Initiation problems and time structuring in brief sex therapy

The paradox of "spontaneous work" appears to be basic to therapeutic intervention in many sexual problems. One area where the paradox of spontaneity and effort is especially acute is that of initiating sexual activity. Numerous couples have initiation problems, whether or not a specific sexual dysfunction also exists. This paper explores the dynamics of initiation difficulties and elaborates a treatment technique that is already part of most approaches to brief sex therapy: time structuring, or scheduling of sexual homework sessions, in such a way as to relieve the anxiety associated with beginning sexual contact.