Getting Clinical Skills in Human Sexuality Psychology

Getting Clinical Skills in Human Sexuality Psychology

As a licensed marriage and family therapist with 20 years of experience in private practice and more than 30 years in education teaching human sexuality psychology, Dr. Jan Parker isn’t somebody who is easily shocked. “I was shocked when I was a brand new therapist — but not now,” says Parker. “Part of what I think makes a good therapist is the capacity to look beyond the behavior.”

According to Parker, learning to develop this non-judgmental attitude is a key component of the Advanced Psychology of Human Sexuality course which is part of National University’s Master of Arts in Counseling Psychology program.

“I want students to come out of the four-week class having been exposed to enough information so they are not totally overwhelmed or shocked with what their clients tell them,” says Parker. “They need to face that initial shock of ‘Oh my God, how do I handle this?’ first in the classroom.”

Understanding the psychology behind human sexuality is important because our relationship with sex often acts as a barometer of our wider health and happiness.

“I’ve worked with a lot of individuals and couples who are having trouble in their relationship and that’s leading to difficulties sexually because sex is one of the places that relational issues show up fairly quickly,” says Parker. “When people don’t feel connected, or safe or loved or cared about, then sex either goes away or becomes fairly mechanical.”


What Is Healthy Sexual Behaviour?

One of the central concepts developed in the human sexuality course is the understanding of what constitutes healthy sexual behavior. This isn’t always something that can be so easily put into categories of “normal” or “atypical” behavior.

What Is Healthy Sexual Behaviour?

“I don’t like the word ‘normal’ because sexuality is fluid and it’s very different for one person than it is for another,” says Parker. “There is a wide range of sexual behaviors that fall within the limits of healthy human sexuality. There are some that I would never engage in — but that doesn’t make it wrong, it just makes it wrong for me. When that happens in a loving relationship, especially in a loving and committed relationship where both people enjoy what’s happening and they engage in it willingly with each other, then we are not going to put that outside the bounds of ‘OK’ sexual behavior. Rather than asking about what is normal, the better question would be what is healthy sexuality — and that varies from person to person.”

Culture can have a big impact on a person’s understanding of what constitutes healthy sexual behavior.

“In the United States, the cultural messages about sexuality are very confusing,” says Parker. “There’s the message that sex is pleasurable and you should enjoy that. There’s the message that you should only be sexual in a marriage. There’s the message that too much sex is a problem. There’s the message that women don’t want sex as much as men, etc., etc. There are all those confusing societal messages.”

If the message is already confusing, even more so is the wider question of what constitutes “normal” human sexuality on a societal level.

“The heterosexual/homosexual continuum is another example,” says Parker. “There are a lot of people who are bisexual who go back and forth. There are people who have mild leanings one way and major leanings in another way. None of that is outside of the boundaries of ‘normality’ — but that’s in this culture. If you were in a different culture, there would be much stricter boundaries or there might be wider boundaries.”


Healthy Human Sexuality — No Guilt, No Shame

According to Parker, there are three elements that signify healthy human sexual behavior: No unwilling victims, no guilt, and no shame.

Parker highlights some of her experiences when working in private practice to demonstrate how the concept of guilt and shame contribute to problematic and damaging sexual behavior.

“For quite a while, I had a specialty of working with clients who had sexual compulsivity,” says Parker. “Some people call that sexual addiction but I don’t think that’s the correct term. Sexual compulsivity is where clients act out sexually in a way that is out of bounds and where they don’t feel like they have real control over it. That’s the definition of compulsion. In any behavior that is compulsive, the person has thoughts about ‘I don’t want to do this,’ ‘I’m not going to do this,’ and then anxiety builds up and builds up, until the only way to release the anxiety is to act out — and so they act out.”

There can be serious consequences if this compulsion is not properly addressed. Moreover, sexual compulsion may also be an underlying cause of other addiction-related issues.

“I had a client early in my career who was in recovery from a chemical dependency addiction and he couldn’t stay sober,” says Parker. “Before he was referred to me he would hold it together for two or three years and then he would relapse. I figured out pretty quickly that he had sexual compulsivity as well as the chemical dependency and that was causing the relapses. So, I sent him for a month’s residential treatment and then worked with him for a couple of years and he was able to stay sober and get married and have a good relationship.”

The similarity between sexual compulsion and chemical dependency is often reflected in the treatments available.

“The treatment for sexual compulsivity consists of helping the client find other ways to discharge the anxiety and eventually working through whatever it is that is causing the anxiety to surface in the first place,” says Parker. “Some people go through a 12-step program. Some people learn meditation or yoga. For some folks there has to be an emotional experience of enough magnitude that pierces the denial system that the person has; it’s very similar to chemical dependency treatment in a lot of ways.”


Human Sexuality Psychology — Successful Outcomes

Parker believes the quality of the therapeutic relationship between the client and the therapist is key to delivering a successful outcome; because every individual is different, this can make it difficult to assign specific success rates to the field of human sexuality psychology.

