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# Psychosexual Therapy

Learn what psychosexual therapy involves, why a GP check often comes first, what happens in sessions and how to find a qualified therapist.

## What is *psychosexual* therapy?

Psychosexual therapy, also called sex therapy, is a talking therapy for sex and intimacy. It looks at how your feelings, your body and your past affect your sex life.

Everything in the room happens by talking. There is no touching and no physical check.

You can come on your own or with a partner, and you do not need to be in a relationship.

Sources: [COSRT: therapies](https://viacara.com/approaches/psychosexual-therapy/#ref-1), [Relate: FAQs](https://viacara.com/approaches/psychosexual-therapy/#ref-6)

## Why a *GP* check comes first

Some sexual problems have a physical cause, such as diabetes or a heart condition. The College of Sexual and Relationship Therapists, or COSRT, says a doctor should check for that first.

If erection problems keep happening, the NHS says to see a GP or a sexual health clinic. The problem can be a sign of a health condition that can be treated. The NHS gives the same advice for vaginismus.

Sexual health clinics are free and open to everyone. Many have a walk-in service, so you may not need an appointment.

COSRT says therapy can still help when there is a physical cause. You can learn to adjust, and find the kinds of sex that work for you. Our [sexual difficulties page](https://viacara.com/support/sexual-difficulties/) covers the physical checks in more detail.

Sources: [COSRT: how therapy works](https://viacara.com/approaches/psychosexual-therapy/#ref-2), [NHS: erectile dysfunction](https://viacara.com/approaches/psychosexual-therapy/#ref-9), [NHS: vaginismus](https://viacara.com/approaches/psychosexual-therapy/#ref-10), [NHS: sexual health clinics](https://viacara.com/approaches/psychosexual-therapy/#ref-12)

## How it *works*

In the first session, your therapist asks what has brought you and what the problem is. They are likely to ask about your health and any medicines you take.

You set the pace. You decide which questions to answer and which exercises to try.

Between sessions, you work at home. Your therapist designs exercises for you to do in private. In each session, you talk about how they went and what to try next.

A partner can take part in the work if you have one.

One set of exercises you may meet is sensate focus. Partners take turns to touch and be touched for an agreed time. They notice how it feels, without trying to force arousal.

In the early stages, intercourse is usually set aside.

The researchers Masters and Johnson pioneered sensate focus. They set it out in their 1970 book, Human Sexual Inadequacy.

Talking and practice *between sessions*

- **Talk about the concern** You talk about sex and your relationships. You also discuss your health and any medicines you take.
- **Agreed practice** Your therapist may suggest tasks to try at home.
- **Review together** You talk about how things went and what to try next.

You can return to each area. You try tasks at home, then talk about them in the session.

Sources: [COSRT: how therapy works](https://viacara.com/approaches/psychosexual-therapy/#ref-2), [Relate: FAQs](https://viacara.com/approaches/psychosexual-therapy/#ref-6), [NHS: ejaculation problems](https://viacara.com/approaches/psychosexual-therapy/#ref-11), [Brotto et al. 2025](https://viacara.com/approaches/psychosexual-therapy/#ref-14), [LPT: sensate focus](https://viacara.com/approaches/psychosexual-therapy/#ref-13), [Frühauf et al. 2013](https://viacara.com/approaches/psychosexual-therapy/#ref-15)

## What *sessions* look like

Sessions usually last 50 minutes. They may be weekly, or every two or three weeks to leave time for the exercises. The first session is sometimes longer.

At Relate, a couple's first assessment includes time with each of you alone and time together.

Your therapist should explain the contract they work to, and give you a copy. You do not have to do any exercise you do not want to.

Sources: [COSRT: how therapy works](https://viacara.com/approaches/psychosexual-therapy/#ref-2), [Relate: initial assessment](https://viacara.com/approaches/psychosexual-therapy/#ref-7)

![The summer house seen from the armchair, its door a little open and lamplight on the step](https://viacara.com/img/content/approaches-psychosexual-therapy-mid-light.webp)

Psychosexual therapy takes things one step at a time, at a pace you set

## Who it may *suit*

Problems with sex are common. In a large British survey, about one in ten sexually active people felt distressed or worried about their sex life.

about 1 in 10

sexually active people were distressed about sex

British national survey [Mitchell & Mercer 2013](https://viacara.com/approaches/psychosexual-therapy/#ref-16)

It can be a good fit if:

- Desire has changed, whether it has faded or feels out of step with a partner's
- Erections, orgasm or ejaculation have become hard to rely on
- Vaginismus has made sex something you avoid
- An illness, a treatment or a disability has changed your sex life
- Your sexual behaviour feels out of your control
- Sex has become a source of distance between you and a partner

The NHS points to this kind of therapy for vaginismus and early ejaculation. It also says therapy can help when erection problems have an emotional cause.

