If you decide to see a professional about your issues, this section tells you about what to expect from the initial assessment session, the sessions as a whole, and what will and won’t happen during them. Remember that there are various kinds of professionals available, and various routes to finding a professional.
The First Session
During the initial assessment session, the professional is likely to focus on finding out all about you and what you are going through. They will probably ask you to tell them about what brings you to see them, why you have come now, and a bit about the history of the issues.
If it is a sexual problem, they are likely to ask about any medical problems you’ve had or any medication you take. If you go to them with a partner then the professional will probably ask you both to describe your relationship and any difficulties you are having.
You should also use the assessment session to find out anything you want to know about how this professional practises and what to expect from the service. An NHS clinic might only be able to offer a limited number of sessions (6, 10 or 20 are common limits). A private professional will charge and you will probably want to know how much and how you go about cancelling sessions if you can’t attend one week.
The professional should tell you about the contract they work to and may give you a copy.
Towards the end of the assessment session the professional is likely to ask you what your hopes are from seeing them and you will discuss what you might be able to achieve. Some people find it useful to think of it as a scale of 1-10 where 1 is the worst that the issue could possibly be and 10 is how it would be in an ideal world. Think about where you would put yourself on this scale now. It is unlikely that you will get all the way up to 10, but what number do you think you could realistically get to? What would it take to move you just one point up the scale?
The end of the assessment session is a good time to think about whether you and this professional are likely to work well together. It is up to you to choose your professional but its worth noting that at some clinics the person who does the assessment may be different to the professional that you are assigned to.
For the first session it is worth coming with:
- Any forms you have been asked to fill in
- Answers to the question of what brings you to the professional, why you have come now, and what the background is
- Any relevant medical information such as the names of any drugs you are prescribed
- Any questions you have about how the professional or their organisation works
- Your diary so that you can arrange the next appointment
General Sessions
The main point of seeing a sexual health professional is to give you a safe space and regular time to talk about what is going on in your life.
The focus is generally on sexual issues, but these may well be linked with what is going on in the rest of your life such as stress, problems at work, financial, family or physical difficulties. It is fine to talk about these issues too.
The main thing to expect is to be talking about what is going on in your life. Professionals are usually skilled at helping you to do this, so don’t be worried about not having anything to say. Some people find it useful to keep a journal or notes between sessions to remind them what they want to talk about.
Professionals are all different so you may find that some encourage you to talk openly about whatever is on your mind, whilst others have more specific suggestions about what to talk about or do between sessions. Some may suggest exercises you can do between sessions.
When you go to a professional with someone you’re in a relationship with, they may well encourage you to talk to each other more than to them. This is because the focus is on how you communicate together, and improving that. The professional might ask you to have a conversation about a disagreement you’re having, or they might suggest ways that you could ask each other questions or respond to each other and get you to practice these.
What Can Seeing a Professional Achieve
Some people go to a professional hoping that they will fix all their problems. In reality it is only you who can make changes or address what is going on in your life. The professional is someone who can help you to think about what you want and how you might go about getting that, but they can’t do it for you.
Sexual health professionals have extensive knowledge and experience of techniques that work well for people who are having sexual difficulties. They will have some useful suggestions that have been helpful for other people. But it is up to you to decide whether these are things you are comfortable trying and, if not, to talk about this with the professionals.
This kind of help works best for people who are really committed. Try to make time for the sessions and also make time between them to think about what you have discussed or to try out ideas. It helps if you are open-minded and ready to think about different possibilities. Sometimes there might be options you haven’t considered.
Some people with sexual issues think that they are entirely physical problems and don’t see the point in talking about their feelings or relationships. It is true that sometimes sexual difficulties are linked to a physical problem such as a heart condition, multiple sclerosis or diabetes, and your doctor should certainly examine that possibility before referring you on to another professional. However, even in these cases a sexual health professional can help you to adjust to those changes and to explore what kinds of sex are possible given what has happened and any medication you are on.
In many cases sexual problems come about because of the way your body responds to other things like your feelings, your relationships, and your environment. For example, most people with sexual difficulties begin to get anxious that they will have problems when they next have sex, and this generally makes the situation worse. You will get the most out of seeing a professional if you are ready to talk about things like your views on sex, how you feel about your issues, and how you communicate with you partner, if you have one.
What Won’t Happen
If you go to a Sexual health professional then you generally won’t be expected to have any kind of medical examination or to take your clothes off. Only trained doctors and nurses conduct medical examinations, and only specifically touch-based sex coaches or surrogates use any form of touch in therapy (and then only after discussing this with you in depth and ensuring that it is what you want).
If you decide, with a therapist or counsellor, that there is anything physical that needs checking out then they can refer you back to your GP, or another specialist doctor, who can do that.
You don’t have to answer any questions you feel uncomfortable with or do any exercises that you don’t want to do. Sometimes it takes a few sessions to feel comfortable talking with a professional so it may be that you don’t say everything straight away. They won’t mind if you say something later on that you didn’t say at first.
The professional is very unlikely to tell you what to do. They may suggest things that have worked for other people, or things they believe you might find helpful but mostly they are there to listen to you and help you find your own way.
The professional should not be unethical in any way with you. Examples of unethical behaviour would include them touching you in a way you found uncomfortable, or writing about their work with you without getting your permission. If you feel that your professional has been unethical then you should end your sessions and consider making a complaint to the organisation, to the person who referred you, or to any other organisation that accredits that professional.
Confidentiality
One of the most strongly held principles of all sexual health professionals is that it should be confidential – just between you and your professional.
However there are some circumstances where professionals are obligated to break confidentiality and it is worth being aware of these.
The professionals will normally not tell anyone outside their practice about you and your problems. However professionals usually have supervisors who help to make sure they are doing good work with their clients. So your professional will probably talk about their work with you to their supervisor for this reason. They might also ask other members of their team for any advice if they have one. Generally speaking they will not tell those people your name or details that might let them know who you are.
Professionals will probably make some notes about their sessions with clients to help them to remember what you have talked about. Such records will also be kept confidential, for example in a locked filing cabinet, or on a computer file which only professionals working with you have access to. Under the Data Protection Act you also have the right to see any records kept on you.
Confidentiality has to be broken when there is good reason to think that a person might harm themselves or somebody else, but wherever possible this will be discussed with the client first. There are also a limited number of circumstances where the law requires confidentiality to be broken, for example terrorist activities, drug trafficking or money laundering. Sometimes court cases or complaints can also mean that confidentiality is compromised.
In the vast majority of cases the details of what is discussed with a professional will be between the professional and the client. If you want to know exactly how confidentiality works with your professional then it is a good thing to ask them about in the assessment session.
Sense about sex 