliefs. If they do cause harm, a good therapist will be accountable and make attempts to repair the damage they’ve caused, which has potential to strengthen your bond.

Expect therapy to be collaborative. This means every decision and every path taken is decided by you and your therapist together. This is because you are the expert in your own life and the only person who really know what you’ve been through and what suits you best. After exploring your history and learning more about you and your experiences, your therapist will offer suggestions, theories and new or reframed perspectives. It’s then up to you to accept or reject what feels most helpful, relevant and fits with your needs. Your therapist will ask thoughtful questions to assist you to delve deeper into topics. At times they might challenge your ideas, behaviours or encourage you to try a different approach if you’re feeling stuck.

Therapists are people who walk beside you rather than lead you. They’re your investigative partner or co-researcher. They’re there to talk it out with you, whatever it may be. In so many ways, therapists are privileged people who have had access to knowledge and support to advance their expertise and they’ll share their understanding and resources as a way to extend that privilege to you.

Therapists aren’t advice givers. Be cautious of those that do offer unsolicited advice or their personal opinions. The issue with advice giving is that it’s condescending, it’s not personalised and it’s often disempowering. It doesn’t recognise the external, social, cultural or systemic factors that are intersecting and impacting on challenges and it reinforces a power imbalance of the therapist being the expert and knowing what’s best for you.

When Virtual Therapy Is Less Appealing Than In-Person Support

It’s not uncommon to feel hesitant when it comes to virtual therapy because it’s so different to what you might be use to. Sex therapy via video chat or phone might be perceived to be a more awkward, intimidating and way less comfortable version of in-person therapy. Yet for most people virtual therapy really works. It’s just as confidential and safe. While you don’t have a cosy office to visit, if you can find a quiet, private space in your home or car, online therapy allows you to sit in your favourite spot, wearing your comfy clothes or your dressing gown, snuggle up with your pets and talk about difficult subjects. For some people, being grounded and safe in the comfort of their own space allows them to go to deeper places and feel safer than they would in someone’s office. 

Opting for phone-based therapy means you can put in headphones, go for a walk or sit in a quiet space in a park to talk things through. Phone therapy is often described by the people I work with as an experience that gives them a certain level of anonymity while feeling safe and being more open and vulnerable than they ever have before.

Some of the benefits associated with virtual therapy include reduced driving time and stress associated with transport and parking, having more time in your day to focus on the things you need to get done, increased accessibility to disabled people, those with agoraphobia or other mental health challenges that make it difficult or stressful to attend appointments. Online only sessions can also reduce session costs and increase the number of sliding scale or fee reduced places a therapist has. Without having to rent office spaces, therapists may have the ability to make therapy more affordable to those who need it.

How Many Sessions

Sex therapy and counselling are not covered by Medicare or Private Health and Mental Health Care Plans aren’t applicable when seeking support with me. This also means we aren’t bound by these services and locked into a certain number of sessions. You’re free to decide to come as often as you’d like or only when you need it. You might want one to two sessions if you’re seeking to enhance your sexual knowledge and skills or you might want to deep dive and unpack your experiences and beliefs over 5-10 sessions spread across weeks and months. Having this freedom to access support whenever you need it means therapy is more likely to be accessible and have a greater impact on your sexual wellbeing.

How To Prepare For A Session

In the moment it’s easy to forget the questions you really wanted to ask. Write some notes and let these guide you if you’re worried you’ll draw blanks from nerves. Think about your hopes, goals and what you want to get out of the experience (this might change over time and if it does be sure to let your therapist know). Reflect on your relationship with your sexuality, your body, your past sexual encounters and your pleasure. Do some journaling on the areas that you want to explore more and tell your therapist. The lead up to the first session (or every session) can be nerve-racking. Sessions can be challenging and it’s ok to feel anxious about them. Do some deep breathing, mindfulness practice, emotional regulation and make space to feel your feelings and prioritise self-care.

Tips For During A Session

Have a pen and paper nearby to write things down as you need. Ask your therapist to slow down or speed up if you find you’re feeling over or underwhelmed. What you discuss each session is up to you. Let your therapist know where you’d like to focus on and don’t be afraid to let them know when you find things are getting off track. It’s ok to correct your therapist if they misunderstand you, say the wrong thing or something hurtful and discriminatory. Therapy is a shared experience so its important to be on the same page. 

Ongoing feedback is so important and one of the most effective ways at letting your therapist know what is and isn’t working, giving them the opportunity to change their approach or make repairs for harm they’ve caused. Practicing giving your therapist feedback and insight into how you’re feeling about your work together can support you to refine your skills for sharing feedback with other people in your life.

Self-Care Post Session 

Quick self-care ideas by @thehealingtherapist

Create a plan of self-care activities to do after each session. Sometimes sessions are hard work, exhausting and may bring up difficult thoughts and feelings. After an in-person session, you probably use the drive home to reflect and transition from therapy back to everyday life. When you’re accessing therapy in the same place you work and chill out, this transition period is easily neglected. Take a 20+ minute break after your session to wind-down. Focus on relaxing activities that support you to feel connected and calmed. Go for a walk, have a hot shower, listen to some music, journal, cuddle or play with your pet or do a colouring page. Spend some time outside and connect with nature. Being in nature can regulate your nervous system and create feelings of safety and connection.