COSRT gives a longer list of the issues its therapists work with. Not every therapist works with every issue, so ask at the start.

Sources: [Mitchell & Mercer 2013](https://viacara.com/approaches/psychosexual-therapy/#ref-16), [NHS: vaginismus](https://viacara.com/approaches/psychosexual-therapy/#ref-10), [NHS: ejaculation problems](https://viacara.com/approaches/psychosexual-therapy/#ref-11), [NHS: erectile dysfunction](https://viacara.com/approaches/psychosexual-therapy/#ref-9), [COSRT: issues](https://viacara.com/approaches/psychosexual-therapy/#ref-3)

## Not the same as psychosexual *medicine*

Psychosexual medicine is a different thing. The Institute of Psychosexual Medicine trains doctors and other healthcare professionals in it. They can talk through your worries, and examine you when that is right for you.

A psychosexual therapist works by talking only, and does not examine you. If something physical needs checking, they can refer you back to your GP.

Sources: [IPM: about](https://viacara.com/approaches/psychosexual-therapy/#ref-17), [IPM: find a specialist](https://viacara.com/approaches/psychosexual-therapy/#ref-18), [COSRT: therapies](https://viacara.com/approaches/psychosexual-therapy/#ref-1), [COSRT: how therapy works](https://viacara.com/approaches/psychosexual-therapy/#ref-2)

## Finding a psychosexual therapist

Anyone in the UK can call themselves a psychotherapist or a counsellor. The title sex therapist is not protected by law either.

COSRT keeps a voluntary public register of psychosexual and relationship therapists. Its register has three levels, from registered member up to senior accredited member. The NHS says sex therapists should belong to COSRT or the Institute of Psychosexual Medicine.

The Professional Standards Authority does not accredit COSRT's register. You can ask a therapist whether they are also on one of those.

Some areas offer sex therapy on the NHS, but it varies widely by where you live. Most NHS services need a GP or another healthcare professional to refer you. Waits of several months are common.

Relate offers sex therapy online. In England and Wales, its fees depend on household income, and you do not need a GP referral.

Sources: [POST: regulation of professionals](https://viacara.com/approaches/psychosexual-therapy/#ref-19), [HCPC: protected titles](https://viacara.com/approaches/psychosexual-therapy/#ref-20), [COSRT: PRT register](https://viacara.com/approaches/psychosexual-therapy/#ref-4), [COSRT: registered membership](https://viacara.com/approaches/psychosexual-therapy/#ref-5), [NHS: erectile dysfunction](https://viacara.com/approaches/psychosexual-therapy/#ref-9), [PSA: accredited registers](https://viacara.com/approaches/psychosexual-therapy/#ref-21), [NHS: ejaculation problems](https://viacara.com/approaches/psychosexual-therapy/#ref-11), [Sheffield Partnership: psychosexual](https://viacara.com/approaches/psychosexual-therapy/#ref-22), [Sexual Health West Sussex: therapy](https://viacara.com/approaches/psychosexual-therapy/#ref-23), [Relate: choosing a service](https://viacara.com/approaches/psychosexual-therapy/#ref-8), [Relate: FAQs](https://viacara.com/approaches/psychosexual-therapy/#ref-6)

## The *evidence*

NICE has no guideline on sexual problems in general. Its Clinical Knowledge Summaries, written for GPs, do cover erection problems.

For a cause in the mind or the relationship, they say to arrange a referral. That can be to psychosexual or relationship counselling.

A 2013 review pooled 20 trials that compared talking therapy with a waiting list. The evidence varied a lot from one problem to another. It was clearest for women with low desire or with orgasm difficulties.

