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Sexual Counselling/ Role
Play – Reaching Greater Heights
Dr. Martha Tara Lee, D.H.S.
28 July 2018
Certificate in Practical Andrology, Society for Men's Health Singapore, Academy for Men's Health,
Universiti Kebangsaan Malaysia, The Malaysian Society of Andrology and the Study of Aging
Male, Kuala Lumpur, Malaysia (28 July 2018)
Agenda
1. Why is Sex
Important?
2. How Can You Do
Better?
3. What Do I Need to
Know?
Dr. Martha Tara Lee
Clinical Sexologist
• Doctorate in Human Sexuality
• Masters in Counselling
• Masters in Public Policy and
Management
• Bachelor of Arts (Comm)
• Certificate in Sex Therapy
• Certificate in Practical
Counselling
• Cert in Life Coaching
Psychosocial Issues
• Lifelong or acquired
• Symptom or situational
• Unresolved sexual abuse or
trauma
• Body image/ Self-esteem
issues
• Psychiatric history
• Stress, anxiety, sadness
• Relationship conflict
• Partner’s sexual dysfunction
Relationship Problems
• Anger
• Poor Communication
• Criticism
• Neurotic Interactions
• Incompatible Sexual
fantasies
• Alcoholism & Sexual Abuse
• Phobic Avoidance of Sexual
Intercourse
• Unconscious Conflict about
Sex, Commitment, Pregnancy
• Sexual Abuse Issues
H O W?
1) Sex is More than Sex
2) Practice/ Research
Yes No Maybe (Want Will Won’t)
Yes Maybe No
3) Know Yourself
1) Self Awareness
2) Friends
3) Family
4) Patients/ Strangers
Copyright 2012 Eros Coaching
4) Practice Every Chance You Get
Professional Organizations
• AASECT - American Association of Sexuality Educators,
Counselors & Therapists
• SSSS - Society for the Scientific Study of Sexuality
• SSTAR - Society for Sex Therapy & Research
• Kinsey Institute
• WPATH - World Professional Association for Transgender
Health
• IPSA - International Professional Surrogates Association
• ACSB - Association of Certified Sexological Bodyworkers
• Source School of Tantra Yoga
WHAT
Treatment Techniques
1. Kegels
2. Stop-start method
3. Scale
4. Pendulum
5. Progressive steps
6. Sexual Attitude
Restructuring
7. Sensate Focus
Sensate Focus
Stage 1
–Without genital touch
Stage 2
–With genital touch
Stage 3
–Go with the flow
1.Relationship Assessment Scale
Link: https://goo.gl/XnBLbs
2.Men: Erection Hardness Score
Link: https://goo.gl/8yEFYZ
3.Men: International Index of Erectile Function
Link: https://goo.gl/RuiBmu
4.Female: Female Sexual Function Index
Link: https://goo.gl/ALSBTk
5.Female: Female Sexual Distress Score – Revised
Link: https://goo.gl/SSnWX9
Sexual Function Assessment Tools
for Clinicians
Assessment by interview of
Both Partners
Assessment by interview of
Both Partners
Assessment by interview of
Both Partners
Psychological therapy
Quick Assessment
Postmodern and Integrative
Approaches
Bring together:
• Narrative
• Cognitive-Behavioral
• Solution-Focused
• Contemporary
Psychoanalysis
• Existential-
Humanistic
7 - 38 - 55 Rule of Personal Communication
by Albert Mehrabian
What % is
1. Spoken
Word
2. Non Verbal
Cues
3. Tone of
Voice?
Tone of Voice
Spoken Word
Non Verbal Cues
7 - 38 - 55 Rule of Personal Communication
by Albert Mehrabian
Counselling Skills
1. Open Questions
2. Closed Questions
3. Summary
4. Paraphrasing
5. Reflection of Feeling
Changing Closed to Open
Are you having troubles with your
partner
vs
What is your relationship with your
partner like?
Are you feeling stressed now?
vs
How are you feeling right now?
The Problem with Why
They put people on the spot
Might pressure the individual to provide an
explanation when they don’t know
Useful exploring questions
Could you tell me more about your……?
