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The SRTS offers treatment to adults (i.e., individuals aged 18 years and over). Services are geared toward individuals who experience distressing sexual concerns, including:

• low sexual desire

• difficulties with sexual arousal/interest,

• erection difficulties,

• problems with ejaculation,

• genital pain (e.g., vulvodynia),

• difficulties with sexual intercourse/activity due to anxiety/discomfort (including vaginismus), and

• problems with orgasm.

We offer treatment to individuals and those in relationships who attend therapy with or without their partner/s. For those who experience general relationship issues (e.g., communication problems, conflict) and will attend therapy with their partner/s for these concerns, please see “Relationship Issues” section below for more information on the services offered by the SRTS.

We also offer group programs (see below in the Group Therapy section) for certain sexual concerns for group program information and offerings. Please note that, usually, individual clients will attend a group program before individual sessions are considered, unless there are extenuating circumstances.

We do not offer treatment to clients with sex/porn addiction or paraphilic disorders, such as pedophilic disorder or fetishistic disorder.

When there is another presenting concern (such as complex and/or unresolved trauma or problematic substance/alcohol use) that needs clinical attention before someone can fully benefit from our services, we will offer our services after appropriate treatment has been completed.

We offer relationship therapy for those who have distressing concerns with their relationships (e.g., communication problems, disagreements or conflict, sexual desire/frequency discrepancies, etc. that interfere with their relationship) and who will attend therapy with their partner/s.

We do not offer treatment to clients in relationships with intimate partner violence, ongoing infidelity, or sex/porn addiction.

We provide support for individuals who are transitioning and/or who do not identify with their birth-assigned sex, in the forms of support, therapy, and assessments (e.g., for a referral for hormone therapy, surgical procedures). Note that we only see trans and nonbinary clients aged 18 years and older.

The type of therapy that we provide is evidence-based, meaning that its effectiveness is supported by scientific evidence. Our approach is primarily based on Cognitive Behavioural Therapy (CBT), and some of the relationship therapy is rooted in Integrative Behaviour Couples Therapy (IBCT).

CBT is a type of therapy that focuses on how the way that you think and behave impacts your mood, and in turn, how that is connected to your sexual life/relationship. It is a structured and skills-building therapy, and it involves active participation from clients during sessions and in between sessions to practice these skills. CBT is also goal-focused, which means that during sessions, we focus on your goals for therapy. A CBT approach is used in sessions with individuals and may be used in therapy with those in relationships.

IBCT may also be used in relationship therapy. IBCT combines techniques from behavioural couples therapy with strategies to cultivate acceptance and understanding of each other’s emotions.

The therapy that we provide is different from what’s called “supportive counselling”. Supportive counselling is a type of counselling that involves meeting with your therapist on a regular basis to talk about your concerns, but has less of a focus on structure, goals, and practicing skills between sessions.

We adhere to a range of 12-16 sessions for most cases involving individuals and those in relationships who attend with their partner/s. Our group programs usually consist of 4-12 sessions.

For those presenting individually for sex therapy, whether in a relationship or not: The initial appointment is a consultation that lasts around 1.5-2 hours. It is completed with Dr. Pukall (and/or another supervising psychologist) and a student therapist to determine whether our treatment services are appropriate for you, including specific recommendations about what program/s (e.g., individual, relationship, group) and other resources we recommend. If you are interested in the services offered, you will be provided with information related to the program.

Please note that, usually, individual clients will attend a group program before individual sessions are considered, unless there are extenuating circumstances.

For those presenting with their partner/s for relationship therapy: Depending on the nature of the issue, the consultation may last 1.5-2 hours (with Dr. Pukall and/or another supervising psychologist) or several one-hour sessions (with a student therapist under the supervision of a psychologist). The consultation is completed to determine whether our treatment services are appropriate for you, including specific recommendations about what program/s (e.g., individual, relationship, group) and other resources we recommend. If you are interested in the services offered, you will be provided with information related to the program.

This 4-week program is for men who are motivated to improve their experience of sexuality. The group is cognitive-behavioural, meaning that it involves learning specific skills—actions and ways of thinking—that have been shown through research to be effective for improving sexual function and satisfaction. Topics we will cover range from information about anatomy and sexual response, exploring barriers to sexual arousal, and learning strategies to increase sexual pleasure.

This 8-week cognitive-behavioural group is for women experiencing recurrent and persistent pain during sexual activity. The group will provide education about genital pain and its effects on sexuality, help identify factors that can influence the experience of chronic pain, and teach a variety of skills—actions and ways of thinking—to cope with pain and improve sexuality.

This 6-week program is for women who want to learn about and improve their experience of sexual pleasure. The group is cognitive-behavioural, meaning that it involves learning specific skills—actions and ways of thinking—that have been shown through research to be effective for improving sexual function and satisfaction. Topics we will cover range from education about anatomy and sexual response, exploring barriers to sexual desire, and learning strategies to increase sexual pleasure.

This 8-week cognitive-behavioural group is for women experiencing persistent and unwanted genital arousal sensations in the absence of mental arousal and sexual desire. The group will provide education about our understanding of PGAD/GPD symptoms, help identify factors that can influence the experience of symptoms, and teach a variety of skills—actions and ways of thinking—to cope with symptoms and the distress and interference associated with them. For the time being, participation in this group coincides with participation in a research study examining the group’s effectiveness on a variety of outcomes, like symptom intensity. For more information about this study, please email SHRL@queensu.ca