Clinical Considerations for Mental Health Professionals Working with Women Who Sell Sex

Abstract

This book reviews empirical literature on a number of psychological concepts related to selling sex. The goals of the book and the boundaries of what is included can be found in Chap. 1. In brief, this book focuses on private, in-person, consensual sex acts exchanged between a cisgender woman and a paying customer. Research on men, minors, and victims of sex trafficking are deliberately excluded, unless otherwise noted. The review favors peer-reviewed sources of research and is most inclusive of comparative studies. Qualitative findings are used illustratively. This chapter is written with psychotherapists in mind, however, other helping professionals may glean insights as they see fit. To date, very little has been written about providing competent care to psychotherapy clients who are or have been involved in commercial sex. Given the paucity of clinical writings, the goal of this chapter is to explore therapeutic themes that may be relevant to women who sell sex and seek mental health services. Future research will be required to evaluate the effectiveness of particular interventions among this population. This chapter is not intended to suggest that all women who sell sex face particular psychological problems. Clinical assessment will indicate which of the discussed themes, if any, are relevant to the treatment of a particular client. We begin with some basic and ethical considerations for working with women who sell sex. We then focus on a variety of themes relevant to individualizing treatment, including suggestions for assessment and therapeutic work with women who sell sex, women transitioning out of selling sex, and women with a history of selling sex.