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MFT Practice Exam - Sex Therapy > MFT Practice Exam - Sex Therapy 58 Q & A > Flashcards

MFT Practice Exam - Sex Therapy 58 Q & A Flashcards

1
Q

<p>Three categories of sexual dysfunction:</p>

<p></p>

A

<p>1. Sexual Dysfunction</p>

<p>2. Sexual Dissatisfaction</p>

<p>3. Sexual Deviation</p>

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2
Q

<p>Prevalence of Sexual Dysfunction (based on gender)</p>

A

<p>Women = 43%</p>

<p>Men = 31 %</p>

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3
Q

<p>Prevalence of sexual dysfunction in women</p>

A

<p>Hypoactive sexual desire disorder = 33.4%</p>

<p>Difficulty with orgasm = 24.1%</p>

<p>Pain during intercourse = 14.4%</p>

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4
Q

<p>Causes of low sex drive in women</p>

A

<p>Vary.</p>

<p>Fatigue/stress from daily responsibilities</p>

<p>Psychological</p>

<p>Certain health conditions or medications (ex. mood stabilizers)</p>

<p>Depression/anxiety</p>

<p>Birth control pills</p>

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5
Q

<p>Prevalence of sexual dysfunction in men:</p>

A

<p>Hypoactive sexual desire disorder = 15.8%</p>

<p>Erectile dysfunction = 34.8% (increases with age)</p>

<p>Premature ejaculation = 30%</p>

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6
Q

<p>4 Types of Sexual Dysfunction</p>

A

<p>1. Disorders of Desire</p>

<p>2. Arousal Dysfunction</p>

<p>3. Orgasm dysfunction</p>

<p>4. Pain</p>

<p></p>

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7
Q

<p>Disorders of Desire (male and female)</p>

A

<p>Hypoactive sexual desire disorder</p>

<p>Sexual aversion disorder</p>

<p>30% women, 15% men</p>

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8
Q

<p>Most common psychological causes of disorders of desire:</p>

A

<p>Depression</p>

<p>Anxiety</p>

<p>Stress</p>

<p>Substance abuse</p>

<p>Fatigue</p>

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9
Q

<p>Hypoactive sexual desire disorder</p>

A

<p>Persistent or recurrent deficiency (or absence) of sexual fantasies/thoughts and/or desire for or receptivity to sexual activity that causes personal distress (not just partner distress).</p>

<p>Lifelong or acquired (lifelong = more difficult to diagnose/treat)</p>

<p>Generalized or situational</p>

<p>Single or multiple etiologies</p>

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10
Q

<p>Arousal Dysfunction (by gender)</p>

A

<p>Male erectile disorder</p>

<p>Female sexual arousal disorder</p>

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11
Q

<p>Sexual Arousal Disorder</p>

A

<p>The persistent or recurrent inability to attain or maintain sufficient sexual excitement, causing personal distress.</p>

<p>May be expressed as a lack of subjective excitement, genital response (lubrication/swelling), or other somatic responses.</p>

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12
Q

<p>Orgasm Dysfunction (by gender)</p>

A

<p>Male orgasmic disorder</p>

<p>Premature ejaculation</p>

<p>Female orgasmic disorder</p>

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13
Q

<p>Orgasmic Disorder</p>

A

<p>The persistent or recurrent difficulty, delay in, or absence of attaining orgasm/ejaculation following sufficient sexual stimulation and arousal, causing personal distress.</p>

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14
Q

<p>Pain</p>

<p>(Type of sexual dysfunction)</p>

A

<p>Dyspareunia</p>

<p>Vaginismus</p>

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15
Q

<p>Dyspareunia</p>

A

<p>Recurrent or persistent genital pain associated with sexual intercourse.</p>

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16
Q

<p>Vaginismus</p>

A

<p>Recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with vaginal penetration, causing personal distress.</p>

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17
Q

<p>All 4 types of sexual dysfunction may be:</p>

A

<p>Lifelong/acquired</p>

<p>generalized/situational</p>

<p>psychological/combined factors</p>

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18
Q

<p>Masters and Johnson (1970)</p>

A

<p>Crystallized cognitive/behavioral methods to treat sexualized problems.</p>

<p>Revolutionized treatment (like Viagra revolutionized pharmacology) - prior treatment for sexual disorders was long-term, multi-year psychotherapy or psychoanalysis with very low rates of success.</p>

