Sexual and relationship therapy is an important clinical discipline, which requires specific training. It is far more than an extension of general counseling. Practices that do not have such a therapist available ‘inhouse’ will have to refer appropriate individuals or couple to an accredited sexual and relationship therapist. Sexual and relationship therapy may be considered a specialized branch of psychotherapy. It usually involves the use of cognitive behavioral techniques aimed at the relief of the individual’s (or couple’s) sexual dysfunction, involving sex education and the practice of sexual and communication tasks as a par t of the treatment process, with regular feedback sessions with the therapist.

It differs from psychoanalytic treatment , which attempts to resolve unconscious conflicts that might be causing dysfunction, and marital therapy, which attempts to improve a couple’s general relationship quality by helping them to resolve unrecognized conflicts. Psychoanalytic and marital therapy techniques may be used by a therapist , but are not at the core of sexual and relationship therapy. Sexual and relationship therapy is generally considered effective treatment for ED, although this has not been unequivocally demonstrated in trials.

A ‘success rate’ of around 60% is commonly quoted, although the size and durability of effect is uncertain. It is likely that older men with complete ED, diabetes and severe vascular disease are less likely to respond than younger men with intermittent or situational ED, and no concomitant medical problems. Sexual and relationship therapy is effective in the treatment of premature ejaculation, delayed or anorgasmia (for which there is good research evidence), and vaginismus. It may also be beneficial in desire disorders, although those affected should also have an appropriate endocrine and medical assessment.