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Sex Therapy in Michigan | Counseling & Psychology

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Sex Therapy in Michigan is talk therapy that helps people feel safer, more confident, and more connected in their sexual lives. Many people struggle in silence with low desire, pain, or worry about sex, and it can affect sleep, mood, and relationships. Sex therapy is for adults and couples of all genders and orientations who want help with sexual concerns, intimacy, or communication. You do not need to be “broken” to come in—if sex feels stressful, confusing, or painful, support can help.

Signs You Might Benefit

Sex therapy can help when your body, mind, relationship, or past experiences make intimacy hard. You might benefit if any of these feel familiar:

  • Low desire or mismatched desire (one partner wants sex more than the other)
  • Performance anxiety (worrying you won’t “do it right” or satisfy a partner)
  • Erection problems or trouble with arousal
  • Orgasms feel difficult or impossible or take much longer than you want
  • Pain with sex (including burning, tightness, pelvic pain, vaginismus, or pain after sex)
  • Lubrication concerns or discomfort from hormonal changes (postpartum, perimenopause, menopause)
  • Shame, guilt, or fear about sex, bodies, or pleasure
  • Recovery after betrayal, porn concerns, or unwanted sexual behaviors
  • Difficulty after childbirth, illness, surgery, or medication changes
  • Sexual trauma history or triggers that affect intimacy
  • Communication problems about touch, boundaries, consent, or fantasies
  • Questions about sexual orientation or gender identity and how it affects relationships and intimacy

Benefits often include less anxiety, better communication, clearer boundaries, improved confidence, more comfort in your body, and more satisfying intimacy. For many people, simply having a calm, skilled space to talk about sex reduces shame and helps change happen faster.

Evidence-Based Approach

Good sex therapy is not about quick tips or pressure to perform. It is a careful, step-by-step plan that fits your goals, values, and health. Our approach uses methods supported by research and clinical guidelines, with attention to both mental and physical factors.

Common therapy methods we may use

  • Cognitive Behavioral Therapy (CBT): Helps identify unhelpful thoughts (like “I’m failing”) and replace them with more realistic, supportive thoughts. CBT can reduce anxiety and avoidance patterns. The American Psychological Association recognizes CBT as an evidence-based treatment for many anxiety and mood concerns that can affect sex. (American Psychological Association, n.d.)
  • Mindfulness-based skills: Teaches you to notice sensations and feelings with less judgment. This can help with desire, arousal, and performance anxiety. Mindfulness is also widely studied for stress reduction, which can improve sexual functioning. (NIH National Center for Complementary and Integrative Health, n.d.)
  • Sensate focus and gradual intimacy exercises: A structured, gentle set of steps that helps couples rebuild touch and closeness without pressure. These exercises are always customized, consent-based, and paced to your comfort.
  • Emotionally Focused Therapy (EFT) for couples: Helps couples understand patterns like “pursue/withdraw,” build safety, and reconnect emotionally—often a key part of sexual connection.
  • Trauma-informed care: If past trauma is part of your story, we move slowly, focus on safety, and use grounding tools. You stay in control of what you share and when.
  • Psychoeducation: Clear, shame-free education about arousal, desire, anatomy, consent, and common sexual concerns so you can make informed choices.

Clinical reasoning: why sex problems happen

Sexual concerns are often multi-factorial. We look at the whole picture, including:

  • Body factors: hormones, pelvic floor tension, chronic pain, diabetes, heart health, sleep, medications (like SSRIs), postpartum changes, and menopause
  • Mind factors: anxiety, depression, stress, body image, ADHD, OCD traits, or fear of pain
  • Relationship factors: conflict, resentment, trust injuries, lack of time, unequal labor at home, or unclear consent and boundaries
  • Culture and values: faith background, shame messages, family expectations, or identity stress

When needed, we collaborate (with your written consent) with your medical team, such as a primary care clinician, OB/GYN, urologist, pelvic floor physical therapist, or psychiatrist. This “team” approach can be important for pain, hormonal concerns, or medication side effects.

