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Management

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The management and psychological treatment of sexual dysfunctions altered drastically with the publication of the work of Masters and Johnson (1970). Until then, most attempts at treatment had involved lengthy psycho-analysis or psychotherapy of an individual and these produced only fair results.

The principles of the approach of Masters and Johnson are as follows :- - the couple is treated regardless of the problem. - the partners are helped to communicate both verbally and non-verbally about, and during, sexual behaviour. - education is provided in both sexual anatomy and physiology. Ignorance as to how to engage in effective stimulation is very common in couples with dysfunctions. - the couple should concentrate on the uninhibited giving and receiving of sexual stimulation and allow spontaneous physiological reactions such as erection and orgasm to take care of themselves.

Masters and Johnson advocated a very intensive treatment programme over two to three weeks in which the couple are encouraged to carry out a graduated series of 'homework' assignments aimed at establishing a rewarding sexual relationship. Therapists work in pairs with one male and one female therapist in each co-therapy team. The results obtained from their therapy have been quite remarkable.

It has proved possible to adapt Masters and Johnson's approach to the NHS setting using either single or co-therapists who see couples on a weekly basis over two to four months.

(Hawton,(1982) Sex Therapy : A Practical Guide. Oxford University Press).


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