A qualitative study of Australian psychologists’ diagnostic questioning of clients’ sexual functioning: motivations from practitioner perspectives

Abstract

ABSTRACT Objective Sexual health problems can be pertinent to psychological function/diagnosis and psychologists are key players in treatment and education regarding sexual health. Despite this, little evidence exists to determine if sexual dysfunction is explored during routine client intake interviews, when the client does not present with relationship difficulties, or from a specialist referral for sexual dysfunction. We aimed to explore psychologists’ decision-making around questioning of client sexual functioning through the lens of the Dual-Processing Model. Method This qualitative study assessed 16 registered psychologists working within Australia who answered an online questionnaire around their beliefs and clinical experiences of sexual health practice. Results Data was analysed using thematic analysis, revealing multiple themes favouring sexual health investigation. Main themes included risk management, relevance to clinical presentations, scope of practice, positive beliefs about asking, and competency beliefs. Primary barriers against sexual health investigation included perceived incompetence, organisational constraints, concerns around damaging rapport, sexual health not being relevant to the client’s needs, and perceptions around unethical practice. Conclusions This paper challenged the applicability of the Dual Processing Model to psychological decision-making, and suggested personal biases influence Australian psychologists’ sexual health questioning.