Principles and Practices of Sex Therapy



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Course Information Sheet

Course: Coun 7288 Semester: Summer 2010

Principles and Practices of Sex Therapy

Instructor: Richard P. Long, Ph.D. Time: M 9:20a.m.-3:30p.m.

Office: JH 219 Location: 213 Jordan Hall

Phone: 706-565-7819 (O) Office Hours: TBA

e-mail: long_ric@colstate.edu Teaching Schedule: TBA

FAX: 706-568-5088 Prerequisite: Coun 6115

ADA Compliance Statement

If you have a documented disability as described by the Rehabilitation Act of 1973 (P.L. 933-112 Section 504) and Americans with Disabilities Act (ADA) and would like to request academic and/or physical accommodations, please contact Joy Norman at the Office of Disability Services in the Center for Academic Support and Student Retention, Tucker Hall (706) 568-2330, as soon as possible. Course requirements will not be waived, but reasonable accommodations may be provided as appropriate.

I. Course Description:

This course will provide students with an understanding of human sexual development with a particular focus upon sexuality counseling from a systems perspective.

II. Educational Objectives:

Knowledge

The student will be expected to:

1. To understand the principles and practice of sex therapy

2. To understand the use of Emotionally Focused Therapy as a model for treating cases involving sexual issues

3. To explore the theology of black sexuality and its relevance to sex therapy

4. To understand the gay and lesbian experience on the practice of sex therapy

5. To understand the impact of gender on the practice of sex therapy

6. To understand the impact of sexual addiction on the practice of sex therapy

7. To understand the impact of sex abuse on the practice of sex therapy

8. To understand the impact of culture on the practice of sex therapy

Skills

1. Ability to take paper-pencil quizzes

2. Ability to lead a case discussion

3. Ability to write an EFT-based sex therapy treatment plan

Disposition

1. Ability to complete assignments for the course on time and in compliance with stated criteria

2. Ability to participate in class in a well-informed, positive manner

CACREP Standards

“The counseling profession evolves in anticipations of and response to societal and other changes in the United States and throughout the world. Counselor Education programs prepare students to be effective in a dynamic world and profession. It is imperative that programs explicitly prepare students to be counselors first and counseling specialists second.

CACREP Standards are written to ensure that student develop a professional counselor identity and also master the knowledge and skills to practice effectively. Graduates of CACREP-accredited programs use their education and preparation as paths to careers in community mental health and human service agencies, educational institutions, and private practice, government, business and industrial settings. However, no professional preparation is ever complete, and advances in knowledge, skills and technology within the profession require life-long continuing education for counselors as well as monitoring and review of processional standards.” (Introduction section, Council for Accreditation of Counseling and Related Educations Programs (CACREP): The 2001 Standards, for December 27, 2003).)

”Curricular experiences and demonstrated knowledge in each of the eight common core areas are required of all students the program(s) for which accreditation is sought. The common core curricular experiences include the following areas (see, Section II, Standards K. 1-8):

a. Professional Identity

b. Social and Cultural Diversity

c. Human Growth and Development

d. Career Development

e. Helping Relationships

f. Group Work. Assessment

g. Research and Program Evaluation”

(Eligibility Requirements Section, Council for Accreditation of Counseling and Related Programs (CACREP): The 2001 Standards.)

III. Caution

Material discussed in this class is considered sexually explicit. Students who are uncomfortable with the frank discussion of sexual issues, attitudes, and practices should consider whether participation in this course is appropriate for them at this time. Discussion with the professor may prove helpful in this regard. Some class discussion will be assisted by appropriate self-disclosure. Students are reminded that they bear responsibility for the level and content of their self-disclosure and that such self-disclosure has no bearing on the final grade. Confidentiality is encouraged and appreciated, but cannot be guaranteed in this setting.

IV. Textbooks:

Leiblum, S. R. (Ed.). (2007). Principles and practice of sex therapy. New York: Guilford Press.

Douglas, K. B. (1999). Sexuality and the black church. Maryknoll, New York: Orbis Books.

Heywood, L. (1998). Pretty good for a girl. Minneapolis, Minn.: University of Minnesota Press.

