Entering the field of sex therapy is both exciting and challenging. As new therapists navigate this specialized area, they often encounter hurdles that can impact their effectiveness with clients. While mistakes are part of the learning process, being aware of common pitfalls can help new sex therapists build confidence, avoid unnecessary struggles, and provide better care.
Here are five common mistakes new sex therapists make—and what to do instead.
Many therapists enter sex therapy because they want to help clients work through issues related to intimacy and pleasure. However, that doesn’t mean they are immune to their own discomfort around certain sexual topics. Whether it’s kink, non-monogamy, fetishes, or sexual trauma, therapists may unconsciously steer conversations away from subjects that make them uneasy.
What to Do Instead:
•Engage in self-reflection and ongoing training to explore personal biases and blind spots.
•Seek supervision or consultation with experienced sex therapists.
•Get comfortable using explicit but professional language to discuss sexual topics without euphemisms.
It’s tempting to immediately prescribe behavioral interventions like scheduling sex, trying sensate focus, or introducing novelty. While these techniques can be useful, they often fail if deeper emotional or relational issues remain unaddressed.
What to Do Instead:
•Assess whether emotional barriers (e.g., unresolved resentment, attachment wounds, power struggles) are present before assigning behavioral interventions.
•Use interventions from the Developmental Model of Couples Therapy to help partners differentiate and navigate emotional gridlock.
•Help clients explore underlying fears or messages about sex rather than just prescribing a “to-do” list.
Many sexual issues, such as low desire, painful sex, or avoidance of intimacy, are linked to trauma—whether it’s a history of sexual violence, religious shame, or childhood experiences of neglect. New sex therapists sometimes focus solely on the presenting problem (e.g., lack of desire) without exploring the deeper impact of past trauma.
What to Do Instead:
•Use trauma-informed approaches, such as EMDR, to help clients process sexual trauma that may be impacting intimacy.
•Normalize the connection between trauma and sexual difficulties without assuming every sexual issue is trauma-based.
•Pay attention to body cues—sometimes clients intellectualize their experiences, but their bodies tell a different story.
Desire discrepancy is one of the most common issues couples bring to therapy, but not all cases are alike. Some couples struggle due to unresolved relational tension, while others have mismatched sexual wiring. Assuming a one-size-fits-all approach can lead to frustration for both the therapist and the couple.
What to Do Instead:
•Differentiate between responsive vs. spontaneous desire and educate clients accordingly.
•Explore whether the low-desire partner actually has low desire—or if they are avoiding sex due to relationship resentment or past experiences.
•Address any pursuer-distancer dynamics that might be fueling the problem.
Sex therapy brings up strong feelings—not just for clients, but for therapists as well. New sex therapists may feel frustration when a client resists interventions, embarrassment when discussing explicit details, or even attraction toward a client. Ignoring these reactions can impact the therapeutic process.
What to Do Instead:
•Notice your emotional responses and bring them to supervision or consultation.
•Practice self-awareness and self-regulation—your ability to hold space for sexual topics without over-identifying or withdrawing is crucial.
•If a particular case is triggering, explore whether it’s a sign of unresolved personal experiences or an opportunity for professional growth.
Becoming an effective sex therapist is a journey of continued learning, self-reflection, and skill development. By recognizing and addressing these common mistakes early in your career, you’ll be better equipped to help clients navigate their sexual concerns with confidence and compassion.
What challenges have you faced as a new sex therapist? Share your thoughts in the comments below!
Need more support? Reach out to Lisa Delaplace, LCSW-S, CST, EMDR-CIT.
Supervision, Consultation and Training for Mental Health Therapists
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