Behind the book: Handbook for Human Sexuality Counseling: A Sex Positive Approach

Sexuality is often a taboo topic in the United States, and that extends to the counseling profession. Only two states, Florida and California, require a human sexuality course for counselor licensure.

Not only are there few counselor-specific resources on human sexuality, but the majority of them “address the basic concepts of sexuality and gender … from a narrow cisgender, heteronormative, and pathological framework,” write Angela Schubert and Mark Pope, co-editors of the new American Counseling Association book Handbook for Human Sexuality Counseling: A Sex Positive Approach.

“Sexuality is part of the human experience,” they note. “However, it is often disregarded in both counselor training and the actual process of counseling.”

Pope, a past ACA president and professor emeritus at the University of Missouri–St. Louis, and Schubert, a former student of Pope’s and associate professor at Central Methodist University in Missouri and lead clinician at Brightside Counseling Services in Colorado, collaborated on the book to begin to address this knowledge gap. They are both also leaders in the Association of Counseling Sexology & Sexual Wellness (ACSSW), an organizational affiliate of ACA. (Schubert is past president and Pope is trustee.)

What does a sex positive approach look like in counseling? And what might counselors be missing if they fail to bring up sexuality in the counseling room? Counseling Today sent the co-editors some questions via email to learn more.

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Q&A: Handbook for Human Sexuality Counseling: A Sex Positive Approach

Responses by co-editors Angela Schubert and Mark Pope

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Sexuality is an uncomfortable topic for some people. Have you received any pushback from within the counseling profession as you’ve researched and published this book?

Angela Schubert: Not at all. In fact, quite the opposite response. People, and more specifically mental health professionals and students alike, are eager for this information. Yes, there are books out there that discuss the basics of sexuality, but none have taken on a candid and comprehensively sex positive viewpoint.

Mark Pope: What Angie said. And when we approached ACA to publish our book, they were so very supportive and eager to have such a book in their publications list. There is nothing like and as comprehensive as our book available to counseling professionals. It’s historic for ACA to publish this book and we are quite proud of it. We assembled an amazingly knowledgeable and talented group of authors from a variety of professions who deal with human sexuality, including professional counselors, school counselors, counseling psychologists, clinical social workers, urologists, neurologists and others. One of the urologists even did the drawings in the physiological chapter.

 

Sex education is lacking — or nonexistent — for many American students. From your perspective, what should professional counselors’ role be in filling that knowledge gap?

AS: This is a tough question because most professional counselors in the U.S. are in fact former American students. They too may have received minimal sexuality education. As a result, it is highly likely a counselor may first need to become educated themselves on the topic of human sexuality as it relates to counseling. This can be done via workshops, trainings, webinars or a class conducted by licensed mental health professionals and/or organizations that support comprehensive sexuality training. Joining associations like ACSSW would also greatly benefit counselors. ACSSW in particular provides free sexuality counseling webinars to their members. When a counselor has the proper knowledge, they are better equipped to fill the gap with their clients. Ultimately, we hope this book contributes to bridging that gap for counselors and counselor educators.

MP: We have chapters in our book that address this directly. One that focuses on sex education for students in elementary, middle and secondary schools and another for counselors-in-training. It is so important that counselors take the lead in their work settings to advocate for comprehensive sex education for the whole person. But first we must be educated ourselves about sex. This is where counselor education programs are failing their students and where the Council for Accreditation of Counseling and Related Educational Programs (CACREP) is as well.

 

What should those conversations look like with individual clients (or students)?

AS: Conversations with clients should be conducted from a sex positive framework. This type of approach asks counselors to engage in a dialog inclusive of intentional curiosity, radical respect and candid openness. What do each of those look like? Intentional curiosity sets the stage to speak freely and without judgment. Radical respect embraces the belief that every sexual story deserves to be heard. Lastly, it is imperative for counselors to approach sexual issues in the same way they approach suicide, depression, anxiety, etc. — with candid openness.

MP: Realistically, each client/student is different, but each requires the foundational unconditional positive regard that we all learn in our counseling techniques classes.

 

What would you want counselors to know about examining their own feelings and possible biases regarding sexuality in order to best help clients? What is the best way to do this?

AS: It is important to recognize that we are all full of biases when it comes to sexuality. There is nothing wrong with that. The key is to lean in to any discomfort and open yourself up to exploring your personal biases, baggage and damage that might influence your therapeutic filter with clients. This could be done by picking up this book, for example, and reflecting on how you feel and think about the material presented. You might also participate in individual counseling or engage in a formal experience such as a Sexual Attitudes Reassessment (SAR) seminar. A SAR is an intensive professional development program that aims to challenge participants to evaluate their own internal beliefs, values and attitudes toward sexuality topics.

