PSYCHOSEXUAL PROBLEMS IN THE CONTRACEPTIVE CONSULTATION – FURTHER TREATMENT OR REFERRAL? (REFERRAL 2)
Referral may be to a counsellor who is trained to work either with the individual or the couple (or sometimes the family). It is essential that the counsellor is known to be comfortable with sexual issues and to be able to make people comfortable talking about them in private. Counsellors who have had training in sexual therapy will be able to discuss the basic facts about normal sexual functioning, and draw out from the patient or couple ideas about how they might modify their sexual activity, or alter their interaction to improve the difficulties. Counsellors are often particularly helpful where there are communication difficulties between a couple. Counsellors should have recognized training, such as a BA in counselling studies, social work, psychological or psychiatric training, and have continuing supervision and a code of ethics. There are many unqualified counsellors, who may well do a good job, but may equally well project their own prejudices or difficulties onto their clients. A psychiatric social worker or community psychiatric nurse may have special skills in this area, but is more likely to be of help where other disturbances are affecting sexual functioning as well: for example, in a hypomanic patient who is exhibiting inappropriate sexual behaviour, or a depressed individual with loss of libido.
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