Indirect behavioral treatment of erectile failure and premature ejaculation in a man without a partner

Premature ejaculation and erectile failure in a 54-year-old man were treated by a combination of exposure in vivo and social skills training. The intervention was not aimed directly at the dysfunctional sexual response but at features of the patient's interpersonal behavior hypothesized to be instrumental in maintaining it. Change was assessed on the basis of the patient's records of weekly rate of successful intercourse, performance of target behaviors, and associated anxiety within a single-case multiple baseline design. Change occurred only with the introduction of treatment and not before it, ruling out the effect of mere therapeutic contact or passage of time. The intervention resulted in an increased rate of performance of adaptive social targets in real life, a decrease in associated anxiety, and eventually a correlated moderate increase in the rate of successful intercourse. The outcome maintained for 1-year follow-up. Systematic data collection was discontinued after 6 months.