MP: It’s not much different than dealing with any personal bias that you have — [it’s about] awareness, knowledge and skills. Be authentic and ask caring questions of your peers.

 

What advice would you give to a counselor who has a client who talks about a sexual topic that the counselor doesn’t understand, know about or feel comfortable addressing?

AS: I start off an initial session by stating to the client, “I know a lot about a lot of things, but I don’t know you. You are the expert of your story. There might be moments where I might need some more information to better understand how to support you.” Counselors not only set the stage to give permission to their clients to express themselves freely about sexuality, but they also need to give themselves permission to ask.

With that said, it is not on the client to do the work for the counselor. If you have a client who starts talking about sexual contracts and your only knowledge of that is what you saw in 50 Shades of Grey, you might want to clarify what the sexual contract means to the client. If emotions are coming up, it is important to bracket any feelings that arise and check back in with yourself to see where the discomfort came from and find ways to adequately educate yourself on the topic.

MP: Listen to your client/student and then consult with a specialist in this area. It’s basic ethics 101. And if you don’t already have such a specialist in your professional referral list, then do the research to find one now, before this happens, because it will happen. It happens to all of us.

 

What topics or discussions (with clients) regarding sexual issues might be beyond counselors’ scope of practice? Is there anything you’d want practitioners to know about this?

AS: In Chapter 3, Robert J. Zeglin and his co-authors did a phenomenal job addressing this very issue. They created a knowledge-based decision-making matrix that incorporated both the ethical decision-making model and Jack Annon’s PLISSIT (permission giving, limited information, specific suggestions and intensive therapy) model. The combination allows for counselors to ethically identify what topics fall within scope of practice, as well as those in need of referral. Ultimately, practitioners are in an optimal position and within their scope to give permission to clients to speak freely about sexual issues, as well as to provide limited information and specific suggestions (within the scope of competency, of course).

MP: As we work with clients/students, we always must be concerned first with ruling out physiological causes which would require an appropriate physician referral, but we must be sure to not send them off unprepared for such a meeting or to send them off too early without us having a full picture of the problem or problems.

 

Only two states, Florida and California, require a human sexuality course for counselor licensure. What would it take to change that? What would you want counselors who don’t live in those two states to know about educating themselves?

AS: The first question really is, why is this the case? It could be assumed that human sexuality is not considered a core aspect of human identity — not just by the mental health field but also by those in position to create and implement the educational and licensure requirements. And because most counseling programs abide by their respective state licensure requirements and CACREP standards, most do not require students to take a human sexuality course. This is where counseling programs can really make a difference. Regardless of what the state says, counseling programs can still require students to take a human sexuality counseling course. Counselors can also join efforts with their state counseling association to lobby for an inclusion of a sex education requirement for licensure.

MP: Counselors can also join groups such as ACSSW and attend their human sexuality and counseling webinars. They can subscribe to the Journal of Counseling Sexology & Sexual Wellness, the only journal dedicated to counseling and sexual wellness. Last, they could attend any sexual mental health conferences, such as [those of the] American Association of Sexuality Educators, Counselors and Therapists (AASECT), the Society for the Scientific Study of Sexuality (SSSS) and the Center for Sex Education.

 

What made you collaborate on this book — why do you feel it’s needed now?

AS: We met each other when I first entered the master’s program at the University of Missouri-Saint Louis (UMSL) in 2004. Dr. Pope and the rest of the UMSL faculty went as far as they could with elective courses on the topic of sexuality, yet more was needed. We made an agreement that once I graduated with my Ph.D. and settled into a professor position, we would create a book that addressed every topic I wished I had seen during my training. And here we are. Ultimately, the way I see it [is that] it is unethical as a mental health profession to not train practitioners on the topic of sexuality. Sexuality is, in fact, a key component of mental wellness. This book aims to support the ethical practices of the mental health field.

MP: It is clear to me that this topic and human sexuality as a whole need to be formally recognized as an integral part of human wellness and human development. Human sexuality is not an elective! And we need to advocate for this as a core component of our profession.

 

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Handbook for Human Sexuality Counseling: A Sex Positive Approach was published by the American Counseling Association this year. It is available both in print and as an e-book at counseling.org/store or by calling 800-298-2276.

 

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.