Sex Therapists: Training Beyond the Norm

Sex is in our lives whether we like it or not; that’s the truth.

We either have sex and talk about it, or we aren’t having sex and we’re talking about it. Or we think about it, but can’t talk about it, or want to talk about it but are too ashamed to. Sex has dominated the media; everywhere we turn we see some reference to sex, whether that be desire, enhancement, lust, or intimacy. So why is it then, that it is still so incredibly taboo to talk about?

 Sex is taboo?  It’s like I’m saying something completely revolutionary.

As therapists, we should see no topic about the body and mind as off limits in our offices. The one person who is designated to keep confidentiality and talk to you about anything and everything your heart desires, your therapist, is not always fully trained in the entirety of your body and mind. Did you know that? As a couple’s therapist, before becoming trained in sex therapy, I took one Human Sexuality course in my graduate program (and my program was known as one of the more comprehensive and well rounded programs). What? Only one? And yet, I talk about sex every day of my life. As therapists, I believe we do a disservice to our clients and to ourselves by treating half of a person rather than their full sexual and intimate self.

As a Marriage and Family Therapist, I see the world as relational. I work with individuals, who happen to be in relationships. And I see individuals who are in multiple relationships. I see individuals who aren’t in relationships but are dating. I see individuals who are scared to date. I see couples who are in relationships who are also dating. The thing is, there is not a single client I have ever seen, that has NOT brought up sex, intimacy, or sexuality. So please tell me, how can we effectively treat any population without being trained in the full mind, body, and spirit? The answer is, you can’t.

The best trained and most effective therapists that I know, are Sex and Intimacy Therapists, and I am going to tell you why:

Sex therapy is not just a treatment of symptoms; sex therapy is an all-encompassing treatment of our bodies. We are trained to look beyond symptoms, beyond just the medical, and search for the whole. We are taught to treat based on the psychological and organic parts of a being, rather than the splitting of the mind and the physical body. Sex, inherently, is an act of melding these two parts of ourselves; our sexualities are biological, and yet they are relational, and both intertwine with one another with every move we make.

Often times clients believe sex therapists are those who only treat sexual symptoms; however this is not the case. We are not here to simply treat a dysfunction; we go much further than that. We ask ourselves, how does a specific sexual dysfunction affect the relationship? What has this person been told or taught about their sexuality as a child? How does this affect their lifestyle, their confidence, and their love for themselves? How does this inhibit them to interact with those around them? As Sex Therapists we are taught to dig deeper.   

Sex therapists make a difference. Humans are social beings, and therefore their problems stem from these interactions. If therapists are not competent in dealing with problems that are affected by every part of a person, how can they effectively treat someone? Sex therapists work with their clients on all of their presenting issues, that stem from and are directly affected by social values and attitudes surrounding sexuality. Sex therapists challenge one’s beliefs and attitudes about sex.

There is not a single person I have met that did not have a question about sex, sexuality, or intimacy. I believe the most holistic treatment in therapy, is one from a sex and intimacy therapist.

by Devin Grenley MA, LMFTA, CIIP (Certified Integrated Intimacy Professional)

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Value of Mentors

Tina with her mentor Gina Ogden, PhD
Tina with her mentor Gina Ogden, PhD

The other day I was listening to the On Being podcast, with Krista Tippitt discussing friendship. She talked about getting advice in her twenties from a woman in her 50’s, about how you always want to have people in your life who are younger and older than you. That friend remained in Krista’s life well into the woman’s 80’s. Krista now finds herself as both the older and younger person in relationships, with friends at both ends of the spectrum.

Her comments struck me when I realized I had unintentionally done the same in my life!

Continue reading “Value of Mentors”

Sex, Self-Care & New Motherhood

“I don’t know how to put it exactly. I guess I just don’t feel like a sex kitten anymore, you know? I think something about this having a baby process has made me grow up. All of a sudden it’s like I want real intimacy.” I was chatting with a friend whose son was born two days before mine. Now both a year old, we watched them dump toys and toddle around while we were catching up. Somehow we found ourselves on a topic that felt hard to talk about, both because of its taboo nature but also because whatever it was seemed difficult to put to words.

“No one ever tells you about that part of things,” she continued. “No one ever tells you how it impacts your sexual relationship after you have a kid. I mean, people joke all the time about how you never have sex again. But that’s just really unhelpful. It’s more that my priorities are different and what I want out of my romantic relationship feels different.”

