Sex Therapy
On Call
"You can't do therapy over the Web," she said. " . . . It
would be very foolhardy to do that. I think the only thing you can
do is offer some discreet information, some concrete information."
While she retains a professional Web site, www.mindspring.com/~
debfox, she said she does not promote it, rarely gains clients
through it, and has raised the price of an online consultation to
discourage people from contacting her online.
Few states issue a sex therapy license per se, so most who
specialize in this field are licensed in something else -- commonly,
psychology or social work -- and then seek certification from
professional organizations. Some have also attended one of the few
graduate schools that offer degrees in human sexuality, such as at
Widener University in Philadelphia. Most offer therapy in an office
setting, incorporating sex therapy as part of broader psychotherapy
sessions or using it to address specific sexual dysfunctions or
perversions. Those issues can range from orgasm difficulties to
sexual conflicts in a relationship to specific fetishes.
The
Therapist Is In
Many sex therapists who offer
distance therapy have an office practice as well, and typically set
up a Web site to advertise their services. Some of these sites give
contact information for the therapist, while others have online
forms they ask prospective clients to complete. Clients find these
sites through search engines or online catalogs of sex therapists,
such as the one at sexualtherapy.com. Some patients pay a therapist
for a one-time e-mail exchange, while others pay for weekly
sessions, which are conducted in their medium of choice and can be
held regularly for months or years.
At e-sextherapy.com, Florida-based sex therapist Earl
Ledford has a cartoon traffic light that turns green when he's
online and available for a live chat. For his single or ongoing
consultations, he charges from $7.50 for an initial e-mail to $50
for a 50-minute phone, chat or video session via webcam. His hourly
in-person fees can be twice that.
A clinical social worker, Ledford said he likes using the
Internet to reach clients he knows won't ever walk through his door.
Ledford said he's reported remarkable changes in the patients he's
worked with by phone and e-mail, and believes they're often more
prepared to help themselves than the patients who come into his
office. He said many of the patients who seek out a therapist online
have already researched their problems, and just need an extra push
to overcome them.
"Look at the process of change," he said. "There's millions
of people who change behavior or solve a problem without talking to
anybody about it. . . I see myself as a facilitator of that with
people. If you look at it and accept that, you can accept that
someone online, that [patients] don't see, can be a facilitator for
that process of change."
Other therapists widely affirm the value of online
information in addressing some people's problems -- by providing
answers to questions, for example, about erectile dysfunction and
orgasm. But the relaying of such information, many contend, is
entirely different from a clinical healing process.
Taking
License
Distance sex therapy has also raised
legal questions.
Some groups, including AASECT, are wrangling over whether
such therapy sometimes violates state-issued counseling licenses,
according to Barratt. Can a sex therapist licensed as a psychologist
in Virginia, for example, legally provide therapy by phone to a
person in Oregon, where the therapist is not licensed?
Ronald Coleman, who practices Internet law in New York,
said almost every licensed profession has dealt with similar
questions, which arose long before the Internet -- or remote sex
therapy -- came into being. What if, he said, a client goes on
vacation out of state, and then calls to talk with his therapist? Or
suppose the therapist travels with the client to another state?
Since sex therapists are not even offered licenses by most states,
he said, the legality of distance sex therapy is "murky as
hell."
© 2004 The Washington Post
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