The Use of Dual Sex Therapy Teams Versus A Single Therapist

In Masters and Johnson’s 1970 publication of Human Sexual Inadequacy, their two-week rapid treatment sex therapy program for couples is outlined and discussed, and the concept of the dual-sex therapy team introduced. In their treatment programs, aside from the initial interviews, the couples met regularly with one male therapist and one female therapist for “round table” discussions of the couple’s problems and the treatment objectives. This approach to sex therapy went on to become the prototype for many other sex therapists working with couples, including Hartman and Fithian. Masters and Johnson elaborate, in their book, why a dual-sex therapy team is preferable to an individual therapist working with a couple. Hartman and Fithian support Masters and Johnson’s reasons for this preference and add some of their own ideas in their book, Treatment of Sexual Dysfunction. However, Helen Singer Kaplan, in her book, The New Sex Therapy, argues her belief that the dual-sex therapy team is not essential to the success of treatment.

The main reason that Masters and Johnson claim the dual-sex team approach to sex therapy is necessary for the successful treatment of couples with sexual problems is that it gives each spouse a “friend in court” and interpreter. The “friend in court” and interpreter is the client’s same sex therapist who is believed to be more capable of understanding and representing them because of their shared gender. After all, no man can ever experience an orgasm as a woman and conversely, no woman can experience ejaculatory demand or seminal fluid release. A distraught and emotionally unstable female client or an anxiety ridden and hostile male client may not be able to clearly and successfully articulate their feelings, which is where the clear and calm “friend” who can interpret for them comes in handy. Essentially, the dual-sex teams serve as translators to assure that no misunderstandings develop due to sexual language or emotional barriers, or a male or female bias.

Masters and Johnson also note that the dual-sex team approach “lessens the need for enactment of social ritual designed to gain the attention of the opposite-sex,” (p. 6. Masters and Johnson) and they comment on the built-in, mutual protection and defense for both patients and co-therapists with the dual-sex team, in regards to the potential for a romantic or sexual transference or counter transference between client and therapist. Also, having two therapists, allows one to be silent and observe, and figure out in which direction the therapy needs to go.

In The Treatment of Sexual Dysfunction, Hartman and Fithian elaborate on how socialization of men and women is different and how having a therapist of each sex to relate to that gender’s conditioning is pertinent. They comment on the “profound psychogenic learning” which “conditions men and women to think, feel, and act differently sexually, both coitally, and non-coitally.”(p. 3. Hartman and Fithian) They also go into detail about how the dual-sex team approach enables the therapists to comprehend and work with a wider scope of socio-economic, cultural, religious, and educational points of view. As well, they note that having two therapists multiplies their observations, especially if the socio-economic, cultural, religious, and educational backgrounds of the two therapists are different. Hartman and Fithian also stress that the dual-sex team approach enables them to handle any sexual offers or indication of sexual interest with greater scrutiny, noting that the chance of sexual involvement is “nil.” Unlike Masters and Johnson, they stress the importance of therapeutic touch and its effectiveness in getting clients comfortable with touching and getting feelings flowing, and the dual-sex team approach, they believe, makes touch between therapist and client more safe and comfortable.

In The New Sex Therapy, Helen Singer Kaplan notes that despite such claims as to the benefits of dual-sex team approach, there have been no actual controlled studies that prove it is a more effective approach than a single therapist approach. She remarks that while there are certain advantages to the dual-sex team approach, in her experience, mixed gender sex therapist teams have not always been essential to the success of treatment. She further remarks that a sensitive, well-trained, and experienced therapist of either gender can “effectively conduct sex therapy on a solo basis,” (p. 239. Kaplan) and that at Cornell where she was in charge of Student Teaching of Psychiatry, their training seminars sought to “raise the consciousness” of their therapists to the psychosexual reactions of both genders. The use of co-therapists at Cornell, remarks Kaplan, occurs only when a “therapeutic impasse arises which is puzzling or when strong resistances are mobilized in one or the other partner by the gender of the individual therapist,” and this is rare. Kaplan also argues that erotic transferences rarely occur in sex therapy, and if they do, it is usually due to the therapist’s counter-transference feelings.

References

Hartman, William E. and Fithian, Marilyn A. Treatment of Sexual Dysfunction: A Bio-Psycho-Social Approach. New York: Jason Aronson. 1974. pp 268.

Masters, William H. and Johnson, Virginia E. Human Sexual Inadequacy. Boston: Little, Brown, and Co. 1970. pp 384.

Kaplan, Helen Singer. The New Sex Therapy: Active Treatment of Sexual Dysfunctions.

New York: The New York Times Book Co., Inc. 1974. pp 544.

LoPiccolo, Joseph and Leslie. Handbook of Sex Therapy. New York: Plenum Press. 1978. pp 531.