What my friend was describing is the profound shift in priorities felt by all new moms. Dr. Louann Brizendine, author of The Female Brain (2006), tells us that motherhood literally alters a woman’s brain—structurally, functionally, and irreversibly. The close and constant contact with her child becomes an all-consuming reality. “A woman’s innate brain wiring, like that of other mammals, responds to basic cues—the growing fetus in her womb; her baby’s birth; its suckling, touch, and smell; and frequent skin-to-skin closeness with her child. Even fathers, adoptive parents, and women who have never been pregnant can respond maternally after close, daily contact with an infant. These physical cues from the infant forge new neurochemical pathways in the brain that create and reinforce maternal brain circuits aided by chemical imprinting and huge increases of oxytocin. These changes result in a motivated, highly attentive, and aggressively protective brain that forces the mother to alter her responses and priorities in life. She is relating to this person in a way she has never related to anyone else in her life” (p. 96).

This internal shift matches the demanding external reality she now finds herself in. During the first years of parenthood, there is a lot stacked up against a couple seeking to maintain positive romantic and sexual connections. Whether it’s the myriad of physical symptoms felt during pregnancy (morning sickness, fatigue, swollen feet, or heartburn just to name a few) or the in-the-trenches reality of tending to a newborn (lack of sleep torture, cleaning up every bodily fluid known to mankind, and trying to hold sanity when your infant appears to be screaming for no reason), or later on as your toddler tests every limit you have, a couple’s time, attention, energy are now primarily focused on keeping the baby alive and the family system afloat.

I asked my friend, “When you say you want real intimacy, what do you mean? What does it mean to you to have real intimacy now?” She thought about it for a few minutes. “I guess it’s not that we didn’t have good sexual connection before, but I guess when I think about what I want now, what I had before seems to pale in comparison. Before it was just like, I’ll go throw on something sexy and play this part. Now I want something gentler and more in tune with me. I want eye contact. I want to feel like our sexual connection is somehow more integrated with the rest of our life together. I mean, show me that you have sexual or romantic feelings for me outside of the bedroom. Show me that you can be on the same team as me, that together we’re creating the life and family we want.”

My friend’s words were honest and vulnerable. They felt like an important reframing of what sex could be: perhaps even with all of its stressors and challenges, new parenthood can invite a couple to deeper levels of engagement and intimacy. With the limited time and energy to be found, it takes an immense amount of determination to find the new equilibrium where each partner gets a break, the couple gets time together, and all the other pieces of life find their place.

As impossible as it might seem, a new mom’s best chance at establishing a deeper level of intimacy and connection with her partner comes out of first taking care of herself. Being constantly dialed in to the demanding needs of her little one(s) while also tending to competing needs of career, household chores, life partner, and other significant relationships is a lot for anyone to balance. In this situation, a mom’s anxiety and stress levels can naturally tend to be high. Not only does this impact the way she can function, it is also a hurdle to being able to experience sexual pleasure. Sexual turn-ons can only happen when the fear and anxiety centers of the brain have been shut down (Brizendine, 2006, p. 77). It is by stepping away or by asking for particular care, by taking a few moments to breathe, and tending to her own needs, that a mom can re-center, re-focus, and feel relaxed enough to engage her partner intimately.

So, new moms … what little piece of goodness can you reach for? What way can you retreat and reclaim a little piece of you? Partners, you want to have more ‘sexy time’? Offer to take the kids to the park for a couple hours or do the dishes or encourage her to go take a long bubble bath. As the Gottman’s point out in their book And Baby Makes Three, even the smallest chore can become an act of foreplay.

On a larger scale, couples who have the most success finding each other will be the ones held by a larger community. The huge shifts that occur in this transition are ones that are often too big for the couple to hold all by themselves. Extended family, friends and other significant groups can go a long way for a couple by offering listening ears, babysitting, and encouragement.

Ultimately, new parenthood can be an invitation to a more integrated understanding of “making love.” Each bid for connection can become a way to offer pleasure, reassurance, understanding, and comfort. And now you have this new little person to marvel in: the creation of your love and connection manifest before you. As your infant grows, so do the two of you.

Jessica Szymas is a Licensed Mental Health Counselor and a Certified Integrated Intimacy Practitioner with Northwest Institute on Intimacy. You can find out more about her practice at

What’s the #1 Training Topic YOU DID NOT GET in Grad School That Could Either Get You Sued or Fill Your Practice?

