Sex Therapy

It’s not always easy to talk about sex. Many people grow up in environments where sexual topics were off-limits or surrounded by shame. Others may have had negative or painful experiences that made vulnerability around intimacy feel risky. But sex and intimacy are a core part of many people’s lives, and when something feels off, it can ripple into everything from self-esteem to relationships to overall mental health.

At Cognitive Behavioral Therapy & Assessment Associates (CBTAA), we offer expert sex therapy for individuals and couples across New York City, New York, New Jersey, and Connecticut. Our therapists are highly trained in treating the emotional, psychological, and relational challenges that can impact sexual health. Whether you’re navigating personal struggles or relationship dynamics, we’re here to provide compassionate, evidence-based support.

We don’t believe in a one-size-fits-all approach. Instead, we take the time to understand your goals, values, and experiences so that therapy is tailored to your needs with care, respect, and zero judgment.

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Understanding Sex Therapy

Sex therapy is a specialized form of psychotherapy focused on addressing concerns related to sexuality, sexual function, intimacy, and emotional connection. It may involve working through individual issues like anxiety, shame, or trauma, or it may explore relationship dynamics that are creating distance or conflict. Therapy can also be a space for deepening emotional and physical intimacy, exploring identity, or healing after sexual pain or confusion.

Despite what the name might suggest, sex therapy doesn’t involve any physical exams or sexual activity. It’s a talk-based therapy that takes place in a safe, confidential setting with a licensed clinician trained to help you process and resolve the emotional and psychological factors impacting your sex life. At CBTAA, we view sex therapy as an extension of holistic mental health care because how you feel about yourself, your body, and your relationships matters deeply.

Sex therapy can help whether you’re single or partnered, confused or clear about what you want, or somewhere in between. There’s no “right” reason to seek sex therapy. If you’re struggling, curious, disconnected, or simply want to understand yourself better, therapy is a meaningful place to start.

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Common Concerns That Bring People to Sex Therapy

Sexual challenges can take many forms, and they often don’t show up in isolation. What might start as physical discomfort can lead to anxiety or avoidance. Emotional disconnection in a relationship might become sexual withdrawal. Unspoken shame from the past may quietly shape your ability to be present or vulnerable with a partner.

Some clients come to therapy after years of wondering if something is “wrong” with them. Others are navigating transitions whether it’s a new relationship, changes in desire, the aftermath of trauma, or a shift in gender identity or sexual orientation. Many simply feel confused or stuck and want a safe place to sort through it.

Sex Therapy isn’t one-size-fits-all and we work with a wide range of sexual concerns, including low or mismatched desire, arousal challenges, erectile dysfunction, difficulties with orgasm, pain during sex, body image concerns, sexual trauma, performance anxiety, compulsive sexual behavior, and more. We also support clients exploring non-traditional relationship structures, LGBTQ+ identity development, or questions about sexual values and expression.

What all of our clients share is the desire for more clarity, connection, and confidence. Therapy offers a supportive path forward.

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What to Expect in Sex Therapy

Your first session is all about understanding your experience. We’ll explore what’s been going on, what you’re hoping to work on, and how therapy can best support you. You’re encouraged to go at your own pace. Nothing is off-limits, and nothing is required before you’re ready.

If you’re in a relationship, therapy may include sessions with your partner, or it may begin with individual work. We take time to understand your relationship dynamics, communication patterns, and what emotional or psychological blocks may be contributing to sexual concerns. Throughout the process, your therapist will offer education, tools, and techniques rooted in evidence-based treatment, all while holding space for your story and goals.

We know that for many people, this kind of therapy can feel especially vulnerable. That’s why we emphasize safety, consent, and collaboration at every step. You’re in charge of your process — and we’re here to support and guide you along the way.

