I got the idea for this handout when I was conducting a 10 hour training for an interdisciplinary Brain Injury Unit team. The training was focused on interventions and considerations for sex and relationships for people with brain injury. The team asked a LOT of questions about how to respond to sexually relevant comments and questions. There were a lot of “well what about this scenario…?” and “what if this happens…?”

60% of people with brain injury report difficulties with sexual health. 75% demonstrate hyposexual difficulties, while 25% demonstrate hypersexual behaviors. Since there is often no guidance on how to navigate these symptoms or address the sexual goals of patients, staff can often be at a loss for what to do….

Clinicians can, rightfully so, feel cautions to challenge what clients admit as cultural messages. For example, "I grew up in a Catholic home and still view sex as 'dirty' and 'sinful,' and I’m having a hard time enjoying it,” or “My culture values young women, and women over 40 aren’t considered attractive anymore…

Before you read on, here's a self-assessment to stoke self reflection.

Take a look at Victoria's Secret's website and Rihanna’s SavagexFenty website. Ask yourself: “if my sex and intimacy occupational therapy practice was either Victoria’s Secret or SavagexFenty, which one would it be?”

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.