How Do I Know If I Need A Sex Therapist? What Can I Expect During Sex Therapy?

My experience is that most of us don’t realise that our sexual health can have a significant impact on our overall health and wellbeing. Sex is an integral part of health and wellness which is why the WHO defines Sexual Health as a HUMAN RIGHT!

Sexual Health refers to everything about you and your sexuality. The lens of Sexual Health encompasses your mental, physical and social wellbeing as it relates to your sexuality. Sexual Health is premised on your right to sexual pleasure and your right to safe sexual expression and experiences.

Because most people never even think about whether they need a Sex Therapist or not, they live with a host of issues that can affect them negatively on all these levels – when indeed there are people like us Sex Therapists who can help with such a wide range of these issues!   

So what is Sex Therapy all about?

Well there is the stuff about your sexual identity, like:

  • Your sexual orientation – who do you find yourself sexually attracted to?
  • Your romantic orientation – who do you find yourself developing romantic feelings for? (The answers to these 2 questions don’t have to be the same and don’t have to remain static over time!)
  • Your gender – now this goes way beyond whether you are a man or a woman but extends to how you like to present yourself to the world, and also how you feel about yourself in terms if your gender – and this too does not have to remain fixed or static over time

Then there’s stuff about the act of sex:

  • What kind of sex do you like? And by ‘what kind’ I mean – when, how, with whom, with what, how often, if at all?
  • What turns you on?
  • What grosses you out?
  • Does sex hurt sometimes?
  • Is there anything you wish you could try, but feel totally weirded out by the idea?
  • Have you ever been aroused by something that took you completely by surprise because it’s just “not normal”?
  • Are you happy with your current level of sexual satisfaction?

Then there’s your sexual relationship with others:

  • What do your sexual relationship structures look like, and what do you wish they could be?
  • How important is monogamy to you in a sexual relationship? And to your partner/s?
  • How do you talk to your kids about sex?
  • How are you feeling about the sex with your current partner/s?
  • What kinds of things did you learn and experience about sex growing up? How do you think this may be influencing your expectations and experiences of sex and sexual relationships now?

These are just a few of the things that a Sex Therapist can help you explore, this list is by no means exhaustive.

As Sex Therapists we can help you whether you are experiencing extreme distress and dysfunction relating to the kinds of topics listed above, or if you are just wanting to find out if there’s more to the sex that you are currently experiencing.

Most people have questions about sex that they find difficult to explore within their social circles, so they google it and often don’t find answers, or just live with the uncertainty, disappointment, or distress that the issue causes.

What can I expect from Sex Therapy?

Sex Therapists are typically trained in Psychology or Social Work, and have obtained further training and or experience working in the field of Sexual Health. Much like general counselling, Sex Therapy does NOT involve any touching, bodily exposure or manipulation of any kind! It’s all “talk therapy” based on general counselling techniques, where we would explore topics that relate to your sexual health.

We may give you homework that can involve you and/or your partner exploring various physical techniques and exercises, which we would then talk about at the follow up sessions.

*You should NEVER allow a Sex Therapist to engage with you in any physical way, unless they are a qualified medical practitioner, and qualified to do what they are offering! It is also very important that you check the credentials and registrations of the professional that you seek help from before you see them.

Besides social or psychological problems relating to your sexual health, there can often be problems of a physical nature as well.

Sex Therapists are qualified to assess whether this might be the case, but we can’t diagnose or offer medical treatment. We thus work closely with medical health professionals who have training in sexual health, and will refer you to them if deemed necessary. We may also do this just to rule out any organic cause for dysfunction. Most often we work hand in hand with the medical practitioner to help you achieve resolution.

So how do you know when you need a Sex Therapist?

Everybody needs to talk about sex. You may not need to talk to a professional, but talking to one, can help you talk about sex to the people in your life who influence your sexual health.

There is a strong link between sex and psychology because sex is often about relating to others and requires a level of vulnerability that many other social interactions do not.

I have had many clients who have found that just having a space to talk about sex freely and without judgement, knowing that all is kept 100% confidential, has given them freedom and insights that have helped them experience sex in a much more positive way than they had prior to therapy.

