The Insider Scoop: What really happens in a sex therapist’s office!

I chose to study about sex therapy for a couple of reasons; my own brokenness and the brokenness of others. I truly believe that God can cover our hurts and imperfections and allow us to rest in the peace that through Christ we are redeemed. Even when I get the opportunity to share those points with others, it isn’t at all unusual for people to wonder just exactly what happens in the office of a sex therapist, especially the office of a Christian sex therapist. While, I’ve written before about what you might learn in sex therapy, I thought it would be helpful to also explain the basic process. Like before, I’m going to give a bit of a disclaimer. It takes quite a bit of time and work to actually get certified as a sex therapist. I’m doing my certification through the American Board of Christian Sex Therapists, but I’m not completely through the process. So while I have more training in this area than many of the therapists I know, I’m not a certified sex therapist yet. And…disclaimer over!

The DEC-R Model

The process of sex therapy can be explained through the acronym, DEC-R: Dialogue, Education, Coaching, and Referral. This isn’t a linear process and you’ll likely notice that we move from one domain to the next quite fluidly, going back and forth to each one until you’ve finished the process of therapy.


Part of my job, for anyone who works with me, is just to make the entire process of talking about sexual issues easier. Most people find it quite difficult to share their concerns or disappointment about their sexual lives with their spouse. I work with a couple to create a safe place to speak about sex.  At the same time, as I work to create a safe space for exploration of sexual topics, I also set up boundaries. There are proper and holy ways to talk about the gift of sex. Front and center of our conversations will be Christ and a respect for the boundaries we have in Scripture. We will not talk about sexual issues or concerns in a voyeuristic manner, but instead, remember that as we talk we are also working in a sacred space.


The education portion of this model has to do with education from both a biological perspective and a spiritual perspective. Many times, couples come to therapy with little understanding of their physical bodies, how the reproductive system works, the love-making cycle, or the differences between a man’s and a woman’s sexual response cycle. Add to that the fact that few churches speak on sex (outside of ‘don’t before marriage’ and ‘do after’), few couples understand God’s design for sex. We’ll spend quite a bit of time just focusing on God’s design for sex and learning what Scripture teaches, as well as learning a some skills regarding intimacy.


Most of the time, when a couple comes for sex therapy, they’ve already spent more than a few hours searching the internet for advice and tips for a better sex life. They may have also bought a few books and tried to work through some exercises on their own. But typically, couples need a bit more explanation than can be found on a popular blog or a research article. They need someone to teach them certain exercise or help them to understand the purpose in implementing new behaviors. In other words, couples often have some skills, but are having some difficulty truly committing themselves to improvement. Your therapist can walk along beside you as a coach – training you and encouraging you.


You can just about guarantee that if you come to counseling you’ll receive some type of referral. Sometimes this is a referral for a doctor, psychiatrist, urologist, gynecologist, or even your PCP. I’m going to make sure that if there are any physical or emotional issues for you that we are taking care of that while we work directly on the sexual relationship. Part of sex therapy is treating the entire person, so referrals are an integral part of the process. Hopefully, in reading this you’ve learned that sex therapy doesn’t have to be scary or intimidating process. If you’re finding that online searches haven’t been helpful enough for you to work on the sexual issues in your marriage (dissatisfaction, different levels of sexual desire, affair recovery), it just may be time for you to seek out more help. Find a therapist in your area right here. God bless you, your marriage, and your intimacy!

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