If you’re considering sex therapy for the first time in DC, Virginia, Maryland, or Florida, you might feel a mix of curiosity and apprehension. Sex therapy addresses some of life’s most deeply personal challenges, and knowing what to expect can provide enormous reassurance. At Cushing Counseling, we understand that taking this first step requires courage. Our approach centers on creating a safe, confidential environment where individuals and couples can explore concerns around intimacy, sexual function, trauma, and connection.
What is Sex Therapy? A Clear Definition
Sex therapy is a specialized form of talk therapy focused on helping adults and couples address sexual health, relationship dynamics, and intimacy concerns. Sessions are entirely conversational, grounded in evidence-based techniques, and tailored to each client’s specific needs. At Cushing Counseling, sessions draw upon modalities like cognitive behavioral therapy (CBT), narrative therapy, somatic approaches, and mindfulness, always within a trauma-informed and LGBTQ+ affirming lens.
Step-by-Step: The Sex Therapy Journey
1. Initial Contact and Consultation
The process typically starts with a free phone consultation. This is your opportunity to share your reasons for seeking therapy—whether you're struggling with desire, shame, sexual functioning, or relationship stress. At Cushing Counseling, we use this conversation to clarify your goals, answer questions, and ensure a comfortable therapeutic fit. No obligation is expected at this stage. You can book this consultation directly through our website or by phone. Sessions are available securely online across DC, Virginia, Maryland, and Florida, so access is convenient and discreet.
2. Intake Paperwork and Logistics
Before your first full session, you’ll complete simple intake paperwork. This includes health history, relationship background, and consent/confidentiality forms. You’ll also receive a good faith estimate as required by the No Surprises Act, letting you know your anticipated costs up front. At Cushing Counseling, current fees range from $150 (associate therapists) to $350 (senior therapists) per 50-minute session, with out-of-network insurance options available through platforms like Thrizer. Sessions are conducted by licensed therapists with specialty certifications—credentials like AASECT sex therapy certification and advanced trauma training distinguish our providers.
3. First Session: Assessment and Goal Setting
The first 50-minute session emphasizes building trust. Your therapist’s priority is to create a nonjudgmental space for you to share your concerns at your own pace. We’ll ask about:
- Your reasons for seeking therapy now
- Current sexual or relational challenges (such as low desire, erection issues, pain, infidelity, past trauma, shame, or communication struggles)
- Your goals—what would you like to see change or feel differently about?
- Relevant relationship and sexual history (if comfortable, you’ll be invited to share developmental, cultural, or trauma-related background)
The purpose of these questions is to understand your unique context, not to pry or judge. Everything you share remains strictly confidential, aligning with Cushing Counseling’s core principles of integrity and compassion.
4. Tailoring Your Treatment Plan
Together, you and your therapist will co-create a roadmap for therapy. Common steps may include psychoeducation on sexual health, exercises to improve communication or intimacy, addressing trauma or shame with evidence-based interventions, or working through specific sexual dysfunctions. For couples, the therapist might recommend joint sessions, individual sessions, or a combination, always with the aim of meeting you where you are.
What Techniques and Interventions Are Used?
- Psychoeducation: Learn about sexual response, desire disparities, anatomy, and the impacts of trauma or shame.
- Sensate Focus: A step-by-step series of at-home touch exercises designed to ease pressure and rebuild intimacy, used for many couples struggling with disconnect or anxiety.
- CBT and Mindfulness: Identify and reframe unhelpful thoughts; practice body awareness or grounding techniques to manage anxiety.
- Trauma-Informed Care: For survivors of sexual trauma, therapy is paced slowly, reinforcing safety and control—integrating somatic work, narrative therapy, and emotional regulation.
- Communication Training: Practice new ways to talk about sex, needs, boundaries, and feelings, often through role play or guided scripts.
Our approach at Cushing Counseling is always collaborative and adaptable. Many clients benefit from structured exercises between sessions, but all activities are optional, consent-based, and respectful of your comfort levels.
Sex Therapy for Individuals vs. Couples
Individual Sex Therapy
This setting is best for anyone wanting to address sexual shame, trauma, anxiety, erectile or arousal issues, desire, or identity concerns outside the immediate couple dynamic. You can go at your own pace, focusing on healing, learning, or rediscovering sexuality.
Couples Sex Therapy
Couples often come seeking help for mismatched desire, conflict about frequency, recovery after an affair, or feeling emotionally distant. Our integrative approach blends couples and sex therapy so partners can rebuild trust, address both sexual and nonsexual communication, and grow together. You can learn more about our couples approach in greater detail on our couples therapy page.
Best Practices for Getting the Most from Sex Therapy
- Set honest, realistic goals. Growth in therapy is gradual. Focus on process, not perfection.
- Communicate openly. Share hesitations or discomfort with your therapist—your feedback shapes the process.
- Embrace vulnerability. Many clients worry about embarrassment. At Cushing Counseling, compassion and respect are at the core of every session. Sharing openly (when you’re ready) accelerates progress.
- Prioritize safety and consent. You’re always in charge of what you discuss or decline. No exercise or topic is ever forced.
- Follow through on recommendations. Practicing exercises or journaling between sessions often leads to greater insight and change.
- Ask questions. If you ever wonder why a particular question or exercise is suggested, ask—transparency fosters trust.
- Be patient. For issues like trauma or deep relationship wounds, meaningful improvement often takes several months of consistent work.
Common Concerns and Misconceptions
- Sex therapy is NOT physical or sexual—sessions are strictly professional, entirely talk-based, and focused on education and healing.
- You will not be judged. Concerns like low desire, erection troubles, shame, anxiety, pain, and communication issues are extremely common.
- All information you share is confidential, including identity, session content, and intake paperwork.
- Cushing Counseling is nationally recognized for LGBTQ+ affirmative, trauma-informed, and culturally sensitive care.
Timeline, Progress, and What to Expect Next
Most clients find it helpful to engage in weekly 50-minute sessions, at least for the first few months. Simpler goals may be addressed within 6 to 10 sessions; more complex concerns like sexual trauma or long-term relationship wounds may take longer. Throughout, your therapist will regularly revisit your goals and adapt the approach as you grow.
Financially, therapy is an investment. Cushing Counseling provides clear price transparency and options for insurance reimbursement where available. You can confirm up-to-date fees and insurance details with our team during your free consult.
Red Flags to Watch For in Any Sex Therapist
- Lack of clear credentials—including AASECT certification, relevant licensing, or specialized training
- Minimizes or dismisses your boundaries or emotional responses
- Fails to explain the rationale behind techniques or interventions
- Does not affirm your sexual/gender identity or makes you feel judged
- Breaks confidentiality without your explicit consent
If anything feels off, trust your instincts and consider seeking care elsewhere. You deserve a therapist who honors your safety and autonomy.
