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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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The 3 A's: A great addition to your OT treatment session

We've all seen them. The sex scenes in movies that too often portray those initial moments afterwards to be euphoric and filled with mutual pleasure and happiness. But, we know that just isn't always reality! It can actually be an awkward or uncomfortable time for couples. Add pain, difficulty with communication, or a physical limitation to the mix and it can really become a difficult time to figure out what to say. I often get asked by client's, "how do I ask for what I want?" and "what if I want my partner to do something different?" or often what is more likely is that I'll find out that sex just ends "bad" with one or all partners frustrated or feeling like there's a lack of connection. 

Early on in my clinical practice I developed what I like to call, The 3 A's.

  • Accolades

  • Affirmations

  • Appreciation

 

These are the three things I, and we as OTs, can recommend as talking points for our clients after sex. 

Accolades- Tell them what you...

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"Teach Me Sex" with Anita from Sex Assist

 

I am thrilled to share my latest "Teach Me Sex" interview with Anita Martin, an experienced COTA, Certified Clinical Sexologist, and founder of Sex Assist. Goodness was it educational!... and steamy! 

 

With 15 years of experience as a COTA, Anita has found her passion and niche in the occupation of sex and intimacy. She now owns and operates her business, Sex Assist, through which she helps both individuals and couples find a better outlook through sex and improve their communication. How amazing is that!? She is also a bartender and foodie at heart, which I think makes her even more relatable!

 

 

Anita was so easy to talk with and I loved her honesty and self-disclosure. She understands how hard it can be to communicate our wants and needs, which is a reason why she wants to help others work through those hurdles in their own relationship(s). As occupational therapists who understand the importance of holistic care, which includes...

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Talking Cultural Curiosity with University of Pittsburgh COTAD

The University of Pittsburgh COTAD (Coalition of Occupational Therapy Advocates for Diversity) Chapter conducted a training on "Culturally Inclusive ADLs" that, with their permission, I had to pass along to my crew! Their personal mission is to promote diversity, equity and inclusion within the Pittsburgh OT community and empower students to be more comprehensive and effective clinicians. How awesome is that!?

 

This was an illuminating training presented by COTAD and three speakers who discussed activity analysis related to their grooming, dressing, spiritual, and other meaningful occupations.  While they provided insights into their own routines and rituals, all of the speakers centered the importance of asking culturally curious questions, for example "what products do you use?" or "can you walk me through your morning self-care routine?" Our clients all have routines and rituals, which can be culturally influenced or meaningful, but still are unique...

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Simplifying Documentation and Billing for Sex and Intimacy Goals

Documentation and billing are often the perceived showstoppers for doing sex and intimacy interventions.  Let me tell you, I get a ton of questions about this, so you are not alone if you’re wondering,

“how the heck do I bill for, ‘Ronnie will mount Sammie during sex with mod I”?

So here is a quick and dirty blog post about documentation and billing to match the actual simplicity of this task.   

 

Goals:

First off, I don’t write goals like the one above. (Although straight to the point, it doesn't quite meet the expectations of a S.M.A.R.T. goal ;) )

But, here are some examples of goals I do write, which specifically have to do with sex and intimacy.  Please note, they are generalized so you'll want to modify them to the clinic you work in and the assessments you typically use:

  1. Client will engage in sexual activity with a decrease (insert pain scale) in self-reported pain. 
  2. Client will engage in...
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Creating Privacy in OT Settings to Talk About Sex

I often get asked by OTs how I create a private space to bring up the topic of sex. But, let’s be honest. It’s just not realistic. We’d be waiting for a long time before the opportunity of a private moment presented itself, especially in an acute care setting. Between the client's family and friends, nurses, doctors, and hospital staff you can almost guarantee there’s always someone in the room.  Or think about a busy pediatric outpatient clinic with all of the families and children in the gym.  Think there's always going to be privacy to ask about sexual development and concerns and questions parents may have?  

It’s just not realistic to think we have to first create a private space to ask about sex. 

But, how can you ensure privacy for the discussion if that's what the client wants? I like to first ask about sex and intimacy during the initial evaluation. Around whoever is in the room. Spouse. Kids. Grandma. Grandpa. ...

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Six Steps for Starting a Sex and Intimacy Clinic!

The process of going from your typical 9-5 occupational therapy job to building a sex and intimacy clinic where you work or having your own private practice does not happen over night. But, tiny steps accumulate into big changes! As you embark on the journey you might hit resistance but don’t get discouraged. Just because no one is doing it does not mean you shouldn’t. Identifying a gap in care is exactly why you should fight to fill it. If we can provide the solution, that’s fabulous!

Read on for my top 6 tips for starting a sex and intimacy clinic or private practice!

 

1. Build your competency

How would you build your competency for any other topic?  You'd seek out training and CEUs.  When I first started there wasn't much out there (like none) so I dedicated my efforts to developing CEUs specifically for OTs based on research, my own experience, and the training I took to become an AASECT certified sex counselor.   You can take what...

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"OT Should be Apolitical"... F That!

I am reflecting on the political landscape these past few weeks and on AOTA's statement about the insurrection & white supremacy and especially the comments in response to that statement that said AOTA and OT should not be political and here are some thoughts I'd like to share.  

It's important to remember that what is happening politically in the US right now is not disconnected from our work as OTs, especially OTs working in sexuality and intimacy. It is our duty to uphold the values of occupational justice and stand up against white supremacy, systematic racism, antisemitism, islamophobia, xenophobia, transphobia, homophobia, ableism, and all other forms of oppression/harm towards others that impact people's self-determination to live as authentic and healthy sexual beings.

 Part of being a culturally humble practitioner involves reflecting on yourself and your own internal biases. It also means knowing the populations you serve and the specific harms by...

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Inclusive Infographic for Sexual Positioning Post-Joint Replacement

Many times we have lamented and noted that patient educational handouts rarely show variety in race, gender expression, bodies, and sexual orientation and that they tend to be white, cisgender and heteronormative.  This becomes even more problematic for sexuality handouts as these occupations involve our bodies, other bodies, and those we love and care most about, as well as, the need to navigate body image and stigma.

 

But the trailblazer, Jennifer Hutchinson (they/them), had an answer. 

Jennifer combined their occupational therapy skills and mission to promote social justice with the talent of a self-identified Queer artist to develop an inclusive handout and infographic for sexual positioning post-joint replacement. The soon-to-be Dr. Hutchinson is also a graduate of The Institute for Sex, Intimacy, & Occupational Therapy's Program Development Group Coaching Summer 2019 Cohort, so I am particularly tickled pink at the work they are already...

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Learning Love & Pleasure from Audre, Adrienne and bell

During a week when many of us are wondering, “Do I like Valentine’s Day?” “Do I not?” or “What does Valentine’s Day mean to me?" I wanted to check in with some inspo from Audre Lorde, Adrienne Maree Brown, and bell hooks. These individuals are all love and pleasure radical thought leaders giving a road map to a world that prioritizes pleasure, equity, self-actualization, and humanity. While I could never do their work justice in a short post, I wanted to direct you to their powerful words.

 

The current version of myself is a big fan of this external holiday.  It’s a time to study love, eroticism, and pleasure and how this shows up in my life and my work as a sexuality OT!  For me, it’s a way to center the joys of my giving and I plan out how to intentionally share a little love with my people.

 

But Audre, Adrienne, and bell, using Black feminist perspectives, offer us very special considerations on love...

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