“Occupational Therapy is a safe place for addressing sexuality, allowing the client to express fears and concerns, and offering assistance with problem solving. Empathy, sensitivity, and openness are necessary aspects of the therapeutic relationship, the foundation of occupational therapist, and are used in address sexuality.”
MacRae (2013)
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The Role of the Occupational Therapist
Click through the slides below to learn about sexuality and the role of the Occupational Therapists, according to the American Occupational Therapy Association (AOTA).
A study showed that 90% of healthcare practitioners agreed that the topic of sexuality should be addressed as part of the holistic healthcare of clients, but 94% reported that they were unlikely to discuss sexual health concerns with their clients.
Haboubi and Lincoln (2003)
Despite evidence which emphasizes the significant correlation between sexuality, well-being, and quality of life, the topic of sexuality is commonly disregarded within the rehabilitation healthcare field. Many Occupational Therapists are hesitant to address the topic of sexuality. However, according to AOTA we should be able to address sexuality with all our clients in any setting where we are including sexuality into our routine evaluations and treatments.
How do we begin integrating the topic of sexuality into our practice?
Occupational Therapists can begin integrating the topic of sexuality into our practices by first providing an environment where their clients know and feel comfortable talking about sex. This is further described through the PLISSIT model below.
At a minimum, a practitioner should be able to provide services at the fundamental level of “Permission.”
Taylor and Davis (2007)
The PLISSIT model guides current practices in healthcare on the inclusion of sexuality in clinical conversation and provision of sexual intervention. This model identifies four levels of intervention:
- Permission where the practitioner provides a safe and comfortable environment for their clients to bring up sexual health concerns
- Limited Information where practitioners discuss normal and abnormal sexual functioning information in relation to the client’s identified concerns
- Specific Suggestion where practitioners begin to provide recommendations that will help with client’s specific issue(s) with sexual functioning
- Intensive Therapy where a referral is made to a sexual health specialists, such as a sex therapist, which can provide the client with a more comprehensive support and guidance
As the level of intervention increases, greater knowledge, training and skills are required, therefore, it is recognized that not all healthcare practitioners are expected to be competent and operative at all levels, but at a minimum a practitioner should be able to provide services at the fundamental level of “Permission” (Taylor & Davis, 2007).
How do we start talking to our clients about sexuality?
The BETTER Model was developed in order to aide oncology nurses in addressing the topic of sexuality with their clients (Mick, Hughes, & Cohen, 2004). Occupational Therapists can learn from this model and use it to guide what they can say to their clients. Click on the slides below to learn more.
How do we write goals in regards to sexuality?
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How do we treatment plan in regards to sexuality?
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How do we bill in regards to sexuality?
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References
Annon, J. S. (1976). The PLISSIT model: A proposed conceptual scheme for the behavioral treatment of sexual problems. Journal of Sex Education and Therapy, 2(1), 1-15. https://doi.org/10.1080/01614576.1976.11074483
Haboubi, N. H. J., & Lincoln, N. (2003). Views of health professionals on discussing sexual issues with patients. Disability and Rehabilitation, 25(6), 291-296. https://doi.org/10.1080/0963828021000031188
MacRae, N. (2013). Sexuality and the role of occupational therapy. The American Occupational Therapy Association. https://www.aota.org/About- Occupational Therapy/Professionals/RDP/Sexuality.aspx.
Mick, J., Hughes, M. & Cohen, M. (2004). Using the BETTER model to assess sexuality. Clinical Journal of Oncology Nursing, 8(1), 84–86. DOI: 10.1188/04.CJON.84-86; Quinn, C. & Happell, B. (2012), Getting BETTER: Breaking the ice and warming to the inclusion of sexuality in mental health nursing care. International Journal of Mental Health Nursing, 21, 154-162. Doi: 10.1111/j.1447-0349.2011.00783.x
Taylor, B., & Davis, S. (2007). The extended PLISSIT model for addressing the sexual wellbeing of individuals with an acquired disability or chronic illness. Sexuality and Disability, 25(3), 135-139. https://doi.org/ 10.1007/s11195-007-9044-x
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