5 OT Approaches to Address Sex with People with Disabilities
Occupational therapy clinicians are perfectly situated to address sex with our patients, because the occupational therapy approach already gives us all the skills we need.
Here are 5 Occupational Therapy approaches that make us the go-to rehab professionals for sex and relationships
Adaptive Strategies: OT clinicians are experts in making recommendations on how to adapt and modify the activity, so our patients can participate. Ask your patient specific questions on what sexual activity they want to be able to do, what barriers are making that activity difficult or unattainable, and when that barrier or issue starts to arise in the sexual encounter.
Trial and error: OT clinicians know that we need to actually participate in the occupation using adaptive strategies or new patterns to see how well the adaptation or modification worked. When you give your patients suggestions related to sexual activity, make sure to set up a follow up appointment to discuss how well these suggestions worked and gather more information from patients that can help hone your tweak your suggestion through trial and error. When possible, patients can trial sex toys by making sure they can hold and turn on the sex toy and trial positions with clothing on right in the clinic setting.
Downgrading: Downgrading is a technique used by occupational therapists to reduce the difficulty of the task and find the just right challenge. Through assessment, you can establish what your patient’s sexual goals are and then start to downgrade the tasks to start with an intervention that is challenging but attainable.
Energy conservation: Sex takes energy and oftentimes after illness or injury, energy is limited as people are building up their endurance or acclimating to new expectations around energy. Educate your patients on energy conservation techniques and to plan sex for a time when they have the most energy. You can also analyze the sexual activities your patients do and make suggestions on ways the activities can be less strenuous.
Assistive Technology Recommendations: The best part about assistive technology for sexual activity is that we get to talk to our patients about sex toys. Sex toys can help patients be able to participate in activities such as masturbation or fingering. You’ll want to assess whether they can hold and turn on the toy, which you can likely do by looking at a picture online of the sex toy and considering your patient’s difficulties and preferences. Some sex toys incorporate universal design features that make them easier to hold. The Dame Fine has a loop incorporated into the design that eliminates the need for a grasp.
Patient collaboration and not being afraid to ask need-to-know questions is key to letting our OT skills shine. Here’s a few questions to get you started:
When you have sex, what does it look like?
What specific sexual activities are you doing when you’re sexual?
What activities do you want to do?
What do you think is the barrier or what makes it difficult for you to do the activities you want to do?
Where do you feel pain?
What does your partner like to do and are you able to do those activities?
Found this helpful? It’s just the start. Check out the Certified Sexuality OT CEU program to build your confidence and comfort addressing sex with your patients. Stop shying away from the conversation, own it!