Students are to critically analyze the application of sensate focus exercises, creating next steps in the appropriate decision-making involved in employing this treatment method. Such practices bolster students’ familiarity with the effective application of clinical sexology exercises, allowing them to anticipate challenges or issues that may arise.
Scenario:
After assessing and diagnosing issues related to a couple, Bob and Julie, presenting with sexual intimacy issues, you’ve decided to assign sensate focus exercises as a treatment model. This application assignment involves detailing the next phase of your clinical case notes regarding the intervention and follow-up, given the conversation that transpired in your most recent session, as recorded below:
Therapist: When you do the touching exercises, I want you to keep your minds focused on two things—what is feeling good, and what you would like to do or say to keep it feeling good. This means you will need to communicate with one another. Let your partner know what feels good. Most couples don’t do this, and it is much harder than you might think. How would you say you have communicated in the past about things you wanted sexually?
Bob: I don’t know what she wants. I told her, tell me what you want me to do.
Julie: But I feel like I’m giving him orders.
Therapist: But he is asking you to tell him.
Julie: Yeah, but any time I ask him to do something, he doesn’t do it.
Therapist: Do you mean sexually?
Julie: No (laughing); he listens better during sex.
Therapist: So, what stops you from telling him?
Bob: She always looks uptight.
Therapist: Let me hear more from Julie.
Julie: I’ve just never been comfortable telling him. I dated several men before my husband and could never say what I wanted. It just seemed like it was being selfish, and men might be turned off by it.
Therapist: You think it will mean you are selfish and turn Bob off? Where did you get that idea?
Julie: I don’t know. It’s always been my thinking.
Therapist: Bob, jump in here. Tell Julie how you would feel if she were to start telling you what she wanted.
Bob: I think it would be great. It would tell me she is interested. I never know what is going on in her head; maybe she likes what I do and maybe not.
Therapist: Say more; talk directly to Julie.
Bob: I want you to talk to me. It would help me if I knew you felt turned on, what you liked. The last thing I would think is that you are selfish. You would be giving me something I’ve wanted for years.
Julie: I’ll try.
Therapist: Just do your best. As I said, this won’t be easy. Start with a few words next time and keep building up. If you start to feel uncomfortable about talking, then talk about that (Weeks & Gambescia, 2000).
Directions:
- Give a description of sensate focus exercises. What are some goals behind the exercises?
- Highlight relationship factors, e.g., commitment, or feelings, e.g., pessimism, that can impact the sensate focus approach. Give suggestions on how such issues can be reframed.
- Explain the structure and application of sensate focus exercises that you would employ in assisting Bob and Julie.
- Outline the steps of the sensate focus part of the treatment and then the steps involving the transition to intercourse.
- Include any follow-up questions related to sensate focus exercises that will need to be asked by a therapist between sessions.
Your final product will be a Microsoft Word document of approximately 2–4 pages in length. Include the clinical case notes. Where appropriate, use the headings “subjective, objective, assessment, and plan (SOAP)” in describing your impressions and planned interactions/follow-up. Your responses should be written in a clear, concise, and organized manner; demonstrate ethical scholarship in the accurate representation and attribution of sources (i.e., in APA format); and display accurate spelling, grammar, and punctuation.
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