Sex Therapy or Couples Therapy: What's the Difference and What Do You Need?

If you're struggling with sexual issues in your relationship, you might wonder: do I need a sex therapist or a couples therapist? At Praktijk de Liefde, we believe this separation is often unnecessary. Sexual concerns and relationship problems are almost always intertwined.

What is sex therapy?

Sex therapy focuses specifically on sexual concerns and dysfunctions. A sex therapist or sexologist treats issues such as decreased desire, pain during sex, erectile problems, orgasm difficulties, and differences in sexual needs. Treatment consists of conversations, psychoeducation, and homework assignments.

What is couples therapy?

Couples therapy focuses on the relationship as a whole. In systemic couples therapy, as practiced at Praktijk de Liefde, we look at patterns and dynamics between partners. Communication, conflict management, emotional safety, and attachment are central. We combine systems therapy with EFT (Emotionally Focused Therapy).

The main differences

There are some concrete differences between traditional sex therapy and couples therapy:

• Focus: sex therapy focuses on sexual functioning, couples therapy on relational dynamics
• Approach: sex therapy often works with specific exercises and techniques, couples therapy with patterns and emotions
• Training: a sexologist has specific sexological training, a systems therapist is trained in relational dynamics
• Referral: for a sexologist you sometimes need a referral letter, for couples therapy at Praktijk de Liefde you don't

The integrated approach of Praktijk de Liefde

At Praktijk de Liefde, we deliberately don't separate sex therapy and couples therapy. Our experience with more than 10,000 couples teaches us that sexual concerns almost always have a relational component, and vice versa.

Our systems therapists are trained to integrate sexual themes into the couples therapy process. We look at:

• The patterns in your relationship that affect what happens in the bedroom
• Emotional safety as the foundation for physical intimacy
• Communication about desires, boundaries, and needs
• Underlying fears or insecurities that influence your sex life

By addressing both aspects simultaneously, you achieve lasting improvement in both the relationship and intimacy.

When do you choose what?

A few guidelines:

• Choose sex therapy if there's a very specific sexual concern without clear relationship problems (for example, vaginismus or erectile problems in a new relationship)
• Choose couples therapy if your relationship is under pressure and sexuality is one of the symptoms
• Choose an integrated approach (like at Praktijk de Liefde) if the sexual concern and the relationship reinforce each other, which is the case in most situations

Conclusion

In practice, at Praktijk de Liefde you don't have to choose. Sex therapy is part of our couples therapy. This saves you an extra referral, extra costs, and extra barriers. You work with a therapist who sees the complete picture.

Want to know more or schedule an appointment directly? Visit our sex therapy page or schedule an intake session right away.

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