A 2025 review by international experts found strong evidence for some problems, such as low desire in women. For erection problems, it called the evidence for talking therapy alone limited. It says talking therapy plus medicine is now the preferred approach.

For early ejaculation, it found the high success rates of the first studies have not been repeated. Sensate focus has been in use since the 1970s, but few studies test it on specific problems.

For vaginismus, a Cochrane review compared desensitisation with a waiting list and other options. It found no clear difference. It warned that the evidence is limited, so any conclusions should be drawn with caution.

If your question is about identity, our [LGBTQ+ and gender identity page](https://viacara.com/support/lgbtq-and-gender-identity/) may suit you better.

Sources: [NICE CKS: erectile dysfunction](https://viacara.com/approaches/psychosexual-therapy/#ref-24), [Frühauf et al. 2013](https://viacara.com/approaches/psychosexual-therapy/#ref-15), [Brotto et al. 2025](https://viacara.com/approaches/psychosexual-therapy/#ref-14), [Melnik et al. 2012](https://viacara.com/approaches/psychosexual-therapy/#ref-25)

On this page

[What is psychosexual therapy?](https://viacara.com/approaches/psychosexual-therapy/#what-is-psychosexual-therapy) [Why a GP check comes first](https://viacara.com/approaches/psychosexual-therapy/#why-a-gp-check-comes-first) [How it works](https://viacara.com/approaches/psychosexual-therapy/#how-it-works) [What sessions look like](https://viacara.com/approaches/psychosexual-therapy/#what-sessions-look-like) [Who it may suit](https://viacara.com/approaches/psychosexual-therapy/#who-it-may-suit) [Not the same as psychosexual medicine](https://viacara.com/approaches/psychosexual-therapy/#not-the-same-as-psychosexual-medicine) [Finding a psychosexual therapist](https://viacara.com/approaches/psychosexual-therapy/#finding-a-psychosexual-therapist) [The evidence](https://viacara.com/approaches/psychosexual-therapy/#the-evidence)

Related

[Sexual Difficulties](https://viacara.com/support/sexual-difficulties/) [Couples Therapy](https://viacara.com/support/couples/) [LGBTQ+ and Gender Identity](https://viacara.com/support/lgbtq-and-gender-identity/) [Emotionally Focused Therapy (EFT, not EMDR)](https://viacara.com/approaches/emotionally-focused-therapy/) [Understanding Different Approaches](https://viacara.com/guides/understanding-approaches/)