Carnes, P. (1994). Out of the shadows. Center City, Minn.: Hazelden.

Johnson, S. M. (2004). The practice of emotionally focused couple therapy. New York: Brunner-Routledge.

Optional:

Barret, B & Logan, C. (2002). Counseling gay men and lesbians. Pacific Grove, Calif.: Brooks/Cole.

Leiblum, S. (Eds.). (2010). Treating sexual desire disorders. New York: Guilford Press.

Supplemental materials will be provided online.

V. Attendance

Graduate students are expected to be responsible for regular class attendance.

VI. Course Requirements:

1. Complete all readings identified in the course schedule in advance of the day the material will be discussed in class. Short answer quizzes will be given based on chapter lectures.

2. Write a Case Study Discussion Guide. The Guide should be two-word processed pages and submitted during the class period in which the student is assigned to lead a discussion. Criteria: Each Guide should include: (a) a synopsis of the situation, using APA format to cite the source, (b) two questions related to principles of sex therapy, cite Leiblum using APA format (c) two questions related to the practice of sex therapy from a particular therapeutic theory or model point of view, e.g. cognitive-behavioral, solution-focused, etc., cite books consulted using APA format (d) two questions that encourage self-reflection on the part of the participants. A grading rubric located online details more specifically how you will be graded.

3. Lead a discussion of a Case Study following the format outlined above.

4. Develop a treatment plan for a sex therapy case. Criteria: Treatment plan should include: (a) a synopsis of the presenting problem, (b) assessments given, (c) EFT-based Stage 1 and Stage 2 goals, (d) negative interaction cycle, (e) key emotions, (f) possible EFT interventions, (g) a two page transcript of a hypothetical session in which 2-3 EFT interventions are illustrated, (h) reflection on the use of EFT for sex therapy issues. A grading rubric located online details more specifically how the session will be graded.

5. Demonstrate an ability to provide competent sex therapy in simulated counseling sessions. Criteria: (a) ability to complete Stage 1 EFT therapy. A grading rubric located online details more specifically how the laboratory sessions will be graded.

VII. Grading/Evaluation

Your final grade will be based on a scale of 2000 points, broken down as follows:

Chapter Quizzes 1,000 points

Case Study Guide* 300 points

Case Study Discussion 200 points

Sex Therapy Treatment Plan* 500 points

Lab Work 500 points

_________

2,500points

Grades will be assigned as follows:

2,400 and up = A

2,100 ---2,399 = B

2,000 ---2,099 = C

*These “products” may be included in your portfolio.

VIII. Method of Instruction

Lecture, videotapes, class discussion, quizzes, brief sex therapy sessions, written assignments, technological resources and independent reading will be used in the delivery and assessment of the course content.

IX. Multicultural Education Component

Chapter 13, Therapy with Sexual Minorities, Chapter 14, Sexuality and Culture and Chapter 16, Gender Dysphoria and Transgender Experiences found in the Leiblum text provide grounding for multicultural (sex) education. In addition,

students will be required to read and discuss Kelly Douglas’s Sexuality and the black church and L. Heywood’s Pretty good for a girl, to reinforce textbook reading. Finally, students are expected to take an inclusive perspective when issues related to race, culture and gender emerge in the microcounseling sessions.

X. Recommended Supplementary Books & Articles

Barbach, L., & Levine, L. (1980). Shared intimacies: Women’s sexual experiences. New York: Bantam.

Bernstein, R., & Silberman, S. (Eds.). (1996). Generation Q. Los Angeles: Alyson.

Earle, R., & Earle, M. (1995). Correcting cognitive distortions: Helping the sex addict develop new ways of thinking. In R. Earle & M. Earle (Eds.), Sex addictions: Case studies and management (pp.68-83).New York: Brunner/Mazel.

Goldberg, H. (1976). The wisdom of the penis. In H. Goldberg (Ed.), The hazard of being male: Surviving the myth of masculine privilege (pp. 22-41). New York: Signet.

Heiman, J. & LoPiccolo, J. (1988). Becoming orgasmic (2nd ed.). Englewood Cliffs, NJ: Prentice Hall.

Hof, L., & Beman, E. (1986). The sexual genogram. Journal of Marital and Family Therapy, 12, 39-47.