<p>Birth of the field of sex therapy.</p>

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19
Q

<p>Treatment created by Masters and Johnson</p>

A

<p>Devised a rapid (2 week) psychotherapy in couple, rather than individual, context, working with male/female therapist team - >80% success rate.</p>

<p>Strictly talking therapy (did not observe sexual activity).</p>

<p>Provide appropriate sex information, alleviate anxiety about sexual performance, and facilitate verbal/emotional/physical communication.</p>

<p>Still widely used today.</p>

<p>Revolutionary.</p>

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20
Q

<p>Female Sexual Response Cycle (Basson)</p>

A

<p>Non-linear, intimacy-based model.</p>

<p>Female dysfunction (and desire) appears to have many causes and many dimensions, including biological, psychological, and interpersonal determinants that can aid or impede arousal.</p>

<p>Responsive rather than spontaneous (i.e. sexual stimuli). Begins with cognitive decision to engage in sexual activity (ex. listen to music, direct stimulation).</p>

<p>Goal of sexual activity = personal satisfaction, not necessarily orgasm, but can be physical or emotional</p>

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21
Q

<p>Esther Perel on female eroticism</p>

A

<p>Diffuse, not localized in the genitals but distributed throughout the body, mind, and senses.</p>

<p>Tactile and auditory; linked to smell, skin, and contact.</p>

<p>Arousal is often more subjective than physical.</p>

<p>Desire arises on a lattice of emotion.</p>

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22
Q

<p>Healthy Sex (Wendy Maltz)</p>

A

<p>Conscious, positive expression of our sexual energy in ways that enhance self-esteem, physical health, and emotional relationship.</p>

<p>Mutually beneficial and harms no one.</p>

<p>Requires five basic conditions be met: CERTS</p>

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23
Q

<p>Sexual Energy (Wendy Maltz)</p>

A

<p>Powerful, natural force.</p>

<p>Potential to be channeled and experienced in either destructive or life-affirming ways.</p>

24
Q

<p>Healthy Sex CERTS Model (Wendy Maltz)</p>

A

<p>1. Consent</p>

<p>2. Equality</p>

<p>3. Respect</p>

<p>4. Trust</p>

<p>5. Safety</p>

<p>All five must basic conditions must be met to foster healthy sex.</p>

25
Q

<p>Therapist's Comfort Zone</p>

A

<p>Create a sex-friendly space free of judgment and moralizing where people can safely talk about their sexuality:</p>

<p>Allow client to normalize when therapist conveys she is comfortable dealing with sexual issues.</p>

<p>Allow clients to reveal fantasies, concerns - often for the first time</p>

<p>Allows for greater creativity in the treatment room.</p>

<p>Be aware of countertransferene - aligning with one partner, acknowledging own arousal/discomfort</p>

26
Q

<p>3 Dimensions of Assessment</p>

A

<p>1. Screening - may be the first screening by a professional</p>

<p>2. Incorporate ongoing practice in matter of fact manner</p>

<p>3. Specific requests for sex therapy = comprehensive sexual assessment</p>

27
Q

<p>Importance of biopsychosocial dimensional components to assessment</p>

A

<p>Sexual dysfunctions are often highly related to physical and psychosocial dimensions of an individual's life.</p>

<p>Preventive treatment measure like sexual/senxual education would be more useful than only reproductive education.</p>

<p>Optimal treatments require careful histories and have the ability to impact psychological and physiological sexual response.</p>

<p>Sexualy is core human function but personal functioning remains a difficult topic to discuss for patients/physicians/therapists.</p>

28
Q

<p>Screening Assessment</p>

A

<p>Are you sexually active?</p>

<p>Men, women, or both?</p>

<p>Are you satisfied with quality and quantity of sexual activity in your life?</p>

<p>Is this an area you would like more informaion on or to more fully explore?</p>

29
Q

<p>Assessment: Incorporating in ongoing practice</p>

A

<p>Contraindicated in presence of severe marital distress - marital therapy to pave the way for future treatment of sexual problem.</p>

<p>Quality/quantity of sex and level of satisfaction</p>

<p><em>Meaning</em>of sex</p>

30
Q

<p>Comprehensive Sexual Assessment</p>

A

<p>Medical (thyroid disorder, depression, medications, menopause)</p>

<p>Psychosocial (messages from family/media)</p>

<p>Psychophysiological (which comes first: pain, dryness, erectile dysfunction, or loss of desire?)</p>

