A randomized controlled trial of online mindfulness and cognitive-behavioral interventions for sexual...

Sexual interest/arousal disorder (SIAD) is a common and distressing sexual dysfunction in women. Although efficacious psychological treatments for SIAD exist, they are generally underutilized and inaccessible. eSense is a feasible and useable online intervention containing Cognitive-Behavioral Therapy (CBT) and Mindfulness-Based Therapy (MBT) programs. Our goal was to test the efficacy of the CBT and MBT arms of eSense relative to a waitlist control condition.

Women with SIAD were randomized to eSense-CBT (n = 43), eSense-MBT (n = 43), or a waitlist (n = 43). Both interventions consisted of 8 modules with a recommended completion time of 8-12 weeks. Participants also met remotely with non-expert "navigators" for up to 12 weeks. Participants completed validated self-report measures of primary outcomes (sexual desire/arousal and distress) and secondary outcomes (sexual satisfaction, dissatisfaction, and overall sexual function) at baseline, mid-treatment, posttreatment, and 6-month posttreatment.

Compared to waitlist, both active treatment groups reported significant improvements in primary outcomes at post-treatment (desire/arousal d > .90; sexual distress d < -0.62) and these improvements were generally maintained at follow-up. The two active treatments did not differ in terms of primary outcomes. Effects on sexual satisfaction were also significant (d = 0.70-0.81) and MBT resulted in slightly greater improvements. There was no effect on sexual dissatisfaction. For overall sexual function, the effect was large (d = 1.20 to 1.23) with no between-arm differences. Future steps to improve engagement and increase access are discussed.