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Our Therapeutic Approach to Sex Therapy

At CBTAA, we integrate multiple evidence-based modalities to support each client’s goals, identity, and experience. Sex therapy is never one-size-fits-all. The tools we use are carefully chosen to support you where you are — whether you’re looking to reduce anxiety, rebuild intimacy, or heal from past trauma.

Here’s how some of our most effective therapeutic approaches support sex therapy:

Cognitive Behavioral Therapy (CBT) for Sexual Concerns

Cognitive Behavioral Therapy (CBT) is at the heart of our approach to sex therapy. While it’s common to think of CBT as focused on thought patterns alone, what makes it so effective is its emphasis on how those thoughts translate into behaviors, and how changing those behaviors can lead to meaningful change.

In the context of sex and intimacy, CBT helps uncover rigid beliefs, anxious predictions, or shame-based narratives that may be interfering with your ability to connect. You might believe you’re supposed to perform a certain way, worry that something is “wrong” with you, or avoid sexual situations entirely due to fear of failure or discomfort. These thoughts are important, but so are the behaviors they reinforce.

CBT helps break this cycle by identifying the behaviors that maintain anxiety or avoidance, and replacing them with new, more adaptive patterns. For example, if you’ve been avoiding intimacy altogether, therapy might involve practicing small steps toward re-engagement, supported by tools that build confidence and emotional regulation. If you’ve been stuck in negative self-talk, we’ll work to interrupt those patterns, and help you take real-life actions that challenge and reshape them.

Ultimately, CBT is about building new habits, not just new thoughts. It’s about learning how to respond differently in your body, in your relationships, and in the moments that matter most.

Exposure and Response Prevention (ERP) for Sexual OCD and Anxiety

For clients experiencing symptoms of sexual obsessions or compulsive behaviors, often referred to as sexual OCD or “Pure O,” Exposure and Response Prevention (ERP) can be a powerful and effective approach. This form of therapy involves gradually confronting feared thoughts or situations while learning to resist the urge to avoid or engage in safety behaviors (like excessive reassurance-seeking or rumination).

ERP helps reduce the distress and urgency of intrusive sexual thoughts, allowing you to engage with your life more fully without being ruled by fear, guilt, or shame. It’s a compassionate process that puts you back in the driver’s seat, not by eliminating thoughts, but by changing your relationship to them.

This approach can also be used for clients who struggle with sexual avoidance due to past trauma, religious or cultural shame, or performance anxiety. ERP helps interrupt cycles of fear and avoidance so you can reclaim your agency and connection.

Acceptance and Skills-Based Therapies (ACT and DBT)

Two approaches we often draw on in sex therapy are Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT). Both fall under the broader umbrella of cognitive behavioral therapies and share an emphasis on developing healthier emotional responses and behavior patterns, particularly when it comes to anxiety, avoidance, and relationship dynamics.

ACT focuses on helping you clarify your core values, meaning the things that matter most to you in life, love, and intimacy, and then take meaningful action aligned with those values. Instead of trying to eliminate discomfort, ACT helps you build the capacity to sit with it while still moving forward. For clients dealing with shame, avoidance, or performance anxiety, ACT offers a powerful shift: away from control and fear, and toward presence, choice, and connection.

DBT is especially helpful for clients navigating intense emotions, relationship conflict, or a history of invalidation or trauma. In sex therapy, DBT skills can support emotional regulation, self-soothing, boundary setting, and communication. When intimacy triggers feelings that feel overwhelming or unpredictable, DBT offers grounding, structured tools that help restore stability and trust in yourself and in your relationships.

Trauma-Informed Therapy for Sexual Trauma and Abuse

If you’ve experienced sexual assault, coercion, childhood abuse, or other forms of trauma, therapy can offer a path to healing, but it has to be done with care. At CBTAA, we practice trauma-informed therapy that prioritizes safety, choice, and trust. We never push clients to relive trauma or talk about anything before they’re ready. Instead, we create a supportive environment where healing can unfold at your pace.

