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OT + Accessible Sexual Health Information: Sex Ed for Folks with IDD

One question I often get asked is, how should I address sexuality and intimacy with teens and young adults? And I get it... it sounds like it can be an uncomfortable conversation to have! But, I'm here to tell you it doesn't need to feel that scary. There are a handful of topics that fall within our scope of practice and relate to sexuality and intimacy.  

If you haven't already heard of the podcast OT After Dark, it's another great resource for learning more about this niche world of sex, intimacy and OT. Episode 19, Accessible Sex Education: Addressing the Sexual Needs of Individuals with IDD (Intellectual and Developmental Disability) is a great listen and is available on Spotify and apple podcast!

 

In this episode Dr. Elizabeth Schmidt, PhD, shares her dissertation research and current recommendations on how to address sexuality and intimacy with teens, young adults and more specifically individuals with IDD. 

Individuals with IDD...

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“Sex is Not a Problem, but Lack of Pleasure Is”: Using a feminist and queer lens to critic the absence of pleasure in sexual science research and what this means for OT!

I have often thought about the lack of discussion around pleasure and conversely the prioritization of discussing sexual risk and pathology in sexual dialogues – to include academic dialogues, professional dialogues, and even familial or personal dialogues.   

Dr. Jones (2019) reviewed 300 articles from the Journal of Sex Research that were published between 2010-2015 and found disease and pathology were the main focuses of the articles. 

The articles had little discussion of the role pleasure plays in both enhancing quality of life and motivating high-risk behaviors. 

The researcher also highlighted the heteronormativity and lack of inclusivity pervasive in the articles.  They used a feminist and queer lens to challenge White Supremacy and heteronormative ideology pervasive in the articles which investigates very few social factors related to sex and sexuality.

For example, among many, the researcher found most of the articles related...

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How to be Trauma Informed Care when Addressing Sexuality

Trigger warning: discussion of traumatic experiences.

Trauma-informed care (TIC) practices are becoming more well-known and more widely-implemented in clinical practice. But what does this look like? And how can we as OTs provide TIC while addressing sexuality? In collaboration with OTD Student Hannah Zaininger, I recently did a deep dive into Trauma Informed Care approaches when addressing sexuality and intimacy.

 

The Substance Abuse and Mental Health Services Administration (SAMHSA) is an agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. They have developed a framework to help health providers understand the existence of trauma, as well as support and provide treatment to all individuals whether or not it is known they’ve experienced trauma. This model of care uses six guiding principles, which should be incorporated into health care practices. These...

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What About Sex After Baby?

This week's blog is guest co-written with Kala Plasterer.  Kala will share a bit about herself below, but I’m delighted to bring in a mother, OT, and someone passionate about sex after baby to write about this topic.  Kala and I have been working together for a while as she is a virtual assistant to The Institute.  It was a no brainer to have her write about sex after baby!   

When it comes to addressing sex and intimacy, the impact of breastfeeding and pelvic floor muscles (PFM) may not be the first thing that comes to your mind... but, they will hopefully be something you consider after reading this!

A little bit about me.. I'm Kala. An occupational therapist, first-time mom, and virtual assistant for Kathryn! My personal journey with breastfeeding and motherhood fueled a fire within me and has motivated me to pursue a niche path as an OT and become a certified lactation consultant (CLC). As I’m sure is the case with many of us, we are...
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How to Overcome Unconscious Sexual Bias

If you have a brain, you have a bias. Confronting our own biases is uncomfortable, but it is our ethical responsibility as occupational therapy professionals.  Considering how paramount reconciling our biases are to enhancing the therapeutic relationship and treatment efficacy, and reducing patient harm and health disparities...

Many of us weren't taught this in school.  

Welp, add it to the list of uncomfortable yet essential topics that were and are omitted from OT curriculum !  And it's a double whammy omission-effect when we combine this with sexuality. 

So what does this mean for OT professionals? 

We need to do the work to acknowledge our bias and make sure to include sexuality when doing so.  This is exactly my motivation behind my favorite CEU offering, "Guided Self-Reflection of Sexuality Values, Beliefs, Attitudes, and Biases" (see below section for more info).  We're all sexual beings with our own experiences and beliefs around...