I wonder if……, what are your perceptions?
Could this be what is going on…?
When you say/do……what does that mean to you?
Could you put that in other words so I can understand better?
What went through your mind? Feelings? Behaviour?
Paraphrasing as a form of
questioning
A paraphrase provides:
• Feedback (in your own words) of what has been said in
a clear, concise form
• The opportunity to confirm or correct the feedback
• Be direct and simple. If you don’t understand, say so.
e.g. ‘I’m sorry, I’m lost, tell me again
Client (Ali) – ‘My ex-wife phoned me yesterday; she told me that our
daughter Siti (who is only 9) is very ill after a car accident. I am
feeling very scared for her. They live in Indonesia, so I am going to
have to travel to see her, and now I have been made redundant, I
don’t know how I can afford to go.’
Counsellor/helper – ‘So, Ali, you have had some bad news about
your little girl, who has been involved in an accident. You are
frightened for her and also have worries over money now you have
lost your job.’
Client – ‘Yes yes ... that’s right.’ (Notice that the counsellor/helper
does not offer advice or start asking how long Ali and his wife have
been separated , but reflects the emotion of what is said: ‘frightened'
and 'worries').
Empathic Listening Techniques
Empathy involves two major skills:
Perceiving and communicating
Empathy
The state of perceiving “the internal frame of
reference of another with accuracy, and with
the emotional components and meanings
which pertain thereto, as if one were the
other person, but without ever losing the ‘as
if’ condition”
(Meador & Rogers, 1984)
Model of empathic responding
You feel_________(feeling)___________
because/when ____ (content or what
gave rise to the feeling)______.
Empathy versus sympathy
• Poor you… its terrible that this has happened to you
• I know how you feel. The same thing happened to me
once.
• Your wife is being really mean. It isn’t fair what she is
doing to you.
• Don’t be scared. I am sure you will be fine and I will
help you.
• I am so sorry this has happened. What can I do to help
you?
Practicing Empathy
In groups of 3
Client to describe a “problem” – not too simple nor complex
Counsellor to use ONLY empathic responding for 5 minutes with
the client (use the formula – you feel…. because/when..)
Observer to keep time, record statements and provide feedback
SWAP roles
Feedback and debrief
What was it like to be the client?
What was it like to be the counsellor?
What was it like to be the observer?
Suggestions for responding
empathically
• Be flexible and tentative in your response to allow the client to disagree
• Move gradually towards sensitive topics and feelings
• Use short empathic responses frequently
• After your empathic response, attend to cues that either confirm/deny
accuracy
• Note resistance or distress – are you inaccurate or too accurate?
• Pay attention to what is being said/not said and non verbals
• Take special care when the client’s cultural background is different from
your own
• Empathy is important but only one tool of many
• Empathy needs to permeate every stage of Egan’s model
The Art of Questioning
The curious counsellor approach
• Non verbal prompts
• Verbal prompts (e.g. Tell me more….)
• Probing questions (e.g. What does that mean to
you? What does that look like? Can you tell me
more about …. How does it feel when…..,
• Probing statements (e.g. I'm interested in..., I’m
curious about….,
• Avoid starting questions with Why..
Triad Practice Session
Practice
Affirmation
Summary
Scenarios
• A – Guy with premature ejaculation
• B – Guy with erection difficulties
• C – Guy with low sex drive
Counselling Skills
1. Open Questions
2. Closed Questions
3. Summary
4. Paraphrasing
5. Reflection of Feeling
Values
1. What qualities and behaviors do health
care professionals consider in determining
sexual health?
2. How do we support patients in identifying
their sexual needs and aspirations?
3. How do our personal beliefs and
experiences inform or interfere with this
aspect of our work?
We Can Make a Difference
By Talking about Sex
Thank You!
Dr. Martha Tara Lee, D.H.S.