In recent years it has become apparent to therapists like Esther Perel, Terrence Real, and others that all therapists that treat couples and families need more training in sexuality, intimacy, and sexual dysfunction.  Up until 2015, there was no training in the Pacific Northwest for therapists wishing to add AASECT certification to their skillset. A therapist had to travel outside the state to a program that usually required travel for a long weekend once a month for two years. This made it cost prohibitive.

This is why we were down to 5 therapists with AASECT certification and two certified supervisors.

Is it unethical, however, to practice sex therapy without the minimum training provided through AASECT certification? The title “sex therapist” is not title protected, like “psychologist” is.  It is fair game to say you are a sex therapist or you practice sex therapy.  The onus is on the client to find out the therapists actual training. One quick scan of Psychology Today and you will find hundreds of therapists who say they practice sex therapy simply because they are “comfortable” with the subject.  But this ease did not come through an investment in training or the added credentials. When we practice outside our training in situations like these, we are dancing on a gray ethics line.  The most prudent course for us to take in situations like these is to get a supervisor who is an expert in this area.  Why?  Because, they will bear the liability in the case, while you as the therapist get training through supervision. In the area of sexuality, the research shows over 50% of your clients will come in with an explicit or implicit sexual concern. That’s a lot of your clients! This is the dilemma of inadequate training in sexuality and intimacy in all of our graduate psychotherapy programs.  Many in the field are beginning to recognize that training in this area is a critical ethical requirement if they are to practice in a way that

attends to the bio, psycho, social, sexual and spiritual needs of their clients.

But here is another issue.  Let’s say, you decide to refer out whenever a sexual issue arises or not take clients presenting with sexual issues?  Here is the other problem … you also can’t ignore sexual issues because you are NOT trained.  Double ethical bind, right? YES! Recent court cases have been tried that now make a therapist responsible for the case the moment they return a call, answer an email, take a case – regardless what presents – unless they can make a very clear case the issue is absolutely outside their scope of practice.  Which in this issue as an MFT they could not.  As a psychotherapist, training in sexuality and intimacy is quickly becoming a first-on-the-list training issue. A couple’s therapist would not be able to explain in a court of law how sexuality is outside their scope of practice. On the stand, cross-examination would simply reveal how inadequate the current level of training is (all psychotherapeutic training) by omitting more comprehensive sexuality training.

A therapist would still be held responsible to get the training.

The Northwest Institute on Intimacy (NWIOI) was specifically designed and established for psychotherapists trained in accredited programs to provide a streamlined cost-effective avenue to add these critical skills to their repertoire. Over the last two years, NWIOI has trained over 25 therapists. These therapists are in high demand – fewer than 5% of therapists in the country have this level of comprehensive training.  Yet, ironically every one of our clients walk in with ALL PARTS OF THEM affected by life’s challenges and stressors – and they assume the therapist is trained to help them. Given this, NWIOI also acts as a referral source for many physician groups and community leaders.

There is a place on the website where you can list your practice and receive referrals.

NWIOI offers the two courses for AASECT certification once a year, in this order:

  1. SAR – Sexual Attitude Reassessment               Every June      Four Days: Thursday – Sunday ending with the Pride Parade
    1. The earlybird rate is currently in effect until May 1.  After May 1 it goes up $160.00 to $750
    2. 14 CEUs
    3. Open to 20 students a year
  1. Advanced Clinical Sexology                  2nd Week of November  5 Days: Monday – Friday  46 Hour Intensive
    1. Registration begins Sept 1, 2017
    2. 46 CEUs
    3. Open to 20 students a year
  1. Supervision
    1. In addition to these two courses, over a two-year period, you will need to do 300 hours of case work involving sexual issues, and do 50 hours of supervision w an AASECT certified supervisor (50% group sup/50% ind sup).  If you are still studying for licensure – you can do supervision with an AAMFT and AASECT approved supervisor and have your supervision hours count for BOTH!


Here is more information on the upcoming SAR, which has about ten spaces available:   

The SAR is a required course for AASECT certification and THE SEATTLE SAR AND PRIDE PARADE is one of the most extraordinary SAR’s in one of the most beautiful cities in the country! It is a course specifically designed to help participants clarify their sexual beliefs and biases in a safe environment. It is a highly provocative, experiential, cognitive and affective experience, which is designed to push comfort levels, elicit feelings, confront attitudes, beliefs, and values about sexuality. Presentations encompass media, along with presentations by panels showing the potential range of human sexual expression today. SAR is not a clinical training in sex therapy nor is it traditional sex education; rather it enables the participant to move emotionally, intellectually, spiritually and psychologically into a zone of greater knowing, acceptance, and tolerance of human sexuality in all of its possible dimensions.