Hyde, J. & DeLamater, J. (1997). Understanding human sexuality (6th ed.).New York: Mc Graw-Hill.

Kaplan, H. (1979). Disorders of desire. New York: Brunner/Mazel.

Maletzky, B. M. (1991). Treating the sexual offender. Newbury Park, CA: Sage.

Ryan, G., & Lane, S. (Eds.). (1997). Juvenile sexual offending: Causes, consequences, and correction. San Francisco: Jossey-Bass.

Schnarf, D. (1991). Constructing the sexual crucible. New York: Norton.

Schnarf, D. (2002). Resurrecting sex. New York: Harper Collins.

Weinstein, E., & Rosen, E. (1988). Sexuality counseling. Pacific Grove, Brooks/Cole.

Zilbergeld, B. (1996). The new male sexuality. New York: Signet.

Zucker, K. J, & Bradley, S. J. (1995). Gender identity disorder and psychosexual problems in children and adolescents. New York: Guilford Press.

XI. Instructional Objectives

Female Sexual Disorders

After reading Chapter One, Sex Therapy Today, the student should be able to:

1. Recall the findings of research surveys on sexual problems of women and men (pp. 5-7, Leiblum).

2. Explain what is meant by integrative sex therapy treatment (pp.7-8, Leiblum).

3. Recognize the role of physical examination and laboratory assessment in sex therapy (pp. 8-9, Leiblum).

4. Identify the controversies regarding sexual diagnosis (pp. 9-11, Leiblum).

5. Point out interventions that characterize sex therapy (p. 11, Leiblum).

6. Identify pharmacological innovations and treatment (pp. 12-16, Leiblum).

7. State the goal of sex therapy (pp. 16-17, Leiblum).

8. Illustrate the flexibility required to provide sex therapy to diverse populations (pp. 17-18, Leiblum).

9. Describe the Sexual Crucible™ approach to the treatment of sexual problems (Long).

10. Infer objections Schnarch has to the use of sexual prescriptions, communication skills, speaker-listener techniques, empathy-related experiences or no prohibitions or “bias” and link her perspective to Johnson (Long).

After reading Chapter Fourteen, Sexuality and Culture, and Sexuality and the black church (Douglas) the student should be able to:

1. Describe how religion/spirituality has a cultural influence on sexuality (pp. 419-422, Leiblum).

2. Infer what it might mean for sex therapy if Cornel West is right when he said, “sexual projections are intertwined with racism” (p. 423, Leiblum).

3. Recognize three influences of ethnicity and sexuality (pp. 425-430, Leiblum).

4. Point out questions to ask about cultural issues (pp. 430-439, Leiblum).

5. Identify the function of black sexuality in white culture, i.e. power (pp. 1-30, Douglas).

6. Give examples of the way black sexuality has been impugned by white culture (pp.31-59, Douglas).

7. Recognize the ramifications of black people maintaining silence about sexual issues (pp. 63-86, Douglas).

8. Identify ways the black church privileges heterosexual orientations and penalizes same-sex orientations (pp.87-108, Douglas).

9. Clarify the connection between the church and sexuality (pp. 111-130, Douglas).

10. Give examples of ways in which sexual discourse can be nurtured in black church (pp. 131-143, Douglas).

11. Discuss the implications of sexuality and the black church on Family Life Center & other mental health agencies in the community (Class+Long).

After reading Chapter Two, Sexual Desire/Arousal Disorders in Women, the student should be able to:

1. Recognize the percentage of women presenting with low sexual desire (p. 26, Leiblum).

2. Define sexual desire disorder (p. 28, Leiblum).

3. Clarify the finding that women who complain of low arousal, who report “lack of lubrication/swelling”, show an increase in vaginal congestion (pp. 29-33, Leiblum).

4. Give an example in support of the finding that low desire increase with age but distress about that low desire decreases (pp. 33-34, Leiblum).