Allocate time to reflect or journal topics or feelings that came up in therapy. Write down the things that you didn’t get to talk about or that remained unanswered so you can continue to explore them yourself or to pick up from where you left off. Reflect on the therapy experience and your connection with your therapist. Check this post for some journaling prompts.  

Making The Most Of It 

Your therapist will give you homework (which you probably want to call home-fun!). Usually the activities shared will be relevant to what you’re currently exploring, addressing or the introduction phase of learning and exploring another area. A collaborative therapist might make a few suggestions and then will ask you how you feel about the task and whether its something you’d be open to doing. If you don’t see how that exercise fits, if it’s not your style or you don’t see yourself connecting with it, let them know or ask questions to learn more. Once you’ve negotiated a homework task or exercise that aligns with your goals to explore or understand your experiences, actually doing the homework makes a big difference. Remember that somethings got to change for something to change. If you’re not willing to try anything different or try on a new perspective, then it’s unlikely that you’ll notice anything different. When sessions run for only 60minutes each week, it becomes clear that most of the change happens between sessions. The work you do in sessions will point you in the right direction and may ignite the fire but you have to keep it burning and attending to it.

Set Realistic Expectations 

Nothing worthwhile happens overnight. It often takes days, weeks and months of regular committed practice. All the small things are what makes the biggest differences. Don’t expect to feel changed after one session. 

Your therapist is not there to fix you, because you’re not broken. They’re not there to give you all the answers because they don’t have the solutions and they don’t know what’s best for you. Therapists are there to support you. They can share their knowledge with you, sit with and make space for your pain and your feelings. They will normalise and validate your lived experience and show you empathy, kindness and be non-judgemental. They can teach you healthy boundaries and model a supportive relationship. They can’t make your pain go away and their job isn’t to change your mind on something. Their role isn’t to help you have better or more sex or somehow change your partner to better meet your needs. 

Not All Therapists Are Good Eggs 

Therapists can and do cause harm. Just because someone is a counsellor, psychologist or social worker does not mean they are safe and won’t discriminate. The mental health field was founded on white supremacy by white cis men for white cis women. This means approaches taught to therapists are based on the values of white supremacy and are inherently harmful to anyone that falls outside the dominant narrative. Even research in the field is only representative of the dominant perspective and applicable to only cis, white, heterosexual, monogamous people. 

Therapists have to think critically and unlearn most or their training and replace it with anti-oppressive and trauma-informed perspectives in order to best serve the people they work with. For example, a therapist that responds negatively to feedback might hold beliefs that they are in a place of power and their approach is always right. Receiving feedback from someone the consider to be below them results in anger and retaliation. They may begin to challenge that person more or discredit their experiences as an abuse of their power. This is never an appropriate response and it means that therapist has a lot of work to do to unlearn their biases and harmful beliefs. 

Other forms of harm might be subtle and include oppressed people having to educate and teach their therapist about the role of oppression on their wellbeing and access to resources. Therapists who pathologise people for not being able to overcome the challenges they face or place the blame and responsibility on individual to overcome systemic barriers or who fail to acknowledge sexual and mental health challenges develop in the context of structures and systems of oppression perpetuates serious harm. 

Therapy Is Political 

While therapists like to say they’re non-biased, that’s not completely true. Therapists have to be political and they must take the side of justice if they want to serve and support any of the people they’re working with. Staying neutral in the face of injustice means they’re siding with the oppressors. A therapist that does not acknowledge other people’s behaviour as harmful in that persons life means they condone it. Therapists have to challenge oppression, inequity and they can’t be neutral in situations of violence. For instance, a therapist working with a couple who discovers one partner is abusing the other cannot continue supporting the couple for relationship issues. Working with the couple to address both their behaviours equally implies that the person being abused brought it on themselves. 

Therapy that makes a difference is one that is non-pathologising. It’s important to recognise how social injustice and oppression can impact peoples lives and these lenses must inform all therapists work. For instance, offering a sliding scale means acknowledging not everyone has equal access to resources and finances. A sliding scale makes support accessible while minimising obstacles. Therapists that claim to be anti-oppressive and who value social justice but don’t offer sliding scales to make therapy accessible don’t value equity or inclusion and their claims of being anti-oppressive are performative and a marketing tool.

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Deciding on a therapist to work with isn’t always an easy process. It can take a lot of trial and error to find a therapist who is a good fit, who can support you and who you connect with. It’s not the same as finding any other professional because you don’t have to like your dentist and you don’t have to share your deepest fears and vulnerabilities with your GP or your health specialist. Remember that it’s ok to keep searching and you don’t have to settle and stay with a therapist that doesn’t support or serve you.