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The Highs and Lows of Sensory Processing and Sexuality: What OTs need to consider

It's no surprise that as sexual beings we all have our own sexual preferences. Our likes, wants, and needs are unique to each of us and shape our sexual and intimate experiences. But what about our dislikes? Or aversions to certain stimuli? What if the enjoyment and pleasure of sex can quickly turn to pain and kill the mood.  For some of us, this might be when our partner lightly touches our skin or grasps too firmly.  What is this experience like and how can OT play a role in this??? Many of the clients I have work have sensory preferences and high/low thresholds, and this can be even more so for people with autism or sensory regulation difficulties.

A great research article discussing sensory features and sexuality was recently shared with me by one of the authors, Anne Kirby, so naturally I was excited about it and wanted to share it here with you!

 Autistic Narratives of Sensory Features, Sexuality, and Relationships (full article linked here)

Using...

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Top Tips for Teaching Sexual Communication

If you've been following along then you know this is the last post of my three part series: The Selfies, Sexplay and Sexual Communication

This week we're talking about Sexual Communication. Whether it's with a casual partner, one with relationship potential, or long time partner helping our clients learn how to establish sexual communication in their relationship is an important part of addressing sexuality and intimacy. 

If they are not already communicating about sex with their partner we may need to help them learn how to be the initiator, which can be uncomfortable for them. 

Establishing sexual communication is the foundation of good sexual experiences and most people will find it refreshing to share their preferences and boundaries.

 

So how do you teach sexual communication??

 Tip #1 - Teach your client to discuss their boundaries/ limits:

While reasons for setting sexual limits widely vary, it is not uncommon for individuals to set...

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Up Next...Sexplay

As promised, I'm continuing my three part series of important topics to cover when addressing sexuality and intimacy, which brings us to Sexplay.  As a part of Sexplay, I'm going to talk about dirty talk, pleasure, and sensate focus.  All of these can be helpful for our clients (and let's be real - US!) to understand as potential activity demands.  Below are some strategies and exercises you can share with your clients! 

DIRTY TALK

Communication is a key component during any sexual encounter and this can include using dirty talk to build arousal.

Tips to share with your client for creating their style of dirty talk: 

  • Think about how you like to describe your body. What makes you feel turned on or sexy? Try to describe your partners body this way too. 
  • What words excite you or make you feel aroused? 
  • What sexual activities do you like to do? Describe this activity to your partner. Use your dirty talk inside and outside the bedroom. 
  • Find...
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A Three Part Series: The Selfies, Sexplay and Sexual Communication

When it comes to helping clients with sexuality and intimacy there are several topics I find important and helpful to address: the selfies, sexplay and sexual communication. Being able to acknowledge and validate their wants and needs to their partner can be uncomfortable for our clients, especially if it's a foreign practice. 

Cue, The Selfies.

I've developed some helpful handouts that I use in my practice and wanted to share the content of them here with you! This week I'll be sharing The Selfies, which are a great addition to your OT treatment session and can make for great discussions, worksheets or role play exercises. 

 

Self-Advocacy

The practice of communicating your personal desires, preferences, needs, boundaries, and rights to yourself and to partners. Taking responsibility for yourself as a sexual and intimate person by advocating for what you want and do not want through explicit communication.

  • How to practice...

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The Value of An Occupational Therapy Sexuality and Intimacy (OTSI) Program

It's been several years in the making so I'm so excited to share my very first peer-reviewed publication and the things I've learned! 

(You can check out the full article here) Sexuality and Intimacy Rehabilitation for the Military Population: Case Series

With help from my colleagues, I sought out to find the effect of sexuality and intimacy interventions on injured service members.

Like many client populations, service members can struggle with sexuality and intimacy secondary to physical, emotional, and/or mental injury/illness. Trauma such as amputation, spinal cord injury, and PTSD (to name a few) can lead to trouble with self-esteem, genitourinary dysfunction, pain, loss of desire, testosterone deficiency, body image challenges, and more.

During the time that I completed this case series I was working at a Military Treatment Facility (MTF). This particular facility has an Occupational Therapy Sexuality and Intimacy (OTSI) program,...

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