The Term “Sex Therapist” Isn’t Regulated: What You Need To Know

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Website: http://www.inher-wisdom.com/

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Transcript

Lindsey: New and seasoned OTs are finding their calling in pelvic health. After all, what's more ADL than sex, peeing, and poop? But here's the question. What does it take to become a successful, fulfilled, and thriving OT in pelvic health? How do you go from beginner to seasoned and everything in between? Those are the questions and this podcast will give you the answers.We are inspired OTs. We are out-of-the-box OTs. We are Pelvic Health OTs.I'm your host, Lindsey Vestal, and welcome to the OTs in Pelvic Health podcast. 

Lindsey: Jessica, thank you so much for being a guest on the OTs for Pelvic Health podcast. I am thrilled to have this conversation with you today. 

Jessica: Thank you for inviting me. I mean, I am equally thrilled, maybe a little bit more thrilled. I love OTs. They're my favorite.

So to be able to have a whole audience of pelvic OTs is exciting. 

Lindsey: That's really cool. Yeah, this is going to be great. I'd love to get started with learning a little bit more about your background and what drew you specifically to working with pelvic pain and menstrual dysfunction? 

Jessica: So my license is in marriage and family therapy. So it's an LMFT and I'm licensed in eight states right now, looking at a ninth in Illinois. But the states I'm licensed in, if I can remember them all correctly, are Colorado, Hawaii, Iowa, Missouri, Nevada, North Carolina, Virginia, Florida.

I think that's eight. But I work, I'm also a certified sex therapist with ASECT and I'm currently working on gaining my approved supervisor credentials through ASECT to supervise certified sex therapists as well. But going back to the question on how I got interested in this is with the LMFT, really all that means in my world is my master's degree and training is in systems.

So I've always been drawn to thinking of things through systems and how emotions, reactions, and thoughts just aren't siloed in a body. Systems impact each of us. And it wasn't until grad school where I actually had language to explain kind of how I always saw it.

As for the pelvic pain and menstrual dysfunction, I always had pretty terrible periods, which is similar to many of my clients. I never really had anyone to talk to them about, like talk about my periods to know that they were not normal, not, you know, typical. And hormonal birth control managed my period symptoms for me, but then they came with their own set of issues as hormonal birth control can, including like a ton of anxiety, blood clot issues, all that jazz.

And it was really about 10 years ago that I had a patient in common with a pelvic therapy clinic in Denver. And my client was telling her PT about our sessions and that therapist reached out to me to connect because she really liked what she was hearing from her patient about just sort of my approach. And that snowballed into them referring a lot of clients to me and my name being shared with other pelvic therapists, urogynes, pain doctors around the Denver Metro area.

And then COVID kind of scattered them all. So it branched out into broader Colorado. And then just over five years ago, my blood work showed my platelets came back high.

So going back to the birth control and I was lucky enough to have a primary care doctor who knew enough to immediately take me off the NuvaRing. And it was at that point, I learned a lot more about how many women are having strokes and dying due to the NuvaRing. And that's probably around the point too, I decided to narrow my practice focus to simply pelvic pain and menstrual dysfunction.

I was already an advocate for women's sexual health, but it was important for me to use like my privilege to educate people outside of my clients about medical bias, ableism, dynamic disabilities, all that jazz. And then now this past year, I've launched my new brand, which is In Her Wisdom. And along with my subscription service with that, I moved out of Colorado into the Midwest and began to network and sketch out even advocacy opportunities here in the Midwest.

And I'm hoping to launch an on-demand learning platform for providers in 2026. And then also in the process of being certified in pain reprocessing therapy. So that's kind of a broad background of me.

Lindsey: Oh my goodness. That's phenomenal. You're quite the powerhouse.

Jessica: I mean, people say that, but I was like, I was silly and dumb enough to rebrand and move out of state at the same time. Not something I would recommend to anyone.

Lindsey: I don't know when life's in chaos. I sometimes think it's just best to double down. 

Jessica: Yeah. That's what I told my husband. I was either this is the smartest thing to do or the dumbest. And I'm not going to know until the end. 

Lindsey:I love that. Super quick, just because I didn't know this. Tell me a little bit more about the on-demand learning platform. That sounds really cool.

