The effectiveness of in-person versus remote group couples therapy for the treatment of low sexual desire or frequency

Abstract

ABSTRACT Introduction Low/no sexual desire/frequency or sexual desire discrepancies are one of the most common presenting problems in sex therapists’ offices and among the hardest to treat. Most interventions target the identified patient (i.e., typically the woman with low desire), most recently via biomedical therapies (i.e., flibanserin and bremelanotide). Few interventions to date have shown consistent and successful improvements in this population of distressed couples. Objective To determine whether a group couples sex therapy intervention, offered in-person or via teletherapy, could help couples distressed by low/no sexual desire/frequency. Methods Couples were seen in groups of 4-6 couples (i.e,. 8-12 individuals) for an 8-week, 16-hour intervention led by 13 co-therapist dyads (i.e., 26 licensed clinicians) in 2 countries. Individuals completed the New Sexual Satisfaction Scale (NSSS) plus 3 additional items at assessment, pre-test, post-test and at 6-month follow-up. A total of 107 couples (i.e., 214 individuals) completed the intervention from pre-test to post-test, 75 of whom completed the intervention in-person and 32 via teletherapy during COVID-19. This included 94 heterosexual couples and 13 LGBTQ couples. Of these 107 couples, 42 (i.e., the waitlist control) also completed the assessment at least one month prior to group therapy and 51 couples completed the 6-month follow-up. Paired samples t-tests were conducted between assessment and pre-test, between pre-test and post-test and between pre-test and follow-up. Paired samples t-tests were also conducted between couples’ mean scores on individual items from pre-test to post-test and from pre-test to follow-up. An independent samples t-test was conducted on the mean differences in outcomes between couples who completed the in-person intervention versus those who completed it via teletherapy. Participants also provided written feedback regarding changes in their relationships resulting from therapy. Results No changes occurred on waitlist control scores from assessment to pre-test. For all couples, mean total scores on the NSSS increased by an average of 13.1 ± 10.7 points from pre-test to post-test. This increase in scores was equally significant for groups conducted in-person (p < .001, d = 1.2), and via teletherapy (p < .001, d = 1.3). The amount of change found in couples who underwent the in-person intervention versus those who participated in online group therapy was equivalent. There was a statistically significant increase in scores between pre-test and 6-month follow-up (p < .001, d = 0.6), suggesting that the effects of the intervention were enduring. In addition, there was a statistically significant difference from pre-test to post-test for various individual items on the NSSS, most notably in satisfaction with individuals’ overall sex lives (p < .001, d = 0.9). In their feedback, participants described improvements in emotional connection, embodiment, being “in the moment”, playfulness, enjoyment, authenticity, as well as increased comfort with communication in general, about sex and at times of conflict. Conclusions Group couples therapy for low/no sexual desire/frequency, offered in person or via teletherapy, is an accessible and effective way of enhancing sexual intimacy and thereby ameliorating sexual desire discrepancies for distressed couples. Disclosure Work supported by industry: no.