5. Recognize the multifaceted assessment that guides therapy (pp. 34-40, Leiblum).

6. Clarify how assessing the emotional and sexual satisfaction is relevant to outcome assessment (pp. 41-42, Leiblum).

After reading Chapter Three, Persistent Genital Arousal Disorder (PGAD), the student should be able to:

1. Recall five features of PGAD (p. 57, Leiblum).

2. Distinguish between hypersexuality and PGAD (pp. 57-58, Leiblum).

3. Recognize three etiological theories for PGAD (pp. 63-76, Leiblum).

4. Give an example of how PGAD presents in therapy (pp. 76-80, Leiblum).

5. Outline four components of PGAD treatment (pp. 80-81, Leiblum).

After reading Chapter Four, Orgasmic Disorders in Women, the student should be able to:

1. Distinguish between the perspectives of Freud, Ellis, Kinsey, Master’s and Johnson on female orgasm (pp. 85-87, Leiblum).

2. Identify two difficulties in studying orgasm (p. 90, Leiblum).

3. Summarize research findings separating orgasmic from non-orgasmic women (p.94, Leiblum).

4. Distinguish between psychoanalytic approaches, cognitive-behavioral approaches and systems theory approaches to treating orgasmic disorders (pp. 94-99, Leiblum).

5. Recognize the elements and issues required of an integrated approach to treating orgasmic disorders (pp. 101-116, Leiblum).

After reading Chapter Five, Dyspareunia and Vaginismus, the student should be able to:

1. Define vaginismus and dyspareunia (pp. 126-127, Leiblum).

2. Give examples of treatment variability for vulvar pain as a function of professional specialty (p. 129, Leiblum).

3. Outline epidemiology, etiology and vaginismus treatment research (pp. 130-132, Leiblum).

4. Point out epidemiology, etiology and dyspareunia treatment research (pp. 132-133, Leiblum).

5. Recognize vaginismus self-report criteria (p. 135, Leiblum).

6. Point out three elements of the psychosocial assessment of dyspareunia (pp. 137-141).

7. Outline the role of a sex therapist in treating genital pain (pp. 141-143).

8. Recognize the efficacy of cognitive-behavioral therapy in the treatment of genital pain in women (pp. 143-146).

After reading Chapter 16, Gender Dysphoria & Pretty good for a girl (Heywood), the student should be able to:

1. Define gender dysphoria/identity disorder (pp. 478-480, Leiblum).

2. Describe gender identity problems in children (pp. 480-482, Leiblum).

3. Recall ten standards of care a clinician should achieve in working with gender disorders (pp. 484-485, Leiblum).

4. Recognize topics to include in a gender history (pp. 485-486, Leiblum)

5. Describe three forms to gender dysphoria (pp. 486-488, Leiblum).

6. Outline four situations individuals appear for treatment (p. 489, Leiblum).

7. Summarize four outcomes of treatment for gender dysphoria (pp. 490, Leiblum).

8. Paraphrase four main goals of psychotherapy for gender dysphoria (pp. 493-495, Leiblum).

9. Summarize outcome research on gender reassignment (pp. 495-497, Leiblum).

10. Compare and contrast comorbid psychiatric conditions of gender dsyphoric patients and to the presentation of Leslie Heywood in her book Pretty good for a girl (Students).

11. Discuss the implications of gender on counseling conducted at The Family Life Center (Long+Class).

Male Sexual Disorders

After reading Chapter Seven, Sexual Desire Disorders in Men, the student should be able to:

1. Recall the two types of sexual desire problems according to the DSM-IV (p.185, Leiblum)

2. Recognize three primary subtypes of sexual desire (p. 186, Leiblum).

3. Recall the percentage of men who relate that they lack interest in having sex on average between 1994 and 2003 (pp.186-187, Leiblum).

4. Outline topics to be explored in a clinical assessment of sexual desire disorder in men, under three headings (pp. 187-189, Leiblum).

5. Paraphrase three ways of viewing the etiology of a sexual desire disorder in men (pp. 190-191, Leiblum).

6. Outline etiological factors for situational diminished sexual desire (pp. 192-193, Leiblum).

7. Point out common etiological contributions to sexual desire problems (pp. 192-196, Leiblum).

8. Identify general treatment protocol that follows diagnostic subtyping (pp.197, Leiblum).

9. Report the evidence for the utility of psychotherapy when treating situational hypoactive sexual desire disorder (HSSD) (pp.197-198, Leiblum).

