Joseph LoPiccolo

Assessing Sexual Behavior in Couples.

The role of formal assessment in the practice of sex therapy with couples is discussed. A case is made for the use of behaviorally oriented paper-and-pencil tests of the self-report variety, in clinical settings, at two points in time: prior to any therapist-client contact and following completion of therapy. Such procedures are both efficient and effective, yielding information relevant to diagnosis, treatment planning, and development of clinical skills. Assessment procedures used routinely at the Stony Brook Sex Therapy Center are described and illustrated using sample cases. The authors suggest that behavioral assessment approaches have considerable clinical potential which has yet to be fully realized.

Sexual Dysfunctions and Their Treatment

If we broadly define sexual dysfunctions as physiological, cognitive-affective, or behavioral problems that prevent an individual from engaging in or enjoying satisfactory sexual activity, intercourse, or orgasm, then we can be sure that sexual dysfunctions have been around as long as sex has. Only recently, however, has a discipline been developed that attempts to describe, assess, and treat sexual dysfunctions in an integrated and scientific manner.

The Role of Cultural Values in the Prevention and Treatment of Sexual Problems

The psychotherapist is often perceived as an objective, dispassionate arbiter of mental health, free of cultural biases. In point of fact, however, the psychotherapist is influenced by the culture in which he or she lives (London, 1964). The therapist’s conceptualization of human personality is inevitably shaped by the values of the dominant elements of his or her society. The danger in this cultural bias of therapists is that psychotherapy may become nothing more than an acculturation process. Culturally valued behavior may become synonymous with “mental health,” and culturally disapproved behavior may be labeled “mental illness,” a point that has been made repeatedly by Szasz (1960). In such a situation, the psychotherapist may tend to emphasize cultural conformity at the expense of the client’s individual needs.