31
Q

<p>Psychosocial Evaluation</p>

<p>(in comprehensive assessment)</p>

A

<p>Couple and individual sessions (have each state what they think the other wants,</p>

<p>Self-report questionnaires - expectations overt/covert (take-home)</p>

<p>Clinical interviews (when is last time felt aroused/most desired):</p>

<p>Couple - establish possible working relationship</p>

<p>Individual - treatment plan with both</p>

32
Q

<p>Common male disorders</p>

A

<p>Premature/Delayed Ejaculation</p>

<p>Erectile Dysfunction</p>

<p>Disorders of Desire</p>

33
Q

<p>Common female disorders</p>

A

<p>Dyspareunia/Vaginismus</p>

<p>Orgasmic Disorder</p>

<p>Disorders of Desire</p>

34
Q

<p>Treating Premature/Delayed Ejaculation</p>

A

<p>Relaxation Response</p>

<p>SSRI's</p>

<p>Mindfulness - Fantasy</p>

<p>Relationship Issues</p>

<p>Squeeze Technique</p>

35
Q

<p>Squeeze Technique</p>

A

<p>Ejaculatory control is learned through a stop and go exercise.</p>

<p>Stimulation of the penis until the man feels he will ejaculate unless stimulation stops.<span>Stop simulation and the base of the penis is squeezed by the partner encircling it snugly with the thumb and forefinger.</span><span>Stimulation is resumed when the ejaculatory impulse passes – usually after 10 seconds or more.</span><span>After several sessions, regular intercourse may be tried without the squeeze technique.</span></p>

<p>>95% of men have learned to control ejaculation for five minutes or longer using this method.</p>

<p>Goal = for the man to become accustomed to the feeling of delayed ejaculation.</p>

36
Q

<p>Treating Erectile Dysfunction</p>

A

<p>Focus on nonerotic stimuli</p>

<p>Encourage positive reinforcement</p>

<p>Decrease demands</p>

<p>Encourage open, positive communication</p>

37
Q

<p>Treating Dyspareunia/Vaginismus</p>

A

<p>CRITICAL - Physical Examination</p>

<p>Vaginal dilators</p>

<p>Relaxation training</p>

<p>Greater success with partner involvement</p>

38
Q

<p>Treating Orgasmic Disorder</p>

A

<p>Relaxation (sensate focus)</p>

<p>Mindfulness of sensual pleasure</p>

<p>Appropriate use of erotica/fantasy</p>

<p>Masturbation</p>

<p>Increase positive self-image</p>

<p>Pelvic floor exercises</p>

39
Q

<p>Treating Disorders of Desire (Men & Women)</p>

A

<p>Education</p>

<p>Sensate Focus - sensual awareness</p>

<p>Appropriate exposure to erotica/sexual aids</p>

<p>Explore relationship to sex/erotic mind</p>

<p>Hormonal (estrogen/testosterone) screening (female issues not as related to plumbing)</p>

40
Q

<p>Sensate Focus: Stage I</p>

A

<p>Weeks 4-6</p>

<p>First few weeks couples take turns non-genital touching to establish awareness of sensations.</p>

<p>Person touching does so on basis of what interests them or person being touched can "guide"</p>

41
Q

<p>Sensate Focus: Stage II</p>

A

<p>Weeks 7-9 (longer as needed)</p>

<p>Expanded to breasts and genitals.</p>

<p>Emphasis on physical sensations, not sexual response - no intercourse</p>

<p>Take turns "hand riding" as a means of nonverbal communication</p>

42
Q

<p>Sensate Focus: Stage III - IV</p>

A

<p>Weeks 10+</p>

<p>Mutual touching</p>

<p>Female on top w/out insertion</p>

<p>Progress to tip of penis, moving back if anxious</p>

<p>Full intercourse</p>

43
Q

<p>Sensate Focus: Assessment</p>

A

<p>Weeks 1-3</p>

44
Q

<p>Current Trends in Sex Therapy</p>

A

<p>1. Medicalization of sexual dysfunction</p>

<p>2. Esther Perel's notion of erotic intelligence</p>

<p>3. Jack Morin's peak erotic experiences and core erotic themes</p>

<p>4. Mind/Body Approaches (6th sense = interoception, pleasure-centered somatic tx;<span>Dan Siegel's Mindsight = 7th sense)</span></p>