10. Report on the efficacy of drug and hormone treatment for patients with HSSD (pp. 198-200, Leiblum).

After reading Chapter Eight, Treatment of Rapid Ejaculation, the student should be able to:

1. Define premature ejaculation (pp. 214-217, Leiblum).

2. Recall the prevalence of rapid ejaculation (p.219, Leiblum).

3. State the commonly held myth and age and rapid ejaculation (p.220, Leiblum).

4. Outline etiological explanations for rapid ejaculation (pp.220-223, Leiblum).

5. Describe the impact of rapid ejaculation on the man and the couple (pp. 223-224, Leiblum).

6. Recall commonly used psychotherapeutic approaches to rapid ejaculation treatment (pp.230-231, Leiblum).

7. Recognize five sources of resistance to rapid ejaculation treatment (p. 231-232, Leiblum).

8. Describe the results of outcome studies for judging the efficacy of treatment, either psychological or medical (pp. 234-235, Leiblum).

After reading Chapter Nine, Delayed Ejaculation, the student should be able to:

1. Define male orgasmic disorder (pp. 243-244, Leiblum).

2. Identify the four classes of ejaculatory delay (p. 245, Leiblum).

3. Recognize two misconceptions about delayed ejaculation (p. 245, Leiblum).

4. Recall the prevalence of inhibited male orgasm (p. 246, Leiblum).

5. Outline etiological explanations for delayed ejaculation (p.p.250-256, Leiblum).

6. Distinguish between delayed ejaculation and erectile dysfunction (p. 257, Leiblum).

7. Describe two models for treating delayed ejaculation (pp. 263-266, Leiblum).

8. Recognize commonly used psychotherapeutic approaches to delayed ejaculation treatment (pp. 268-274, Leiblum).

After reading Chapter NineTen, Erectile Dysfunction, the student should be able to:

1. Recall the prevalence of erectile dysfunction (pp. 278-280, Leiblum).

2. Describe the impact of new treatment options of erectile dysfunction (pp. 280-283, Leiblum).

3. Outline the classification of psychogenic erectile dysfunction (p. 284, Leiblum).

4. Recognize psychological factors in erectile dysfunction (pp. 287-288, Leiblum).

5. Outline five major areas of intervention for treating erectile dysfunction in men (pp. 289-295, Leiblum).

6. Identify implications of erectile dysfunction for couple or relationship problems (pp. 301-302, Leiblum).

Special Populations

After reading Chapter Eleven, Sexuality and Illness, the student should be able to:

1. Recognize the relevance of illness-related sexual problems (pp.315-317, Leiblum).

2. Outline factors upon which satisfactory sexual function depends (p. 317, Leiblum).

3. Gives examples of specific illnesses that can affect sexual functioning, including mental health problems (pp. 317-320, Leiblum).

4. Point out four key neurotransmitters affected by psychotropic medication (p. 323, Leiblum).

5. Give examples of how four dimensions interface with general treatment options (pp. 325-326, Leiblum).

6. Recognize how a sexual response feedback loop can inform diagnostic formulations and treatment plans (pp. 326-335, Leiblum).

7. Outline rehabilitative framework categories for managing medically related sexual dysfunctions (pp. 335-342, Leiblum).

8. Recall the results of a public opinion poll regarding physicians and help with sexual problems (pp.342-343, Leiblum).

After reading Chapter Twelve, Sexual Dysfunction and Childhood Abuse, the student should be able to:

1. Define child sexual abuse (CSA) (p. 351, Leiblum).

2. Outline the effects of CSA on functioning in women (pp. 352-354, Leiblum).

3. Point out the effects of CSA on functioning in men (pp.354-357, Leiblum).

4. Recognize two groups of theories regarding the impact of CSA on adult sexual functioning (pp. 357-359, Leiblum).

5. Summarize general principles of sex therapy when there is a history of abuse (pp.360-374, Leiblum).

After reading Chapter 13 Therapy with Sexual Minorities, and selected pages of Counseling Gay Men & Lesbians (Barret & Logan), the student will be able to:

1. Outline major research and theory about homosexuality (pp. 10-16, Barret & Logan & Long).

2. Describe the gay and lesbian identity development models, proposed by Cass, Troiden, Coleman & McCarn & Fassinger (pp. 29-36, Barret & Logan).

