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I recently attended a webinar by Dr. Farris on Sexuality and Intimacy After Brain Injury with the Brain Injury Association of America. It was a great presentation that shed light on some important points that we as OTs should be making sure to address and incorporate into our practice.  

Consider the Partner

When it comes to addressing sexuality and intimacy with a client after brain injury it’s important to consider the impact on the partner, too. How has this injury impacted the couple? What is the partner’s comfort level with addressing sex and intimacy?

Studies have shown that, often, the client is typically comfortable with discussing changes in their sexual function with their healthcare providers and many individuals who did not receive sexual counseling within the first year after an injury wish they would have.

The impact of a brain injury doesn’t stop with the person directly affected. It’s not uncommon for the...

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...

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. ...

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...