Professional standards in Michigan

Sex therapy is provided by licensed mental health professionals who must follow Michigan licensing laws and ethical rules. This includes maintaining confidentiality, practicing within scope, documenting care, and using evidence-based treatment planning. Licensing may include Michigan-licensed psychologists, counselors (LPC), marriage and family therapists (LMFT), and clinical social workers (LMSW), depending on the provider’s credentials and training.

What to Expect

Many people feel nervous the first time. We keep it respectful, simple, and at your pace. Sex therapy is talk therapy—there is no physical exam and no sexual contact of any kind.

Before your first session

  • You may complete intake forms about symptoms, goals, health history, medications, relationship status, and stressors.
  • If you have medical concerns (like pain, bleeding, erectile changes, or sudden loss of desire), we may recommend a medical check-up to rule out underlying causes.

The first appointment (intake)

We will talk about what brings you in and what you want to change. We may ask about:

  • When the concern started and what makes it better or worse
  • Your relationship history and how conflict is handled
  • Stress, mood, and anxiety levels
  • Past experiences that may affect safety and trust
  • Medical history that can impact sexual functioning

You can say “pass” to any question. We will also review confidentiality, limits of confidentiality, and a clear plan for treatment.

Ongoing sessions

Sessions are goal-focused and practical. We may practice communication skills, plan gentle at-home exercises, or work on anxiety and avoidance. You will never be asked to do anything that feels unsafe or against your values. Progress can look like less fear, more comfort talking about sex, or better connection—before any physical changes happen.

How long does sex therapy take?

Some concerns improve in a few months. Others take longer, especially when pain, trauma, or relationship repair is involved. We review progress often and adjust the plan based on what works for you.

Insurance

Many sex therapy sessions are covered under your mental health benefits when medically necessary and documented as psychotherapy. Coverage depends on your plan, your deductible, and whether your clinician is in-network.

  • Copays and coinsurance: Your plan may charge a set copay per visit or a percentage of the session fee.
  • Deductibles: If you have a deductible, you may pay the full contracted rate until your deductible is met.
  • Coverage parity: Under federal mental health parity rules, many plans must cover mental health services similarly to medical services, but details vary by plan.
  • Out-of-network options: If we are out-of-network, we may provide a superbill for you to submit for reimbursement, if your plan allows.

If you are not using insurance, we can discuss self-pay rates and any available sliding scale options. If you are unsure what your plan covers, we can help you know what questions to ask your insurer.

FAQ

Is sex therapy only for couples?

No. Sex therapy can help individuals and couples. You can come alone to work on desire, anxiety, pain, confidence, identity questions, or past experiences. Couples may come to improve communication, rebuild trust, or create a stronger intimate connection.

Will the therapist ask for details or judge me?

You control what you share. A trained clinician asks only what is helpful for care. The goal is a shame-free space. You can set boundaries at any time, and your values and consent guide the work.

Does sex therapy involve touching or sexual activity in session?

No. Sex therapy is talk therapy. There is no physical exam, no undressing, and no sexual contact. Any exercises are discussed and assigned for private, at-home practice only, and only if you agree.

Can sex therapy help with sexual pain?

Yes, often. Sexual pain can involve pelvic floor tension, hormonal changes, fear of pain, trauma responses, or medical conditions. Therapy can help reduce anxiety, improve communication, and support gradual, consent-based exposure to comfortable touch. We may also recommend pelvic floor physical therapy or medical evaluation when appropriate, because pain can have medical causes that need treatment.

References

  • American Psychological Association. (n.d.). Cognitive behavioral therapy. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
  • National Center for Complementary and Integrative Health. (n.d.). Meditation and mindfulness: What you need to know. National Institutes of Health. https://www.nccih.nih.gov/health/meditation-and-mindfulness-what-you-need-to-know