Super Earlybird   Before May 1st     $590.00

Professional        After May 2nd       $750.00

I encourage you to consider, adding this skillset sooner rather than later.  It is a joy to see how fast our supervisees who are preparing for their AASECT certification have found their practices full as they have added sex therapy and spiritual intimacy to their MFT skillset. In addition to seeing how much more confidence, competence, and enjoyment has emerged. My goal is to see the Northwest become the epicenter of excellence in comprehensively trained renegade therapists.

The 5 Steps to Becoming an AASECT Certified Sex Therapist

Northwest Institute on Intimacy was founded to further the field of sex therapy by training therapists to be sex-positive, holistic providers of the couples and individuals they see in their office. There are many important reasons a therapist would want to get training in Sex Therapy. For more information see our blog post The # 1 Reason A Couple Will Be Dissatisfied with You!
Step 1: Enroll in a graduate Marriage and Family Therapy program, or another systems-based psychotherapy program. If you are an MSW, psychologist or counselor don’t fret, you only need to complete training in couples therapy such as EFT (Emotionally Focused Therapy), or a David Schnarch’s Crucible Therapy. MFT is the recommended path to get the most out of this, since your supervision hours post graduation can count as both (more on this later).
Step 2: Complete the first weekend of training by participating in the SAR (sexual attitude reassessment). Many people think that you have to have a master’s degree before you can do this, but that is actually not the case! As long as you are enrolled in a masters program, you can begin AASECT coursework.
The Northwest Institute on Intimacy provides a SAR each June. In 2017, the SAR is June 23-25, and ends by marching in the Seattle Pride Parade, and is arguably one of the most dynamic SAR courses in the country! The cost is $590 until 5/1, and then the cost increases to $750. This course provides 14 CEU’s for the following disciplines: AASECT, MFT, LICSW, LMHC.
Register here for by May 1 and get a $160 discount! 
Step 3: complete a weeklong training by taking the Advanced Course in Clinical Sexology. This course occurs each November and deeply explores many different aspects of human sexuality, evidence-based treatment of sexual disorders and dysfunctions, and provides you with a community of like-minded, sex positive therapists.
The Advanced Course is 4 graduate credits, and costs roughly $2800. This course provides 46 CEUs for the following disciplines: AASECT, LMFT, LICSW, LMHC
Step 4: complete 50 hours of post graduate supervision and 300 client contact hours of sex therapy cases. This is broken in two – individual and group supervision. Group supervision occurs in small groups of 2-4, and individual supervision is alone with the supervisor. These 50 hours can occur in as little as 24 months. This supervision will be overseeing the required 300 hours of sex therapy cases. The Institute offers supervision with our medical director, Dr. Tina Schermer Sellers, PhD.  There are other supervisors in AASECT as well. If you are an LMHCA or LMFTA, Dr. Sellers is an AAMFT approved supervisor as well as an AASECT approved supervisor. This means that ALL of your cases for state licensure AND AASECT certification can be supervised at the same time, by the same person, while connecting you with colleagues in the sex therapy community.
Step 5: Once you are licensed, submit your final paperwork, and voila! You are on a career path that sets your couples up for holistic, biopsychosocial-spiritual-sexual care. At the Institute, we call a person with this extensive training, a Certified Integrated Intimacy Practitioner (CIIP). There are less than 5% of therapists in the country with this level of comprehensive training. This is an elite group. However, ALL OF YOUR CLIENTS will come to you with all of these aspects of themselves affected by life’s stresses and hardships.
They expect and deserve someone with this level of training.
For those that are interested in becoming a Certified Integrated Intimacy Practitioner™ and being listed on our referral page, you would need to take a spirituality CEU.  This can be many different things such as: Hebrew Mystic Sexuality (Dr. Tina Schermer Seller’s specialty, she has a book coming soon that explains how we were meant to have a sex-positive experience of faith!), an applied Tantra course, a Gina Ogden‘s 4-D Wheel training, or another course. This course functions as your “elective” in your training where you choose additional training in the integration of spirituality and sexuality to round out your expertise.
For more info on AASECT certified supervisors, click here
For more info on AAMFT supervisors, click here 
More on Dr. Tina Schermer Seller’s New Book: Sex, God, & the Conservative Church
Synopsis: This book is the first of its kind written to help people of faith who have experienced religious sexual shame. This shame and trauma come as an inadvertent byproduct of the sex-negative sexual ethic of conservative religion.  Based on ten years of research, it explains what happened in the formation of the Christian church, the recent purity movement, and how American culture can compound the problem. It goes on to reveal a sex-positive ancient Hebrew story that was buried in Christian history and the sex-positive gospel ethic that was never developed. Finally, it offers a four-step model for healing religious sexual shame, and actual touch and non-touch exercises to bring healing and intimacy into a person’s life.  The book is appropriate for clients, patients, therapists, clergy, physicians, and those who train sociology students, therapists, sex therapists, clergy or primary care physicians.  It also is a text that would function well in a book group or study group and for those who want to explore the impact of religious sexual shame and those who want to heal or help someone else to heal.  It is sensitive to those who grew up in conservative church environments, while simultaneously providing adequate information for the provider that may not be familiar with that culture.


