Treatment of Low Sexual Desire or Frequency Using a Sexual Enhancement Group Couples Therapy Approach.

BACKGROUND: Sexual desire or frequency problems are exceedingly common, but treatment of them has been less than effective. AIM: The goal of this study was to develop a cost-effective, accessible intervention to deal with sexual desire or frequency problems, including sexual desire discrepancy, by enhancing the quality of couples' erotic intimacy. METHODS: 45 couples (38 heterosexual and 7 same-sex couples) distressed by sexual desire or frequency problems were seen in a 16-hour, group couples therapy intervention. Participants completed the New Sexual Satisfaction Scale (NSSS) at pretest, posttest, and at 6-month follow-up. OUTCOMES: The NSSS plus 3 additional items at pretest, posttest, and at 6-month follow-up and patients' written feedback. RESULTS: Statistically significant differences were found between pre-tests and post-tests in satisfaction with intensity of sexual arousal; creativity; frequency; sexual functioning; partner's sexual availability; partner's initiation of sexual activity; emotional opening up during sex; positive sexual reactions to the partner; communication of sexual wishes, preferences and desires; and balance between giving and receiving during sex. The largest improvement and effect sizes were found in overall satisfaction with one's sex life from pre-test to post-test and 6-month follow-up. CLINICAL IMPLICATIONS: Low sexual desire or frequency problems can be treated effectively by enhancing the quality of the couple's erotic connection, thereby creating desirable sex. STRENGTHS & LIMITATIONS: The strengths include the combination of quantitative and qualitative data. Limitations included the small number of same-sex couples. CONCLUSION: Sexual enhancement group couples therapy provides an effective, accessible, and affordable approach to low desire or frequency complaints in distressed couples. Kleinplatz PJ, Charest M, Paradis N, et al. Treatment of Low Sexual Desire or Frequency Using a Sexual Enhancement Group Couples Therapy Approach. J Sex Med 2020;17:1288-1296.

Childhood Victimization and Physical Health in Women: The Mediating Role of Adult Attachment.

Research has shown that female survivors of childhood abuse (CA) are more likely than nonabused women to experience long-term physical health concerns. Adult attachment may influence this relationship given that attachment insecurity has been linked to poorer physical health and postulated mechanisms of action are similar. This study used structural equation modeling to investigate whether adult attachment insecurity mediates the relationship between four types of CA and self-reported physical health in 538 undergraduate women. CA prevalence rates ranged from 11.7% (sexual abuse) to 34.9% (psychological abuse). In separate structural equation models, direct pathways were significant between CA and adult attachment insecurity, CA and adult physical health, and adult attachment insecurity and adult physical health. Adult attachment insecurity was found to partially mediate health outcomes in CA survivors, S-B χ2 = 116.60 (58), p < .001; comparative fit index = .95; Tucker-Lewis index = .94; root mean square error of approximation = .05; and confidence interval = [.03, .06]. Physical health is a significant concern for survivors of CA, and these results suggest improving attachment security may represent an important avenue of intervention.

From Sexual Desire Discrepancies to Desirable Sex: Creating the Optimal Connection.

Beginning in 2005, our team conducted a series of studies on optimal sexual experiences. We have applied our findings to develop a group therapy intervention for couples presenting with low sexual desire/frequency and sexual desire discrepancy. The goal was to improve the quality of erotic intimacy by focusing on such elements as being fully embodied during sex, increasing authenticity, trustworthiness, and vulnerability. Twenty-eight heterosexual individuals (14 couples) were seen in 16 hours of couples group therapy. Each completed the New Sexual Satisfaction Scale in pretests, posttests and six-month follow-ups. Significant differences in satisfaction (p <.001) were found in overall sample means from pretests to posttests and follow-ups. Significant differences were also found in 10 of 20 items, plus in two of three added items, including satisfaction with intensity of sexual arousal, variety, frequency, partner's initiation, and emotional opening up. Although this is a small sample, the results indicate that this intervention is effective. We interpret these findings in terms of creating just enough safety to enable couples to take erotic risks and thereby create desirable sexual intimacy.