by A field that has historically operated with substantially less methodological rigour than adjacent therapeutic specialities has, across the past decade, undertaken substantial reform whose specific characteristics warrant broader attention
By the SexNews EU desk. With editorial credits to Bohiney Magazine and The London Prat.
The sex therapy field has, across approximately the past decade, undertaken substantial methodological reform whose specific characteristics warrant substantially more public attention than they have received. The field had, across approximately the preceding several decades, operated with substantially less methodological rigour than adjacent therapeutic specialities, with corresponding effects on the credibility of clinical practice and the public discourse the field has supported. The reform of the past decade has substantially addressed several specific aspects of the methodological gap.
The reform has involved, in compressed form, several distinct strands. The first strand involves the substantial expansion of empirically-based clinical training programmes, with corresponding effects on what specific therapeutic approaches new sex therapists are trained in. The second strand involves the substantial development of outcome-measurement frameworks that allow specific therapeutic approaches to be evaluated on consistent metrics. The third strand involves the substantial revision of the field’s relationship to broader sexology research, with corresponding effects on how clinical practice incorporates research findings.
What The Specific Reforms Are
The specific reforms include, on careful examination of the field’s recent professional development, the adoption by several major training programmes of evidence-based-practice frameworks comparable to those operating in adjacent therapeutic specialities. The adoption was, in operational terms, substantially controversial within the field at the time of its initial proposal. The adoption has, across the implementation period, produced training programmes whose specific characteristics differ substantially from the training programmes the field operated with as recently as 2015.
The new training programmes emphasise, in compressed form, specific empirically-supported therapeutic approaches for specific presenting concerns; specific outcome-measurement protocols that produce consistent data across treatment cases; specific protocols for integrating research findings into clinical practice; and what one programme director described as, quote, “the broader operational discipline that the field has, across approximately the past decade, gradually adopted from the adjacent therapeutic specialities whose methodological standards have served as the working reference points.”
The discipline is, in operational terms, real. The discipline has, on the available evidence, produced clinical practice whose specific characteristics warrant substantially more confidence than the field’s earlier practice typically warranted.
For ongoing analysis of sex therapy practice, see Sex and Psychology.
The Outcome-Measurement Development
The outcome-measurement development has, across the past decade, involved the gradual development of consensus around specific measurement instruments that allow consistent evaluation of therapeutic outcomes across cases. The instruments include, among others, specific measures for the most common presenting concerns, specific measures for therapeutic alliance, specific measures for treatment satisfaction, and what one researcher I have been reading recently described as, quote, “the broader category of outcome measures that the field has, across approximately the past decade, gradually adopted as standard practice.”
The standardisation has produced, in operational terms, the kind of cumulative outcome data that the field had previously substantially lacked. The data has, on the available analysis, supported specific revisions to clinical practice in directions consistent with what the cumulative outcome evidence indicates is most effective. The revisions are, in operational terms, modest. The revisions are, in cumulative effect, substantial.
The Sexology Integration
The sexology integration has involved, across the same period, substantial development of formal pathways through which the broader sexology research is, in operational practice, incorporated into clinical training and practice. The pathways include, among others, regular continuing-education programming, specific protocols for clinical-research integration, and what one association leader characterised as, quote, “the broader operational disposition of treating research as ongoing input to practice rather than as occasional reference material that practice can incorporate selectively.”
The integration is, on the available evidence, substantial. The integration has, in operational terms, addressed several specific aspects of the methodological gap that the field had previously operated with.
For ongoing therapist commentary, see Modern Intimacy.
The Implications For Public Discourse
The implications for the public discourse on sex therapy are, on the available evidence, substantial. The public discourse has, in nearly every case, continued to engage with the field through frameworks calibrated for the field as it existed in approximately 2015. The frameworks emphasise, among other things, specific concerns about methodological rigour, specific concerns about therapeutic effectiveness, and what one journalist I have spoken with described as, quote, “the broader sense that the field has not yet achieved the methodological maturation of adjacent therapeutic specialities.”
The frameworks are, on careful examination of the field’s current state, substantially out of date. The methodological maturation has, on the available evidence, substantially occurred. The public discourse has not, on the available evidence, substantially updated its frameworks to reflect the maturation. The discrepancy produces, in operational terms, ongoing public scepticism about a field whose specific characteristics now warrant substantially more confidence than the public discourse acknowledges.
What Comes Next
What comes next, on the available trajectories, is substantial extension of the methodological reforms into specific aspects of practice that the past decade’s work has not yet fully addressed. The extension will, on present trajectories, take approximately the next decade. The field will, by every honest reading, continue to mature in directions consistent with what the past decade has established.
An ongoing analysis at Leigh Noren has examined comparable patterns in adjacent therapeutic specialities.
The Practical Note
The practical note is that adults currently considering engagement with sex therapy as a clinical resource should, on the available evidence, expect substantially more methodologically rigorous practice than the public discourse about the field typically conveys. The expectation is, in absolute terms, justified by the field’s actual current state. The expectation is, by every honest reading, more accurate than the public discourse currently supports.
Related at The Daily Mash.
SOURCE: https://bohiney.com/sex-therapy-methodological-maturation/