Whether you were affected by the church’s negative view of sex, or you are a clinician who works with people whose sexual experience has been diminished, many have been waiting for this book for years! Go to  and sign up to receive a Bonus Chapter of her book and other exclusive information

This chapter is to say thank you for your patience and to give you something NOW you can put into use right away!

If you want to be guaranteed a first edition printing, buy during the presale. The publisher has a limited supply, so don’t delay!


Scholarly Reviews of Sex, God, & the Conservative Church

“Masterfully integrating psychology and theology, Sellers gives us a groundbreaking, razor-sharp view into conservative Christian culture and its shame-inducing sexual ethic. As a psychologist, I am impressed by the precision, validity, and robustness of her research. As a theologian, I am grateful for the Christian sexual ethic — rooted in justice, mutuality and an infinitely relational God — that she introduces. As a millennial who grew up in the conservative Christian purity culture that Sellers describes, the practices in this book lit my pathway to greater freedom from shame and more authentic connection to God, myself and others. I hope that therapists and Christian leaders — pastors, parents and youth workers — will read this insightful book with an open mind.”

– Christena Cleveland, Ph.D., Duke Divinity School, author of Disunity in Christ – Uncovering the Forces that Keep Us Apart


“Most clinical programs – whether they are based in psychology or marriage and family therapy, social work or medicine, pastoral counseling or any number of other fields in the “helping professions” – do not adequately prepare trainees to work with individuals or couples who have been indoctrinated with Church-driven messages of sexual guilt and shame.  As a therapist and educator, I have struggled to find resources that help guide clients on a path to healing and growth – and to do this in a way that simultaneously embraces their sexuality(ies) and religious/spiritual faith.  The wisdom and counsel that Dr. Tina Sellers offers in this book should be in every training curriculum, on every providers’ bookshelf, and in every couple’s home.”

-Tai J. Mendenhall, Ph.D., LMFT; Couple and Family Therapy Program, University of Minnesota


This book is powerful medicine for anyone who has ever suffered religious shame about sex.   You will find compassion for your dilemmas of conscience, wisdom regarding the teachings of the church, and best of all—explicit practices for opening your mind, nurturing your heart, touching your body, and celebrating the spirit of all that is truly erotic.

-Gina Ogden, Ph.D., LMFT, author of Expanding the Practice of Sex Therapy, The Heart & Soul of Sex, and other books


Dr. Tina Schermer Sellers’ provocative book addresses the sex-negative doctrine in the conservative Christian church that instills in many people deep shame about their body and discomfort with the opposite sex, making them ill-prepared for marriage. Showing how notions of Christianity and sexuality are complementary, Dr. Sellers offers both therapist and lay reader examples of working with clients to heal the soul-body split, reduce shame, and deepen a couple’s loving connection.

-Stella Resnick, Ph.D., Couples and sex therapist in private practice in Beverly Hills, CA. and author of The Heart of Desire: Keys to the Pleasures of Love


“This book is a practical and yet deeply theological path towards healing for those wounded by a shame-based purity culture. Dr. Schermer Sellers researched and written a roadmap towards a sex-positive Gospel ethic of intimacy. I will be recommending it to pastors and counsellors and teachers everywhere.”

– Sarah Bessey, author of Jesus Feminist and Out of Sorts: Making Peace with an Evolving Faith


“This is an enlightening, well-written, and a clinically useful book on the problems and potential of conservative Christianity for clients dealing with sexual problems. Tina Schermer Sellers is uniquely positioned to make this unique contribution to therapy for a population often misunderstood by clinicians. Whether you’re new to the field or highly experienced, I promise you’ll learn a lot.”

-William J. Doherty, Ph.D., professor, director, Minnesota Couples on the Brink Project, University of Minnesota; author, Take Back Your Marriage.