Like many people, you might wonder: What does a sex therapist do? A sex therapist guides individuals struggling with certain components of sex, such as arousal and performance. These therapists meet with an individual or a couple in a professional setting -- usually an office -- just like any other mental health practitioner would. Then sex therapists assess the psychological or physical reasons for their clients' challenges and provide treatment through sex counseling.
Professionals in the mental health, therapy, and counseling fields need to earn state licensure in order to legally work. Although most states do not offer licensure strictly for the sex therapy field, aspiring sex therapists still need some sort of therapy or counseling licensure to practice. Then they can apply for certification from the American Association of Sexuality Educators, Counselors, and Therapists (AASECT).
The certification process requires a graduate degree in a mental health, psychology, or therapy field. Candidates must also complete a certain number of supervised clinical hours. You can learn more details about those requirements, and how to become a sex therapist, below.
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Educational Pathways to Becoming a Sex Therapist
Most states do not outline specific educational requirements for sex therapy. However, to gain certification from AASECT, individuals must fulfill the association's expectations. Aspiring sex therapists should obtain at least a master's degree in a mental health field with psychotherapy training. Several sex therapist degrees are available for learners. However, many students choose more common master's programs in psychology, psychotherapy, psychiatric nursing, professional counseling, family and marriage family, or social work.
Master's programs generally last two years for full-time students, and learners in these fields learn about psychological theory, along with therapy techniques. Some individuals also continue on to doctoral programs in their fields, which could last 3-7 years and give students additional expertise.
Obtaining a Sex Therapist License
Sex therapists do not earn licensure in sex therapy. Instead, they can obtain state licensure as mental health counselors or marriage and family therapists. In fact, for certification, AASECT requires applicants to hold licensure in psychology, medicine, social work, counseling, nursing, or marriage and family therapy. Individuals must apply for these through their state licensure boards, which all set different requirements for various types of licenses.
Usually candidates need a master's or doctoral degree for licensure. They may also need to complete some supervised clinical hours. Check with your state's licensing board to learn the specifics.
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Sex Therapy Certification
A sex therapy certification program equips candidates with the knowledge and skills they need to effectively guide clients as sex therapists. Certification prep programs cover the core knowledge areas of sex therapy, including developing sexuality over the lifespan, sexual orientation, intimacy skills, and diversities in sexual expression.
Students in the sex therapy programs study scientific subjects, such as sexual and reproductive anatomy, biological sexual functions, and health and mental health factors that influence sexual behavior. Ethics also make up a significant part of the curriculum. Finally, AASECT certification requires candidates to participate in supervised training before they can apply for their certification.
Clinical Experience Requirements
Candidates should fulfill a few different types of clinical experience requirements to qualify for certification. First, they should complete at least 10 hours of structured group experiences meant to explore candidates' personal values on sexuality. Applicants must also participate in 300 hours of AASECT-supervised clinical treatment, in addition to at least 50 hours of supervision with an AASECT-certified sex therapy supervisor. Candidates can complete these hours either in a group or individual supervision environment, but individual supervision should count for at least 50% of candidates' hours.
Certification Renewal Requirements
Once certified, sex therapists must renew their AASECT credential every three years. These professionals should participate in at least 20 continuing education hours during each three-year period. Many sex therapists accomplish this by enrolling in AASECT-sponsored continuing education courses. They can also earn credit in other ways, such as publishing a scholarly article in a journal or book, developing a teaching tool for others in their field, or completing face-to-face supervision with an AASECT-certified supervisor.
Career and Salary Outlook For a Sex Therapist
It's difficult to find reliable data on sex therapist salary numbers and career outlooks, so instead you may find it useful to look at comparable careers, such as psychologists and mental health counselors. Psychologists earn a median annual salary of $80,370, according to data from the Bureau of Labor Statistics (BLS). Mental health counselors, in comparison, bring home median annual earnings of $46,240. The BLS projects that both fields may grow over the next decade. The number of psychologists may increase by 14% from 2018-28, while the mental health counselor profession could grow by 22% in that same time period.