“The treatment outcome is going to vary, ” says Parker. “The client must want to change, the client must believe that the therapist believes that they can change, and the therapist must believe the client can change. The quality of the therapeutic relationship varies from therapist to therapist. There are therapists who are excellent at forming solid, good, empathic, warm, caring, therapeutic relationships and there are some that are not so good at that.”

Advances in technology and medical science, particularly in the field of neuropsychology, has also brought about huge changes to the way clients are assessed and offered treatment.

“With the development of PET scans you can see how the brain is working and having some kind of stimulus,” says Parker. “This has contributed to the understanding of the interaction between the frontal lobe which controls the decision-making thought process — oh-that’s-not-a-good-idea-to-yell-at-the-boss kind of stuff — and the pleasure center which is in the limbic system which deals with emotion, behavior, and motivation. In people with compulsivity of one kind or another, that communication process between those two parts of the brain is different than it is with people who don’t have that compulsivity. While this doesn’t change anything immediately, it does offer an explanation to the client and their family or loved ones for their behavior and really makes a difference to the way a client engages with treatment.”


What Makes a Good Therapist?

According to Parker, a good therapist needs to develop the skills to look beyond their client’s behavior and tackle the root causes of issues.

“People act out types of behaviors because they are in some kind of pain,” says Parker. “It’s the ability to look at what the pain is and not get caught up in the details of the behavior that I believe is part of what makes a person a good therapist.”

Parker believes that much of what makes a good therapist cannot be taught.

“You cannot teach somebody to be empathetic or relational,” says Parker. “They either have those personality traits or they don’t. What we are teaching students is how to help the client be able to describe the issues they are coming in with and work through those through a number of different approaches including psychodynamic therapy, cognitive behavioral therapy, etc., etc.”

Parker believes that many students are drawn towards a career in therapy because they have a desire to help others — which is often based on their personal experiences of specific issues. As such, students in the Counseling Psychology program are required to engage with 25 hours of personal psychotherapy.

“Helping other people heal is sometimes an unconscious desire to heal themselves,” says Parker. “That’s why it’s so important for the therapist to do their own work because they need to work through their issues outside of the therapy room where they are the therapist.”

A student’s “physiological fitness” is also screened before they are accepted on the Counseling Psychology program.

“We have a two-stage process,” says Parker. “The students have to submit a written application which includes two essays, one which asks about how the important relationships in their life have contributed to how they have become who they are today. The second question is for them to define two positive aspects about themselves and two aspects of growth about themselves. We are looking for people who are able to be self-reflective and who can own the parts of them that still need work. Then, if the students pass the written screening, we have an in-person interview and in that interview, we ask many personal questions. Again we are looking for the capacity for self-reflection and the capacity to own the part that is theirs.”


Taking an Online Class in Human Sexuality Psychology

While National University pioneered many of the online learning techniques which are now commonplace at universities around the world, it has only recently launched the counseling psychology program online.

“We had our first online cohort start in May,” says Parker. “We resisted going online for years because therapy is a relational process. How do you teach somebody to be relational online?”

Two things changed the faculty’s mind.

“Technology has advanced to the point where students can make videos and show them through web conferencing tools like Zoom,” says Parker. “It’s not quite the same as doing it in person but you can see a lot to help the student recognize what works and what doesn’t. The other thing was because of work or family commitments, many of our potential students were unable to get to campus by 5.30 pm to take the program; so by not offering an online class, we were eliminating a whole group of students.”

Video plays a huge role in the delivery of the online class.

“I developed a counseling techniques class,” says Parker. “I did a whole bunch of videos where I demonstrated the techniques. The students then have to submit their own videos where they also demonstrate the techniques.”

However, even students in the online course must come together and practice the techniques in a “real world” environment.

“We’ve also added two in-person intensives where students meet for three days, eight hours a day, and do a lot of role play,” says Parker. “They practice all the different ways in which they meet a client for the first time and do an assessment session, do basic counseling skills, practice running group therapy, working with children and adolescents and working with couples and families. That allows them to have that in-person aspect that we worried we might be missing online.”


Where Can These Skills Be Applied?

Students on the Master of Arts in Counseling Psychology program have the choice of working towards two areas of licensed professional counseling.

The Marriage and Family Therapist (MFT) option is designed for students who are committed to the practice of individual, couples, family, adolescent, and child psychotherapy.

“California is where marriage and family therapists first began back in the late 1960s and early 1970s,” says Parker. “The MFT license here in California is a broad license. It means that people can work with anyone where there is a relational aspect to the therapy. That can be the relationship they have with themselves or with others, for instance, family members, romantic partners, co-workers, or friends.”

The Licensed Professional Clinical Counselor (LPCC) option emphasizes counseling techniques and theory, including those related to career development, and is designed for students who are committed to the practice of individual and group counseling.

“The LPCC license is relatively new in California and it allows people to work with unrelated adults, unless they take specific training in working with children, couples and families,” says Parker. “In our program, if someone takes the LPCC program, they actually take the combined program because it’s much better that they have training in working with children, couples, and families because that is a large part of the population of people who are seeking therapy.”


Learn More

To learn more about developing your skills in human sexuality psychology as part of the Master of Arts in Counseling Psychology program at National University.

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