So the simple answer would be, if you are unhappy, unsure or experiencing distress about any area on your sexuality, an assessment by a Sex Therapist can give you clarity about your issue and also afford you the opportunity to claim your right to live a more sexually healthy and fulfilling life.


Chantal Fowler (SASHA Executive Committee)
Clinical Psychologist
Psycho-Sexologist – European Society of Sexual Medicine (ESSM)
PHD candidate – UCT school of Public Health and Family Medicine



Mobile: 076 586 9857

A Sexologist Vs Sex Therapist

The question is frequently asked – What is a Sexologist? What qualifications do you need to be a Sexologist? There is further confusion between what differentiates a Sexologist to that of a Sex Therapist. The following synopsis aims to clarify these differences.   


Sexology is the general term for the scientific study of human sexuality and sexual behaviour. The people who study this field, are generally referred to as Sexologists.

Some people think Sexologists and sex therapists are one and the same. There is a difference with reference to Sexologists who choose to pursue a career as a sex therapist by working directly with patients in a clinical setting, whilst others may explore careers such as researching sexual behaviour, or sexual health.

Additionally, these persons may choose to become a sex educator helping in expanding sexual knowledge in the general public domain, or a medical doctor specialising in sexual health and treating diseases associated with sexual behaviour, like sexually transmitted infections and other physical symptoms.

Lastly another group of individuals working in Sexology are able to act as public policy activists regarding sexually related issues, such as legalising prostitution, LGBTQI&A rights and building on the general rights of marginalised individuals allowing everyone to have fulfilling sexual relationships.

How do you become a Sexologist?

A small number of Universities in the world offer degrees in sexology, or human sexuality at undergraduate and post graduate levels. It is common that people who do choose to pursue the academic process to become Sexologists, have
educational backgrounds in disciplines such as sociology, psychology, biology, medicine, public health (nursing) or anthropology.

Sexologists generally have a master’s or doctoral degree, although some individuals have another type of advanced professional degree. Although a board certification is not required to call yourself a Sexologist, many students in this field seek credentials from professional organisations such as the American Board for Sexology, or the International Society for Sexual Medicine.

To be certified, you typically need to show a relevant advanced academic degree, relevant work experience in the field and completion of a certain number of training hours. These requirements however may vary based on the certification.

Sex Therapist

Sexologists who are also sex therapists work with clients, either individually or as a couple, to improve and address problems and aspects contributing to distress in their sexual functioning. This might include sexual education for couples who may experience problems such as mismatched libidos, difficulties reaching fulfilling orgasms, sexless relationships, sexual trauma
and other issues specific to personal problems regarding sexual identity and problematic sexual behaviour like pornography addiction.

Sex therapists should have specific qualifications such as an advanced degree in either psychology, psychotherapy or counseling, and specific courses in sex therapy training and clinical experience. Unfortunately, these terms are not currently regulated, so anyone is able to call themselves a Sexologist or a sex therapist. It is good practice when you are looking for
someone to help you in this area, to check their qualifications first.

Do not expect any physical contact during a sex therapy session with a Sexologist!

People sometimes think that a sexologist would do ‘hands-on’ work. This would be regarded as unethical conduct within the profession and is defined as such by the professional boards situated under the Health Professional Council of South Africa (HPCSA). An HPCSA registered practitioner can be charged by the HPCSA, in the event of unprofessional behaviour. Therefore it is rather a matter of “All talk, No action”.

This would clearly differ from being a sex surrogate, which is a different profession all together by involving actual sexual contact with clients.
Thus, if you are in need of, or you are interested in consulting with a certified Sexologist or professional sex therapist, the SASHA website would be able to direct you to a list of professionally qualified Sexologists and sex therapists in South Africa.


Dr Eugene Viljoen (Past President of SASHA)

Clinical Psychologist
B.Sc. Hons. (Physiol. & Bioch.)
B.Sc. Hons. (Psych.); M.Sc. (Clin. Psych.)
Dipl Aviation Psych & Physiol. (USA) Ph.D
ISSM/EFS Certified Clinical Sexologist (European Federation for Sexology)

Phone: 012 346 4760