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## References

1. College of Sexual and Relationship Therapists (2026). *What therapies do we oversee?*. [cosrt.org.uk](https://www.cosrt.org.uk/factsheets/)
2. College of Sexual and Relationship Therapists (2026). *How will therapy work?*. [cosrt.org.uk](https://www.cosrt.org.uk/how-will-therapy-work/)
3. College of Sexual and Relationship Therapists (2026). *What issues can therapy help with?*. [cosrt.org.uk](https://www.cosrt.org.uk/what-issues-can-therapy-help-with/)
4. College of Sexual and Relationship Therapists (2026). *Psychosexual and Relationship Therapy (PRT) Register*. [cosrt.org.uk](https://www.cosrt.org.uk/the-cosrt-registers/cosrt-register/)
5. College of Sexual and Relationship Therapists (2026). *Registered membership*. [cosrt.org.uk](https://www.cosrt.org.uk/registered-membership/)
6. Relate (2026). *Relate FAQs*. [relate.org.uk](https://www.relate.org.uk/about-us/relate-faqs)
7. Relate (2026). *Initial assessments*. [relate.org.uk](https://www.relate.org.uk/what-we-do/counselling/initial-assessments)
8. Relate (2026). *Which service is right for you?*. [relate.org.uk](https://www.relate.org.uk/which-service-right-you)
9. National Health Service (2023). *Erectile dysfunction (impotence)*. [nhs.uk](https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/)
10. National Health Service (2024). *Vaginismus*. [nhs.uk](https://www.nhs.uk/conditions/vaginismus/)
11. National Health Service (2023). *Ejaculation problems*. [nhs.uk](https://www.nhs.uk/conditions/ejaculation-problems/)
12. National Health Service (2024). *Find a sexual health clinic*. [nhs.uk](https://www.nhs.uk/nhs-services/sexual-health-services/find-a-sexual-health-clinic/)
13. Leicestershire Partnership NHS Trust (2018). *Couples sensate focus program, leaflet 505*. [leicspart.nhs.uk (PDF)](https://www.leicspart.nhs.uk/wp-content/uploads/2022/07/505-Couples-sensate-focus.pdf)
14. Brotto, L. A., Atallah, S., Carvalho, J., Gordon, E., Pascoal, P. M., Reda, M. and colleagues (2025). *Psychological and interpersonal dimensions of sexual function and dysfunction: recommendations from the fifth international consultation on sexual medicine (ICSM 2024)*. Sexual Medicine Reviews. [doi:10.1093/sxmrev/qeae073](https://doi.org/10.1093/sxmrev/qeae073)
15. Frühauf, S., Gerger, H., Schmidt, H. M., Munder, T. & Barth, J. (2013). *Efficacy of psychological interventions for sexual dysfunction: a systematic review and meta-analysis*. Archives of Sexual Behavior. [doi:10.1007/s10508-012-0062-0](https://doi.org/10.1007/s10508-012-0062-0)
16. Mitchell, K. R., Mercer, C. H., Ploubidis, G. B. et al. (2013). *Sexual function in Britain: findings from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)*. The Lancet. [doi:10.1016/S0140-6736(13)62366-1](https://doi.org/10.1016/S0140-6736(13)62366-1)
17. Institute of Psychosexual Medicine (2026). *About us*. [ipm.org.uk](https://www.ipm.org.uk/about_us.aspx)
18. Institute of Psychosexual Medicine (2026). *Find a specialist*. [ipm.org.uk](https://www.ipm.org.uk/patients/specialists)
19. Parliamentary Office of Science and Technology (2025). *Regulation of psychological professionals in mental health care*. [post.parliament.uk](https://post.parliament.uk/regulation-of-psychological-professionals/)
20. Health and Care Professions Council (2025). *Professions and protected titles*. [hcpc-uk.org](https://www.hcpc-uk.org/about-us/who-we-regulate/the-professions/)
21. Professional Standards Authority for Health and Social Care (2026). *Find an Accredited Register*. [professionalstandards.org.uk](https://www.professionalstandards.org.uk/organisations-we-oversee/find-a-register)
22. Sheffield Partnership University NHS Foundation Trust (2026). *Sheffield Psychosexual Therapy Service*. [sheffieldpartnership.nhs.uk](https://www.sheffieldpartnership.nhs.uk/services/sheffield-psychosexual-therapy-service)
23. Sexual Health West Sussex (2026). *Psychosexual therapy*. [sexualhealthwestsussex.nhs.uk](https://www.sexualhealthwestsussex.nhs.uk/psychosexual-therapy/)
24. NICE Clinical Knowledge Summaries (2026). *Erectile dysfunction: management*. [cks.nice.org.uk](https://cks.nice.org.uk/topics/erectile-dysfunction/management/management/)
25. Melnik, T., Hawton, K. & McGuire, H. (2012). *Interventions for vaginismus*. Cochrane Database of Systematic Reviews. [doi:10.1002/14651858.CD001760.pub2](https://doi.org/10.1002/14651858.CD001760.pub2)

## Related

### [Sexual Difficulties](https://viacara.com/support/sexual-difficulties/)

Low desire, pain, erection or orgasm problems are common and can be worked on. Check the physical causes with a GP, then find a psychosexual therapist.

### [Couples Therapy](https://viacara.com/support/couples/)

Couples therapy for any kind of couple: how sessions work, time alone with the therapist, what it costs for two and when it is not the right start.

### [LGBTQ+ and Gender Identity](https://viacara.com/support/lgbtq-and-gender-identity/)

Support for sexuality and gender identity from a professional who will not treat either as the problem. Find a professional who works affirmingly.

### [Emotionally Focused Therapy (EFT, not EMDR)](https://viacara.com/approaches/emotionally-focused-therapy/)

Learn how emotionally focused therapy works for couples and families, how it differs from EMDR and tapping, and what the research shows.

### [Understanding Different Approaches](https://viacara.com/guides/understanding-approaches/)

A plain-English guide to the main therapeutic approaches including CBT, person-centred therapy, psychodynamic and integrative methods.