Frequently Asked Questions with a Sex Therapist
Dr. Kate Balestrieri
Dr. Kate Balestrieri is a licensed psychologist, certified sex therapist, certified sex addiction therapist - supervisor, PACT II couples therapist, and founder of Modern Intimacy in Beverly Hills and Miami. The team at Modern Intimacy focuses on helping people heal from trauma, addiction, and sex and relationship issues. Follow her on IG at @themodernintimacy and @drkatebalestrieri.
Why did you choose to become a sex therapist?
For many years, one of the things I’ve frequently said (to patients or anyone else who may be interested) is that “your relationship to sex is your relationship to everything". Cheeky, admittedly, but true in the sense that if someone has a lot of shame regarding sexuality, that likely extends to other areas of their life. If they are compulsive or push boundaries, that is likely to be present in other areas of their life. If they are restrictive or deprivational, they probably are the same way with other pleasure or self-care-related behaviors as well. Entitled in sex? Probably in other domains of life too.
It became clear to me early on in my career that there was a dearth of understanding about the role of sexuality in mental and relational health, and vice versa. It seemed clear that there were a select group of therapists who specialized in understanding the intersection of sexuality and psychology, but even amongst them, there were incredibly disparate views and treatment goals.
It was my opinion that within the field of psychology, there was a parallel process in existence with what was happening in society at large; in that the phenomenon of sexuality was cut off, compartmentalized -- taboo even -- in some psychological circles. For a culture so sexually preoccupied, this seemed to me a grave pattern to perpetuate. As such, I began accruing specialized training in every aspect of sexuality I could anticipate, believing fully in the necessity of a holistic and integrated understanding of sex and the whole person with whom I was working. I obtained specialized training in the evaluation and treatment of sex offenders, those compulsive sexual behavior problems, sexual trauma, sexual dysfunction, gender, sexual orientation, sex and society, and alternative lifestyles.
What does the curriculum model for the sex therapy specialization focus on beyond that of general counseling, psychology, etc?
The curricula vary between institutions, however most over aspects of understanding the biopsychosocial of sexuality, developing knowledge on symptoms and treatment options related to sexual dysfunctions or other conditions, co-occurring mental health conditions, understanding empowerment and sex in a social context, and challenging one’s own sexual biases.
Different states may have different requirements, and some have none, but certainly additional education is required. There are some professional organizations that require additional training and supervision above and beyond, so it incumbent upon any perspective sex therapist to investigate the laws of the state in which they wish to practice and to explore the different professional organizations (along with the advantages and disadvantages that come with joining any or all).
Describe the impact and importance of sex therapy when working with different populations (e.g., sex offenders and survivors of sexual trauma/discrimination). Does working with these different populations require different levels of training?
It is with an emphatic YES that I assert my belief that specialized training is required to effectively treat the myriad layers of sexuality in the field of psychology. The speciality area is large and layered, and expansive knowledge and experience is required to fully understand best clinical practices with different populations, and especially with those populations determined to be vulnerable.
There are even different professional organizations that specialize in the training and treatment of various aspects of sexuality. For example, the International Institute of Trauma and Addiction Professionals (IITAP) is geared toward treating sexual compulsivity, whereas the American Association for Sexuality Educators, Counselors and Therapists (AASECT) provides a broad landscape of attention to various sexual and therapeutic constructs. The Association for the Treatment of Sexual Abusers remains a steadfast organization committed to the treatment and prevention of future sexual offenders.
Each has different points of view about sexuality, diagnostic considerations, and best practices. Stepping to the provision of treatment without proper training and supervision (as with any area of specialization) is unethical and can not only lead to liability issues for the clinician, but can also contribute to iatrogenic trauma at the hands of ill-equipped professionals, as this can be a population with more predispositions of vulnerability.
Why might someone consider a career as a sex therapist?
The reasons someone may choose a career as a sex therapist are varied, but usually come down to a passion for advocacy and holistic representation of human rights or effective care. At times, clinicians may choose this career path out of respect for their own path through sexuality and a desire to help others. Whatever the reason, acute attention to one’s bias, boundaries, and beliefs is essential in providing ethical and effective sex therapy.
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