Jessica: So the on-demand learning platform is like a CE provider. So continuing ed. And right now I got my credentials through ASECT to be a CE provider through them. So that helps. And at least in the mental health side,

ASECT is recognized by a lot of states as reputable CEs. And so even though I'm not credentialed with each state for their CEs, since it's a national one, a lot of states recognize that and accept it.

So I can reach more sex therapists, educators, and counselors and talk about things that I'm passionate about, like understanding the menstrual cycle. That's a topic I talk about a lot is how we conceptualize our clients through the menstrual cycle, particularly like the ableism and the microaggressions around ableism that can show up in the mental health room. I think we all know how they can show up in doctor's offices, unfortunately, but it's still showing up with other therapists too.

I hear that a lot from my clients who have seen other therapists. And just understanding that dynamic disability, just because somebody seems fine on one day doesn't mean that they're not going to have a flare and be bedridden in a couple of weeks. And to really appreciate even how our cancellation policies are mirroring microaggressions around punishing people who are flaring and can't drive or can't make it to a session.

Lindsey: Okay. And is that something OTs would be able to take as well? 

Jessica: So anybody could take it. Everybody would have access to it.

I don't know if OTs could count it as CEs for their credentialing, but I'd hope so. Fingers crossed. 

Lindsey: Yeah. And we'll add it to the show notes too, just to make sure everybody, especially if it's not out yet, we'll make sure that everybody can find you and do all that. I would love if you could share some examples with us, just because I think that there's such an amazing opportunity for OTs to work with sex therapists. And for those that maybe haven't done it before or are curious and want to understand it, would you mind sharing an example of how an OT and a sex therapist could kind of co-create or collaborate together for a client that maybe was experiencing, let's use the example of maybe pain with sex, nervous system dysregulation, maybe some trauma in there.

Jessica: So I would love even more collaboration to be with pelvic OTs. And I think it'd be great for OTs and sex therapists to have an opportunity to talk about their experiences with a client sort of quote unquote off record. You know, even just to go back and forth and not that we should bash clients or anything like that, but simply to be able to talk freely about clients.

Because I'm know I'm already using a lot of the same language as OTs when it comes to the nervous system dysregulation. So it continues to be helpful to clients to continually hear that same message, that same language, but also hearing what tools and techniques each has to recommend. You know, so what am I suggesting to patients or clients and then what the OT is and how it was received.

And so we can support each other versus trip over each other. I had this literally just last night, one of my clients who's seen a pelvic OT was given some homework by her OT for journaling. And she was, she brought it up with kind of not complaining, but she's like, oh yeah, I got this homework.

And I was like, go get it. So she ran and got it. And I said, okay, walk me through some of these journal prompts and what is, what's coming up for you and why are we avoiding the journal prompts? And you know, and then when she, one of the journal prompts, her brain went blank is because I asked her, I said, what's the first thing your brain gives you when you read that? She's like, it just went blank.

Perfect. And so to kind of educate her a little bit more of going, that's what you write. My brain went blank.

And I was like, why do you think it went blank? You know, and we talked about protective mechanisms. And so that being a perfect example of had I not asked her to run and get them, she might not have completed these journal prompts. She still might not complete the journal prompts, but at least has a little bit more language that I could help that OT now have something, you know, in their next appointment.

Lindsey: Oh, I love that. What a great, what a great example of team, team support, you know, and, and continuity of care. That's beautiful.

Could you tell us what pelvic health therapist should be looking for when potentially referring our clients to sex therapists? 

Jessica: So I always say not all mental health therapists are created equal and that includes sex therapists. So yes, sex therapists typically have additional training. And I'm going to put an asterisk at the end of that because even the term sex therapist isn't protected.

So, you know, anyone can use it. So what does that even mean? So first thing I would look for is whether they're certified or not. So certified sex therapist is somewhat more protected, but it's usually comes with, they had some sort of additional training.

And in the sex therapy world, there isn't a whole lot of regulation. So even with the word certified, but my certification is through ASECT, which is the American Association of Sexuality Educators, Counselors, and Therapists. And it's probably the most well-known and they protect the phrase ASECT certified sex therapists.