Clinical Sexologist
Eros Coaching Pte Ltd
Website: www.eroscoaching.com
Email: drmarthalee@eroscoaching.com

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Sexual Counselling/ Role Play

  • 1. Sexual Counselling/ Role Play – Reaching Greater Heights Dr. Martha Tara Lee, D.H.S. 28 July 2018 Certificate in Practical Andrology, Society for Men's Health Singapore, Academy for Men's Health, Universiti Kebangsaan Malaysia, The Malaysian Society of Andrology and the Study of Aging Male, Kuala Lumpur, Malaysia (28 July 2018)
  • 2. Agenda 1. Why is Sex Important? 2. How Can You Do Better? 3. What Do I Need to Know?
  • 3. Dr. Martha Tara Lee Clinical Sexologist • Doctorate in Human Sexuality • Masters in Counselling • Masters in Public Policy and Management • Bachelor of Arts (Comm) • Certificate in Sex Therapy • Certificate in Practical Counselling • Cert in Life Coaching
  • 4.
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  • 7.
  • 8. Psychosocial Issues • Lifelong or acquired • Symptom or situational • Unresolved sexual abuse or trauma • Body image/ Self-esteem issues • Psychiatric history • Stress, anxiety, sadness • Relationship conflict • Partner’s sexual dysfunction
  • 9. Relationship Problems • Anger • Poor Communication • Criticism • Neurotic Interactions • Incompatible Sexual fantasies • Alcoholism & Sexual Abuse • Phobic Avoidance of Sexual Intercourse • Unconscious Conflict about Sex, Commitment, Pregnancy • Sexual Abuse Issues
  • 11. 1) Sex is More than Sex
  • 13. Yes No Maybe (Want Will Won’t) Yes Maybe No 3) Know Yourself
  • 14.
  • 15. 1) Self Awareness 2) Friends 3) Family 4) Patients/ Strangers Copyright 2012 Eros Coaching 4) Practice Every Chance You Get
  • 16. Professional Organizations • AASECT - American Association of Sexuality Educators, Counselors & Therapists • SSSS - Society for the Scientific Study of Sexuality • SSTAR - Society for Sex Therapy & Research • Kinsey Institute • WPATH - World Professional Association for Transgender Health • IPSA - International Professional Surrogates Association • ACSB - Association of Certified Sexological Bodyworkers • Source School of Tantra Yoga
  • 17. WHAT
  • 18. Treatment Techniques 1. Kegels 2. Stop-start method 3. Scale 4. Pendulum 5. Progressive steps 6. Sexual Attitude Restructuring 7. Sensate Focus
  • 19. Sensate Focus Stage 1 –Without genital touch Stage 2 –With genital touch Stage 3 –Go with the flow
  • 20. 1.Relationship Assessment Scale Link: https://goo.gl/XnBLbs 2.Men: Erection Hardness Score Link: https://goo.gl/8yEFYZ 3.Men: International Index of Erectile Function Link: https://goo.gl/RuiBmu 4.Female: Female Sexual Function Index Link: https://goo.gl/ALSBTk 5.Female: Female Sexual Distress Score – Revised Link: https://goo.gl/SSnWX9 Sexual Function Assessment Tools for Clinicians
  • 21.
  • 22.
  • 23. Assessment by interview of Both Partners
  • 24. Assessment by interview of Both Partners
  • 25. Assessment by interview of Both Partners
  • 28.
  • 29.
  • 30.
  • 31. Postmodern and Integrative Approaches Bring together: • Narrative • Cognitive-Behavioral • Solution-Focused • Contemporary Psychoanalysis • Existential- Humanistic
  • 32. 7 - 38 - 55 Rule of Personal Communication by Albert Mehrabian What % is 1. Spoken Word 2. Non Verbal Cues 3. Tone of Voice?
  • 33. Tone of Voice Spoken Word Non Verbal Cues 7 - 38 - 55 Rule of Personal Communication by Albert Mehrabian
  • 34.
  • 35. Counselling Skills 1. Open Questions 2. Closed Questions 3. Summary 4. Paraphrasing 5. Reflection of Feeling
  • 36. Changing Closed to Open Are you having troubles with your partner vs What is your relationship with your partner like? Are you feeling stressed now? vs How are you feeling right now?
