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AN OVERVIEW of SEXUALITY in CLINICAL PRACTICE a Project AN OVERVIEW OF SEXUALITY IN CLINICAL PRACTICE A Project Presented to the faculty of the Division of Social Work California State University, Sacramento Submitted in partial satisfaction of the requirements for the degree of MASTER OF SOCIAL WORK by Miriam M. Yelton Natalie M. Delfin SPRING 2015 © 2015 Miriam M. Yelton Natalie M. Delfin ALL RIGHTS RESERVED ii AN OVERVIEW OF SEXUALITY IN CLINCIAL PRACTICE A Project by Miriam M. Yelton Natalie M. Delfin Approved by: _____________________________________, Committee Chair Teiahsha Bankhead, Ph.D., LCSW _________________________________ Date iii Students: Miriam M. Yelton Natalie M. Delfin I certify that these students have met the requirements for format contained in the University format manual, and that this project is suitable for shelving in the library and credit is to be awarded for the project. ____________________, Graduate Program Director ___________________ S.Torres, Jr. Date Division of Social Work iv Abstract of AN OVERVIEW OF SEXUALITY IN CLINICAL PRACTICE by Miriam M. Yelton Natalie M. Delfin This exploratory study examined the frequency and approach used by mental health care professionals to address sexuality in individual therapy. Using convenience-sampling clinicians (N=75) from a variety of disciplines completed an online questionnaire. Study findings, based on quantitative data, suggest that 36% to 64% of clinicians initiate a discussion of sexuality depending on the diagnosis of the client. When sexuality is addressed in the clinical practice setting eclectic therapeutic techniques are most frequently used. In addition, due to the diversity of the sample a comparison using the Sexuality in Practice Scales showed that clinicians with a background in social work were significantly less comfortable addressing sexuality than clinicians from other disciplines; t(54)=2.15, p=0.036. _____________________________________, Committee Chair Teiahsha Bankhead, Ph.D., LCSW _________________________________ Date v ACKNOWLEDGEMENTS It is with tremendous love and respect that we express our gratitude for the following individuals who provided inspiration, support and endless encouragement: Partners Parents Family Friends Mentors Teachers Clients & Each Other vi TABLE OF CONTENTS Acknowledgements ............................................................................................................ vi List of Tables ..................................................................................................................... xi Chapter 1. INTRODUCTION ...........................................................................................................1 The Problem .............................................................................................................1 Background of the Problem .....................................................................................2 Statement of the Research Problem .........................................................................4 Purpose of the Study ................................................................................................4 Theoretical Framework ............................................................................................5 Definition of Terms ..................................................................................................6 Assumptions .............................................................................................................7 Social Work Research Justification .........................................................................7 Study Limitations .....................................................................................................8 Statement of Collaboration ......................................................................................8 2. LITERATURE REVIEW .............................................................................................10 Social Work Research & Sexuality .......................................................................10 Sexuality, Social Work & Education .....................................................................11 Sexual Health: Mental & Physical Health Implications ........................................13 Sexuality & Pleasure as a Fundamental Human Right ..........................................15 NASW Code of Ethics ...........................................................................................15 History of Sex Therapy: The Origin of Practitioner Attitudes ..............................16 vii Models in Sex Therapy ..........................................................................................17 The Cognitive Behavioral Model ...........................................................................18 The Medical Model ................................................................................................19 The Systemic or Biopsychosocial Model ..............................................................22 The PLISSIT Model ...............................................................................................23 Focus on Dysfunction ............................................................................................25 The Future of Sex Therapy ....................................................................................26 Alternative Models Integrating Sexuality ..............................................................27 Conclusion .............................................................................................................30 3. METHODOLOGY .......................................................................................................34 Study Design ..........................................................................................................34 Data Collection Procedures ....................................................................................35 Participants .............................................................................................................35 Instrumentation ......................................................................................................36 Instrumentation Within The Questionnaire ...........................................................36 Sexuality in Practice: Self Reported Knowledge Scale .........................................37 Sexuality in Practice: Practitioner Comfort ...........................................................37 Sexuality in Practice: Perception of Importance ....................................................38 Data Analysis .........................................................................................................39 Protection of Human Subjects ...............................................................................40 4. ANALYSIS ...................................................................................................................41 Demographics ........................................................................................................41 viii Overall Findings .....................................................................................................45 Initiation of Sexuality Discussion ..........................................................................46 Therapeutic Frameworks & Models ......................................................................48 Influencing Factors ...............................................................................................49 Sex Positive Considerations in Practice .................................................................50 Sexuality in Practice Scales ...................................................................................51 Sexuality in Practice Scale: Self Reported Knowledge .........................................53 Sexuality in Practice Scale: Practitioner Comfort .................................................54 Sexuality in Practice Scale: Perception of Importance ..........................................55 Summary of Significant Findings ..........................................................................56 5. DISCUSSION ...............................................................................................................57 Initiation of Discussion on Sexuality In Practice ...................................................57 Theoretical Models & Frameworks .......................................................................58 Influencing Factors ................................................................................................59 Sex Positive Considerations ...................................................................................60 Summary of Sexuality in Practice Scales ..............................................................61 Limitations & Implications For Future Research ..................................................63 Implications For Social Work ...............................................................................65 Conclusion .............................................................................................................66 ix Appendix A Consent to Participate Form ..........................................................................67 Appendix B Questionnaire .................................................................................................68 Appendix C Institutional Review Board Approval Letter .................................................78 References ..........................................................................................................................79
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