Now there's other national organizations that also people are drawn to maybe ASECT isn't for them, or they have, you know, personal boundaries that ASECT, you know, doesn't align with or whatever. And it's okay just to understand what if someone says they're a sex therapist, are they certified? Where's that certification coming from? Is it a Google-able source? And the second thing I would look for is I would request a copy of the therapist's CV. And especially if you're a potential client or you're looking for someone to refer to, I don't think this is necessarily a big ask.

And that way you can see if and where they received their certification from. They should also list trainings on their CV too. That way you can get a sense of their specialties, what they're drawn to, because most sex therapy training programs barely teach on pelvic health.

So for example, my training program was over 150 hours, and only one of those hours was on pelvic health and not a whole lot on menstrual health. Like I don't remember or recall a menstrual dysfunction as simply other than these are diagnosable things. And then finally, I would talk to them, meet them through Zoom, meet them for coffee.

Is this someone you connect with and feel comfortable with? I mean, I wouldn't recommend referring to somebody you don't like. So do you like them? 

Lindset: I mean, that's really solid advice. And I honestly don't think I knew that the term sex therapist wasn't regulated.

It's crazy once you start looking into even state-by-state some of these things that we as intelligent consumers just bypass when we hear that term. So thank you for bringing that to our attention. And I think asking for the CV, and I will say that Jessica gave me her CV when we were planning this podcast, and I didn't even ask for it.

So I can tell you're an absolute believer in that, in demonstrating the trainings and just who you're made of, and where you've been spending your time. I love that. I know you have strong feelings regarding the word sex positivity.

And I have a sense that you have thoughts regarding whether or not people who claim to be sex positive are actually equipped to work with people that have pelvic health dysfunction. Can you tell us a little bit more about that? 

Jessica: So building on some of the pieces I mentioned just a couple of seconds ago, like you said, sex therapist is a broad term. And when I mentioned my 150 hours through ASECT, under that umbrella of 150 hours, we have ethics, developmentally, you know, pieces for sexuality, gender and sexuality, relationship diversity, so ethical non-monogamy, anatomy, sexual functioning, even abuse, substance abuse, research.

So all of that is a lot in 150 hours. So it kind of means that technically any certified sex therapist should have taken at least one class about, say, pain with sex. And they might know the phrase vaginismus, not might, they should know it.

But do they specialize in that? Do they see it every day, all day? And then, you know, expanding that to pelvic pain and like menstrual dysfunction, like endo. Endo is a hill I will die on. One in nine people with a uterus experience endo.

And yet we don't have training in the sex world on how to handle that from a mental health perspective. And I repeatedly hear sex therapists simply refer to pelvic therapists. They just refer their clients out over and over and kind of expect pelvic therapists to have a magic wand.

I mean, there is the pelvic wand, which I do think is magical, but like to just fix it, you know, versus understanding what can be done in the room. And so without like additional training, just because someone's licensed doesn't mean, or even certified doesn't mean like they can understand what's happening with your client. Now, you know, a client going to a sex therapist who's accessible is still better than nothing.

So even if, you know, in your area, the only, you know, you don't have people specialized in pelvic pain or menstrual dysfunction, that's still better than nothing. But otherwise, like, you know, and going back to the sex positive piece, I would avoid anyone who says they're a certified sex addiction counselor. There are programs out there who are designed for that piece, but they're created by the addiction world. They're not created by the sex therapy world.

And particularly, you know, if somebody says that they're, you know, have a sex addiction, I don't think, you know, our clients are going to be the ones expressing this, but, you know, maybe their partners or, you know, or identify as that. But in the sex positive world, we use the term out of control, sexual behavior versus addiction. 

Lindsey: Okay, Okay. Yeah. That, that, that makes a lot of sense.

A lot of the OT framework, we do a lot with sensory integration. We do a lot with nervous system regulation with our work with clients. I'm curious how you see that intersecting with your work as a sex therapist.

Jessica: So I myself have been diagnosed with sensory processing disorder. So I'm obsessed with sensory pieces. And, you know, it's funny because I'm always like talking about it.

