Why Are Couples and Sex Therapy Taught Separately?

Therapists interested in pursuing couples work often face a dilemma: Do they study and train in a couples therapy modality, or do they pursue sex therapy training? But this choice prompts a larger question: Why are couples therapy and sex therapy taught separately in the first place? Many early career clinicians may be asking themselves this, and as they will discover, these two fields have been largely kept separate.

Couples therapy and sex therapy are taught separately for one reason—they were developed separately. There is no scientific or clinical reason for clinicians not to learn both modalities. In fact, therapists would benefit from knowing both because couples coming to therapy often need help navigating many aspects of their relationship, including communication and sex.

When working with couples, they will undoubtedly face issues related to intimacy, both emotional and physical. Indeed, these two types of intimacy are closely tied. For many, an emotional connection is a necessary ingredient for a sexual connection, and physical intimacy leads to a sense of emotional closeness. Why, then, is there not a more integrative approach to learning how to foster both emotional and sexual intimacy?

The best that most therapists can do is choose to pursue training in both fields so they are as educated and qualified as possible to do this type of work. This puts the burden on therapists to decide which types of training or modalities to pursue, financially invest in multiple programs, and integrate the knowledge on their own.

Perhaps a better approach would be teaching these two specializations side-by-side, allowing students and early career therapists to learn foundational knowledge and skills for treating couples. This approach would also allow therapists to get a sense of their interest in becoming certified in one path over the other, or if they’d like to continue pursuing both specializations.