Case Study Counseling Plan
Brenda J. Owens
COUN 5225 – Human Sexuality
The case study of Sara and Amy was selected to develop a counseling plan. This couple is in a lesbian and bi-racial relationship, Sara is Caucasian and in her early thirties and Amy is African American and in her late thirties. This couple has lived together for 1year and resides far away from both of their families of origin. Both are employed, however Sara recently lost a good paying corporate position and now maintains two lower paying jobs with longer hours. This couple is seeking counseling for Sara’s persistent lack of interest in sexual relations with her ...view middle of the document...
However, sometimes the individual or couple may encounter problems in one or several areas of these events. According to Sewell (2005), sexual dysfunctions are characterized as impairment or a disturbance in one or more of the basic stages of the sexual response cycle. The four phases associated that can determine normality or a state of functioning is desire, arousal, orgasm and resolution (Sewell, 2005). When these phases are not interrupted the sexual response cycle varies from person to person and “even from time to time within persons” with no single, normal, or correct sexual response (Sewell, 2005). The first phase of the sexual response cycle, desire encompasses the want or libido to engage in sexual behavior. This phase is followed by arousal which progresses at varied rates between men and women with men progressing quicker than women. Women need foreplay and intimacy to become physically aroused. In this phase, physical signs of this are vaginal lubrication in women and penile erection in men, with accelerated breathing in both. Through physical touch and intercourse, arousal progress toward orgasm. The succession from the last phase of arousal to orgasm varies between men and women, while both experience muscle contractions, men are able to achieve this quicker with less stimulation. The final phase is resolution where muscles relax and return to a normal state.
According to Sewell (2005), sexual dysfunctions are characterized as impairment or a disturbance in one or more of the three basic stages of the sexual response cycle. Sexual dysfunctions typically occur in the desire phase, arousal phase, orgasmic phase (McCabe, 2005). When a sexual dysfunction occurs in a specific stage of the sexual response cycle, it may cause interruption or further dysfunction in the subsequent stages. For example, if the sexual dysfunction impacts the orgasm phase individuals will likely be unable to reach orgasm without first reaching arousal (McCabe, 2005). Sexual dysfunctions, as cited in Sewell (2005) that impact the first stage of desire of sexual activity include the lack of libido, or Hypoactive Sexual Desire Disorder (HSDD) and Sexual Aversion Disorder (SAD). Both Sexual Desire Disorders and Sexual Arousal Disorders can have a multitude of causes such as distractions, aging, fatigue, psychiatric conditions, illness, medication, and sexual anxiety (Basson, 2001). Sexual dysfunctions can significantly impact an individual’s self-esteem, and cause other psychological problems, such as depression (World Association for Sexual Health, 2008). There are many factors that can contribute to sexual dysfunctions such as health problems, sexual trauma, poor body image, dysfunctional beliefs about sex, or performance anxiety (World Association of Sexual Health, 2008). Factors such as values, religious beliefs, stress and performance anxiety can also contribute to the development of intimate sexual issues and sexual dysfunctions.