And my clients are like, seriously, enough of this. But I, I personally, as well, and professionally as a clinician, I'm looking for constantly looking for sensory stimulation and masking that could be adding to my client's mental capacity and their ability to regulate their nervous system. Things that they might not notice because it took years for me to fully, and I still learn new things about myself, fully appreciate how much of a mental load that is.

And pain and discomfort is a sensory input. And not only has emotional and mental symptoms like irritability, anxiety, burnout, but sensory overload can add to the physical symptoms like nausea, increased pain, like fibro, headaches, migraines, things like that. So I always encouraging whether it's pelvic therapists or even mental health therapists to consider sensory input.

I think OTs do this great. So I usually never have to explain why, but if I do talk to PTs, what messages are their spaces sending from a sensory input? Visual cues like a disorganized space can be telling the nervous system, this is an unsafe, not as unsafe, but can just be distracting unexpected noises in the hallway. I've been to clinics where it's like really echoey.

And so that can, again, just, you know, maybe, you know, just somebody walking by can trigger their nervous system to go on alert. Essential oil blends, certain scents could trigger people. And all this, I think clients are taught to expect, but not consent to, like they don't realize they can consent out of essential oil blends, you know, because they don't want to be a burden or it's fine.

They've learned to cope with it. You know, and so to be able to conceptualize your space that way of like, yeah, how would somebody who's already has a lot of anxiety coming into the space going to calm down? 

Lindsey: Yeah, absolutely. Oh, I love that.

Those are really clear examples. What's your approach if you think that one of your clients has either a sensory profile or trauma history that's showing up and contributing to their sexual challenges? What do you do in those situations? 

Jessica: So usually a ton of psycho-ed around sensory seeking and avoidance. It's usually pretty gentle.

I, because, you know, I have dropped this on clients and that, you know, just be like, oh, it's this, cause I can, I see it every day. I'm not usually sensitive to what it could mean. So now I've learned to slow it down.

So do a lot of just, hey, like, do you like this? Do you notice you avoid this? And usually in the framework of pleasure and disgust versus sensory seeking and avoidance, because those feel clinical to me. Cause I have a lot of clients who avoid sex because of tastes and smells, but they either don't realize that's why they're avoiding it or they feel embarrassed, broken to admit those things because they think I'm supposed to like this, or there's parts of it I do like, but I really hate this. But how do I tell my partner the smell of saliva, you know, repulses me.

And so it's a really slowing down process, making sure it's safe to explore different sensory pieces, validating the sensory avoidance, telling them that it's okay. This is normal. Like you're not abnormal.

And then recognize like how trauma and like how having to tolerate those things can play into even more masking. And again, sucking up that those spoons that they don't have a lot of to begin with. 

Lindsey: Yeah. Yeah. It's, it's can be really challenging to have that like inner mirror pointed at you and, and for you to piece apart, that's actually why I've been avoiding it. It is the smell.

It is the taste. So I think that's, that's such important work. I mean, at the end of the day, sex is sensory, you know, and it is being able to address it like that, I think is so foundational.

So your clients are super happy to have you. 

Jessica: Well, and I'm lucky to have that diagnosis because I can use my own examples, a little self deprecation in there to be like, let me tell you what I hate and, you know, pick something. It's always bacon.

I don't love bacon. And yet it's very un-American of me, you know, to bring that humor into it too, where we can laugh about things we love and things we hate. And yeah.

Lindsey: Yeah. I love that. Do you have any like checklists or communication checklists, yes, no, maybe lists or anything like that, that you use with your clients to help them discover those things with their partner? 

Jessica: So not an official one. I, you know, when I start to sense some sensory stuff, then that's when I kind of go in and be like, Hey, so how do you feel about this? Cause I know some people don't like this or, you know, and like frame it that way or even if I just back up and be like, what are your favorite parts of sex and what are your least favorite? So again, not hate, not discuss, but like least favorite feels a little easier to answer. 

Lindsey:I love that. Yeah. That word choice is really important. It feels less extreme when you kind of just make it less extreme and make it in their brain.

Yeah. That's, that's fantastic. Are there, you mentioned ASEC, but I'm just trying to think about OTs listening to this conversation who may want to refer out and, and find more of these collaborative approaches.

