Every therapist or counselor should be licensed, and should have a scope of practice that is made clear in any advertising, websites and listings. If the scope of practice is marriage and the family, or general mental health issues, counselors should refer out for sexual problems unless they also are board certified sex therapists.

Unfortunately, this does not always happen. Some therapists do not do their homework to help a client find a suitable sex therapist. Other counselors know of sex therapists, but decide they need the income, so they don’t refer out—which is a huge ethical issue.

I often have new couples or individuals who find me from a web search. Sometimes they have been to a marriage counselor, a mental health counselor or another sex therapist without much, if any, help. In these cases, the therapist made no effort to find a suitable sex therapist for them. In most cases, the therapist never admitted they were not sufficiently trained to solve the sexual dilemma. Some of these counselors pass on their own biases rather than develop a sound treatment plan. (“How do you feel?” is not a treatment plan).

As a certified sex counselor, if I identify a problem that I am not trained to solve, I refer the client to a therapist who has the expertise to help. In some cases, I refer a person to an individual therapist while I work with the couple. For example, if a person has experienced sexual abuse, rape or another trauma, I refer them to a trauma therapist who does EMDR (Eye Movement Therapy), so they can put the trauma behind them while I help them with their current dilemma. Some trauma therapists do half-day and whole day intensive sessions, which is often a useful way to help a client deal with deep traumas.

I would hope that marriage counselors and others would do likewise when it comes to handling sexual issues. A marriage counselor typically has a course, or a few courses in Human Sexuality, but this does not prepare them to deal with a range of sexual dysfunctions. With years of experience, I have developed a relationship with therapists who are specialists in a given area. I refer to them as appropriate.

My experience with the referral problem is not totally unique. I have discussed the referral issue with other sex therapists from around the country, and they have had similar experiences with clients finding them on their own after a general therapist could not solve their problem. It makes me realize that part of the problem is the way many therapists are trained and supervised. They either were not properly advised about the ethics of referrals, or they simply did not take the advice of their professors and supervisors to stick to their scope of practice based on their training.

I aim to bring clients to a place where they can experience joyful sex, usually in a few sessions. We can work together while you are in individual counseling with another therapist. I would be happy to speak with you. If you think that sex therapy may help you as a couple, just send an email or give me a call.