Trauma-informed sex therapy helps address the emotional and physiological impacts of trauma that often linger long after the event. These might include hypervigilance, shame, dissociation, numbness, or difficulties with trust and touch. Therapy supports your ability to feel safe in your body again, reconnect with your sexuality on your own terms, and reclaim your right to pleasure, agency, and boundaries.

Our therapists are trained in evidence-based trauma treatments and work collaboratively with clients to ensure that every step of the process feels respectful and empowering.

Supplemental Methods Outside of CBTAA

In addition to the approaches we offer at CBTAA, there are other well-known methods in sex therapy that some clients may encounter. We believe it’s important to acknowledge these options, even if they are not part of our direct services, so clients have a full picture of what may be available to them.

Sensate Focus

Sensate Focus is a well-known set of exercises developed by Masters and Johnson that some sex therapists use to help couples rebuild intimacy. The method involves gradually structured touch exercises designed to reduce performance pressure and increase emotional and physical connection.

The process typically unfolds in phases:

• Phase 1: Non-sexual touch, with partners focusing on sensations and connection rather than intercourse or orgasm.
  
  
• Phase 2: Introduction of genital touch, while keeping the emphasis on pleasure and comfort rather than performance.
  
  
• Phase 3: Gradual resumption of intercourse if desired, with the goal of fostering intimacy rather than achieving an outcome.

While Sensate Focus can be very effective for concerns like performance anxiety, erectile dysfunction, or premature ejaculation, CBTAA does not provide this treatment directly. Our focus is on evidence-based talk therapies such as CBT, ACT, DBT, ERP, and trauma-informed approaches. For clients who may benefit from Sensate Focus or similar experiential strategies, we can provide referrals to trusted sex therapists who specialize in this work.

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Couples Therapy for Intimacy, Connection, and Communication

Sexual concerns are often closely intertwined with emotional and relational dynamics. Challenges around intimacy can emerge when there’s lingering resentment, a breakdown in communication, unmet emotional needs, or a lack of safety in the relationship. For many couples, these deeper patterns need attention before physical connection can improve.

At CBTAA, we offer evidence-based couples therapy that supports partners in addressing both emotional and sexual challenges. Whether you’re struggling with mismatched desire, recovering from betrayal, navigating a transition, or simply feeling distant, therapy provides a structured, supportive space to reconnect. Our approach is collaborative and non-blaming, focused on helping each partner feel heard, understood, and empowered to make meaningful changes.

Throughout couples therapy, you’ll learn how to communicate more effectively, rebuild trust, and explore what intimacy means for you as individuals and as a couple. We work with clients across a wide range of identities and relationship structures, including monogamous, non-monogamous, straight, and queer partnerships. Whatever your dynamic, we’re here to help you strengthen your connection with care, insight, and respect.

When to Consider Seeking Sex Therapy

If you’re unsure whether sex therapy is right for you, know that you don’t need to wait until things feel urgent. Many people come to therapy not because something is “wrong,” but because they want more clarity, more connection, or more understanding of themselves.

You might benefit from sex therapy if you’ve noticed persistent dissatisfaction, anxiety, or confusion around sex or intimacy. You may be navigating a relationship change, struggling to express your needs, or feeling disconnected from your body. You might be dealing with a medical condition that’s affected your sexual functioning, or trying to rebuild trust after a rupture in your relationship.

Whatever brings you in, we’ll meet you where you’re at.

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Getting Started with Sex Therapy at CBTAA

Beginning therapy is a brave and meaningful step. You don’t need to have it all figured out, you just need a willingness to explore. At CBTAA, we’ll support you through every phase of the process, from the first consultation to the work of healing and growth.

We serve clients in person in NYC, New York, New Jersey, and Connecticut. Whether you’re seeking therapy for yourself or with a partner, we’re here to help you move forward with confidence.

Schedule a free 15-minute consultation with one of our clinical coordinators. We’ll talk through what you're looking for and match you with a therapist who aligns with your goals and needs.