45
Q

<p>Medicalization of sexual dysfunction</p>

A

<p>Current trend.</p>

<p>Aim to change person's physiological response.</p>

<p>Historic focus on male erectile disorder, more recently on premature ejaculation in men and sexual arousal/desire in women</p>

<p></p>

46
Q

<p>Medically speaking, sexual issues fall into three general categories:</p>

A

<p>1. Nerve suppy</p>

<p>2. Blood flow</p>

<p>3. Hormones</p>

47
Q

<p>Esther Perel's notion of erotic intelligence</p>

A

<p>Meaning of sex:</p>

<p>What does sex mean to you?</p>

<p>How is sex treated in your family?</p>

<p>What are the important events that shaped your sexuality?</p>

<p>What would you like to experience most with your partner sexually, and what are you most afraid of?</p>

48
Q

<p>Jack Morin's Erotic Equation</p>

A

<p>Current Trend</p>

<p>Attraction + Obstacles = Excitement (flames of passion)</p>

<p>Unpredictability, spontaneity, and risk are where eroticism resides.</p>

<p></p>

49
Q

<p>Privacy vs. Secrecy</p>

A

<p>Emotional connection can dampen desire when closeness becomes an obligation.</p>

<p>Threat to separateness = basis of all attractions</p>

<p>Need connection without terror of obliteration.</p>

<p>Need separateness without terror of abandonment.</p>

50
Q

<p>Sex as source of shame vs. self--affirmation</p>

A

<p>When our innermost desires are revealed and are met by our loved one with acceptance and validation, the shame dissolves, and it becomes an experience of profound empowerment and self-affirmation.</p>

51
Q

<p>Most feared challenge of erotic/sexual intimacy (+shield):</p>

A

<p>May be most fearsome intimacy because it is all-encompassing.</p>

<p>Reaches the deepest places inside of us and involves disclosing aspects of ourselves that are invariably bound up with shame and guilt.</p>

<p>When we express our yearnings, we risk humiliation and rejection.</p>

<p>Shield: many prefer workable, utilitarian type sex (that often leaves them feeling bored or dead inside)</p>

52
Q

<p>Encouraging Change</p>

A

<p>Clarify goals and motivations</p>

<p>Nurture self-worth</p>

<p>Embrace uncertainty</p>

<p>Acknowledge and mourn your losses</p>

<p>Practice mindfulness using your senses</p>

<p>Risk the unfamiliar</p>

<p>Integrate your discoveries</p>

53
Q

<p>Mind/Body Approaches = The sensuality solution</p>

A

<p>Gestalt therapy - focus on experience over performance, what is happening now</p>

<p>Growth model = treatment + enrichment</p>

<p>Mind and body as two-way street</p>

54
Q

<p>Important issues that influence women's sexual well-being:</p>

A

<p>Self-image</p>

<p>Relationships</p>

<p>Psychological health</p>

<p>Social connectedness</p>

<p>Cultural expectations</p>

<p>(All intertwined)</p>

<p>Physiology plays into it for a very small percentage</p>

55
Q

<p>Jack Morin's peak erotic experiences</p>

A

<p>Current Trend</p>

<p>As fulfilling as they are arousing.</p>

<p>Factors:</p>

<p>1. Firsts (new activities, settings, partners) and surprises</p>

<p>2. Idyllic settings/features</p>

<p>3. Extensions and restrictions of time</p>

<p>4. Knowledge of memorability factors that contribute to one’s arousal can help cultivate conditions for more fulfilling sex.</p>

56
Q

<p>5 Personal Responses most mentioned for Peak Experiences (Morin)</p>

A

<p>1. Sensual and orgasmic intensity</p>

<p>2. Reduced inhibitions</p>

<p>3. Validation given and received</p>

<p>4. Mutuality and resonance (synchronicity)</p>

<p>5. Transcendence of personal boundaries</p>

57
Q

<p>Investigate peak turn-ons to understand core erotic themes (Morin)</p>

A

<p>Current Trend</p>

<p>1. Most memorable real-life encounters – two specific that were the most intensely arousing in your entire life? Describe them in as much detail as possible.</p>

<p>2. Ideas about what made these encounters so exciting?</p>

MFT Practice Exam - Sex Therapy (3 decks)

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