3. Distinguish between issues in counseling lesbians and issues in counseling gay men (pp. 48-103, Barret & Logan & 384-386, Leiblum).

4. Recognize common sexual issues in LGBTQ community (p.390, Leiblum).

5. Point out tips for practitioners treating sexual minorities (p.17, 42, 61, 82, 102,123,137,158,173, & 194, Barret & Logan).

After reading Out of the Shadows (Carnes), the student should be able to:

1. Define sexual addiction (pp. 14-15, Carnes).

2. Describe the sexual addictive cycle (pp. 11-32, Carnes).

3. Outline the three levels of addiction (pp. 33-75, Carnes).

4. Illustrate how addictive behavior presents in cybersex (pp. 77-92, Carnes).

5. Illustrate how addictive behavior presents in the family (pp. 93-115, Carnes).

6. Outline a Twelve Step Program for treating sexual addiction (pp. 147-193, Carnes).

7. Discuss the implications of sexual addiction (Class+Long).

XII. Course Schedule

What follows is an overview of how the course will be organized from week-to-week. The schedule is subject to change.

|Meeting |Instructor Activity |Student |Student |

| | |Reading |Activity |

|June 14th |Orientation To CougarView, Lecture: Chapters One and Fourteen, Lead |Read: Chapters |Attend & Participate |

| |Discussion: Sexuality and the black church, Show: Episode 1, Tell me |One, Fourteen & |Download Course Materials |

| |you love me, Lecture: Emotionally Focused Therapy Overview, |Sexuality and the | |

| |Facilitate: Skill Building Session, Process: Skill Building Session |black church | |

|June 21st |Administer Quiz, Lecture: Chapters Two & Three, Facilitate: Case |Read: Chapter |Quiz Ch One & Fourteen, |

| |Study Discussion, |Two and Three |Lead Case Discussion (Leigh|

| |Show: Episode 2, Tell me you love me, | |and Steve) |

| |Facilitate: Skill Building Session, | | |

| |Process: Skill Building Session | | |

|June 28th |Administer Quiz, Lecture: Chapter Four, Five and Sixteen, Video: |Read: Chapter |Quiz Ch Two & Three, |

| |Becoming Orgasmic, Lead Discussion Pretty good for a girl, |Four, Five, Sixteen |Lead Case Discussion |

| |Facilitate: Case Study Discussion, Show: Episode 3, Tell me you love |and Pretty good for a |(Charles and Mike) |

| |me, Facilitate: Skill Building Session, Process: Skill Building |girl | |

| |Session | | |

|July 5th | | |Holiday |

|July 12th |Administer Quiz, Lecture: Chapters Seven & Eight, Video: You Can |Read: |Quiz: Chapters Four, Five |

| |Last Longer, Facilitate: Case Study Discussion, Show: Episode 4, Tell|Chapters Seven & Eight|and Sixteen, |

| |me you love me, Facilitate: Skill Building Session, Process: Skill | |Lead Case Discussion (Ann &|

| |Building Session | |Mallory) |

|July |Administer Quiz, Lecture: Chapters Nine and Ten, Facilitate Case |Read: |Quiz Ch Seven & Eight, |

|19th |Study Discussion, Show: Episode 5, Tell me you love me, Facilitate: |Chapters |Lead Case Discussion (Patty|

| |Skill Building Session, Process: Skill Building Session |Nine , Ten & Out of |& Buddy) |

| | |the Shadows |Prepare Treatment Plan |

|July 26th |Administer Quiz, Lecture: Chapters Eleven and Twelve, Thirteen, Lead|Read: |Quiz Ch Nine & Ten |

| |Discussion of Out of the Shadows, Facilitate Case Study Discussion, |Chapters Eleven, |Lead Case Discussion (Scott|

| |Show: Episode 6, Tell me you love me, Facilitate Skill Building |Twelve & Thirteen |and Ashley, Lauren and |

| |Session, Process: Skill Building Session | |Joseph) |

| | | |Hand In Treatment Plan |

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