  • 37. The Problem with Why They put people on the spot Might pressure the individual to provide an explanation when they don’t know
  • 38. Useful exploring questions Could you tell me more about your……? I wonder if……, what are your perceptions? Could this be what is going on…? When you say/do……what does that mean to you? Could you put that in other words so I can understand better? What went through your mind? Feelings? Behaviour?
  • 39. Paraphrasing as a form of questioning A paraphrase provides: • Feedback (in your own words) of what has been said in a clear, concise form • The opportunity to confirm or correct the feedback • Be direct and simple. If you don’t understand, say so. e.g. ‘I’m sorry, I’m lost, tell me again
  • 40. Client (Ali) – ‘My ex-wife phoned me yesterday; she told me that our daughter Siti (who is only 9) is very ill after a car accident. I am feeling very scared for her. They live in Indonesia, so I am going to have to travel to see her, and now I have been made redundant, I don’t know how I can afford to go.’ Counsellor/helper – ‘So, Ali, you have had some bad news about your little girl, who has been involved in an accident. You are frightened for her and also have worries over money now you have lost your job.’ Client – ‘Yes yes ... that’s right.’ (Notice that the counsellor/helper does not offer advice or start asking how long Ali and his wife have been separated , but reflects the emotion of what is said: ‘frightened' and 'worries').
  • 41. Empathic Listening Techniques Empathy involves two major skills: Perceiving and communicating
  • 42. Empathy The state of perceiving “the internal frame of reference of another with accuracy, and with the emotional components and meanings which pertain thereto, as if one were the other person, but without ever losing the ‘as if’ condition” (Meador & Rogers, 1984)
  • 43. Model of empathic responding You feel_________(feeling)___________ because/when ____ (content or what gave rise to the feeling)______.
  • 44. Empathy versus sympathy • Poor you… its terrible that this has happened to you • I know how you feel. The same thing happened to me once. • Your wife is being really mean. It isn’t fair what she is doing to you. • Don’t be scared. I am sure you will be fine and I will help you. • I am so sorry this has happened. What can I do to help you?
  • 45. Practicing Empathy In groups of 3 Client to describe a “problem” – not too simple nor complex Counsellor to use ONLY empathic responding for 5 minutes with the client (use the formula – you feel…. because/when..) Observer to keep time, record statements and provide feedback SWAP roles Feedback and debrief What was it like to be the client? What was it like to be the counsellor? What was it like to be the observer?
  • 46. Suggestions for responding empathically • Be flexible and tentative in your response to allow the client to disagree • Move gradually towards sensitive topics and feelings • Use short empathic responses frequently • After your empathic response, attend to cues that either confirm/deny accuracy • Note resistance or distress – are you inaccurate or too accurate? • Pay attention to what is being said/not said and non verbals • Take special care when the client’s cultural background is different from your own • Empathy is important but only one tool of many • Empathy needs to permeate every stage of Egan’s model
  • 47. The Art of Questioning The curious counsellor approach • Non verbal prompts • Verbal prompts (e.g. Tell me more….) • Probing questions (e.g. What does that mean to you? What does that look like? Can you tell me more about …. How does it feel when….., • Probing statements (e.g. I'm interested in..., I’m curious about…., • Avoid starting questions with Why..
  • 48. Triad Practice Session Practice Affirmation Summary Scenarios • A – Guy with premature ejaculation • B – Guy with erection difficulties • C – Guy with low sex drive
  • 49. Counselling Skills 1. Open Questions 2. Closed Questions 3. Summary 4. Paraphrasing 5. Reflection of Feeling
  • 50. Values 1. What qualities and behaviors do health care professionals consider in determining sexual health? 2. How do we support patients in identifying their sexual needs and aspirations? 3. How do our personal beliefs and experiences inform or interfere with this aspect of our work?
  • 51. We Can Make a Difference By Talking about Sex
  • 52. Thank You! Dr. Martha Tara Lee, D.H.S. Clinical Sexologist Eros Coaching Pte Ltd Website: www.eroscoaching.com Email: drmarthalee@eroscoaching.com