Are there any specific trainings outside of anything you've mentioned or directories or resources that you know of that OTs can rely on to find more people like you, that they may want to connect with? I mean, there's, I wish there was like your new directory is amazing. and I'm really excited. I keep watching the States.

I'm like one of these days, Iowa is going to have one. Minnesota has one, but we're getting close. Um, and it's a, yeah, you're right.

I keep mentioning a sect and ASECT does, does have a quote unquote, find a provider button. I can't remember exactly what the words are there. Um, and there are a lot of even non-mental health, um, therapists on ASICS.

So any OTs welcome to become a member of ASECT and then network that way. I'd recommend keeping an ear out for anyone who mentions they are a sex therapist or a part of like Ishwish or ISSM, you know, again, organizations that are more specialized that kind of show that that mental health therapist is taking an additional step into, you know, like just sexual health worlds. and I mean, I would just love more OTs to collaborate with sex therapists.

So even if, uh, you, they don't specialize in something, but you really jive with a sex therapist to like ask them if they would like to learn more or do trainings and presentations. Um, right now I'm working with both a pelvic OT and a pelvic PT to try and collaborate more on presentations in each of our worlds. So both in the sex therapy world and the PT OT world and educate more providers on how to network and collaborate and how to, um, just connect and like get this education and information out there.

Lindsey: Yeah. Yeah. I think our intersection is really aligned in the sense that not many people know what OTs do.

Not many people know what OTs in pelvic health do. And I think people think they know what sex therapists do, but once you ask even one question, you very quickly find out they don't. And so it's like, we're both like, you know, double horned unicorns here coming together.

And I think we could really jive and really support our clients and possibly geek out more than likely geek out in the process and learn so much from each other. 

Jessica: Yeah. I'm always geeky.

I always say that pelvic providers are my favorite people because they tend to be more sex positive than the average person out there, but they're not like sometimes sex therapists take themselves too seriously. And so they can be exhausting, but as I try to like, I'm like, they're easier to get along with than sex therapists and yeah. 

Lindsey: Yeah, totally Jessica, is there anything else that you would want our listeners to, to know or hear about that we maybe haven't had a chance to dive into yet in our conversation today? 

Jessica: I mean, I'd want them to know to like how valuable they are to the sex therapy world. And I think about, you know, sometimes people become intimidated by the idea of networking and to be able to know that you have value to sex therapists, you reach out to ask questions, ask for these CVs. If they don't have their trainings listed, ask for their list of trainings and to know that you are bringing something of value to the table to a sex therapist and point of referrals and things like that.

So make sure they're the right fit, make sure they, you know, have the same values and the same interests and the same passions and the, you know, the same geeks out stuff as you do. 

Lindsey: Yeah, that's great. I love that advice. So where can our listeners learn more about what you're up to? You clearly have some amazing things planned. So we want to kind of track, track you taking over the world. 

Jessica: So the new brands website is Inherd.

So I N H E R dash wisdom, W I S D O M.com. And so in her wisdom, we'll also have the subscription service. So the subscription service is it's a bunch of things. So I had to stop and think about it.

So there's like educational videos, there's interviews under what it means to be a girl. And I'm trying to interview more and more people who are dealing with a variety of things associated with being a girl, but more specifically with pelvic pain and menstrual dysfunction. There are book reviews, there are journal prompts.

So all of that will be under the subscription, how to get ahold of me will be there. My Instagram will be there. Once I get the on-demand learning, I think my website person and rebrand or she was can we take a beat before we start the next thing? It was like phase three, we're done with phase two, let's go.

And so we are going to take a beat for both of our sanity's sake. And so hopefully early next year, that will show up. 

Lindsey: Sounds great. I can't thank you enough for taking the time to chat with us today. It was incredible and I learned so much. So I'm excited as our paths continue to cross. Thanks for all that you do.

Jessica: Thank you.

Lindsey: Thanks for listening to another episode of OTs and Pelvic Health. If you haven't already, hop onto Facebook and join my group, OTs for Pelvic Health, where we have thousands of OTs at all stages of their pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and post it to IG, Facebook, wherever you post your stuff, and be sure to tag me and let me know why you like this episode. This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic Health podcast.