Counseling Commons^™

Intersectionality And Infertility: A Framework For Culturally Responsive Mental Health Counseling, Nouna Jalilzadeh

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Infertility affects approximately 11% of women of reproductive age in the United States, with 41–46% developing symptoms consistent with posttraumatic stress disorder (PTSD), a prevalence substantially higher than in the general population. Because existing research and clinical literature predominantly focus on female infertility experiences, this article centers women while acknowledging that infertility profoundly impacts individuals across all gender identities. Despite this, mental health counselors frequently lack training in culturally responsive reproductive mental health care, leaving marginalized clients, including racial and ethnic minorities, low-income individuals, immigrants, LGBTQ+ people, and rural residents without adequate support. This theoretical article applies intersectionality theory to …

Considering Consent: What We Can Learn From Bdsm, Jennie Pless, Kate A. Morrissey Stahl, Madison Reeves

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Consent is a pivotal, defining feature of BDSM. As such, much can be learned by examining conceptualizations of consent among those who engage in BDSM. Using a mixed methods approach, this study explores how 92 BDSM practitioners conceptualize and practice consent. Participants defined consent as an ongoing, enthusiastic, and voluntary agreement. We examine how BDSM practitioners ensure consent, educate others about consent, and handle consent violations. Findings include strategies for consent education and sexual assault prevention. This study highlights the importance of greater awareness and understanding of BDSM and consent.

Transitions From Traditional Gender And Sexuality Roles To Non-Conforming Identities Through Performance Art: A Multiple Case Study, Adrianne Trogden, Dorin Captari-Scirri

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This qualitative multiple case study examined how two individuals from religiously conservative households navigated transitions from traditional gender and sexuality roles to non-conforming and queer identities through performance art. Using case study methodology, five interconnected themes emerged: Performing Gender - pressure to "act masculine," Performing Sexuality – pressure to "act straight," Performing Art - freedom of expression of gender and sexuality on stage, Shame and fear transformed when accepted sexuality, and Finding one's voice and identity - gender and sexuality. Stage performance art served as an underlying foundation, providing a transformative space for safely exploring previously constrained gender and …

Sex And Stigma: The Cisgender Woman’S Experience, Regin Dean, Kara Schneider, Lucas M. Perez, Tae Joon Kim, Ryan G. Carlson

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This study examines how sexual stigma and societal expectations affect the self-esteem of college-aged women within the context of casual sex. Using a qualitative, thematic design, participants were recruited through purposive sampling and interviewed using semi-structured protocols. Thematic analysis revealed three overarching domains: Identity & Self-perception (empowerment, femininity and body image, fluidity), Social Factors (familial and cultural expectations, shame and comparison, formative relationships), and Developmental Influences (social media, scrutiny, knowledge gaps). Findings demonstrate how stigma is internalized and reinforced through interpersonal and media influences, underscoring the need for counseling practices that address both individual wellness and systemic advocacy.

Purity Culture And Sexual Shame, Dr. Amanda Gray, Dr. Kat R. Klement

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

We investigated the relationship between Christian purity culture (PC) exposure/endorsement and sexual shame in 1,273 participants. Purity culture (PC) is a belief system predicated on sexual abstinence until heterosexual marriage and traditional gender roles. Correlational data showed that PC exposure was associated with higher sexual shame, particularly among women, and only among those who no longer endorsed PC. However, we did not find a causal relationship between PC exposure and sexual shame. Based on these findings, we provide recommendations for countering sex-negative messages during adolescence to improve healthy sexual development and better health and relationship outcomes.

Impact Of Test Conditions And Demographic Variables On Response Patterns In The Sdi-R 4.0, Cyrus R. Williams Iii, Kyle Lincoln, Robert D. Loper

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This study investigates the impact of demographic variables and test conditions on response patterns within the Sexual Dependency Inventory-Revised (SDI-R 4.0), specifically focusing on their predictive value for high inconsistency, high exaggeration, and low underreporting scores. Employing logistic regression analyses on data from 2,212 participants, the findings reveal that pre-test delay time, age, and gender significantly influence these outcomes. These insights underscore the necessity for uniform testing conditions for the SDI-R 4.0 and the incorporation of demographic considerations in the interpretation of this and other sexual dependency assessments.

Keywords: Sexual Dependency Inventory, test conditions, demographic factors, test response patterns

The Connection Between Infidelity And Ptsd, Marissa Anderson

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This literature review addresses infidelity and the current limitations of treatment approaches due to incongruences in definitions and clinical acknowledgment. Infidelity, as a phenomenon, is poorly understood due to varying morals, experiences, religious and cultural influences that alter personal and relational constructs and expectations specific to infidelity. One commonality among those who experience infidelity is the lingering traumatic impact due to the violation of personal and societal convictions observed by the betrayal of trust, loyalty, commitment, self-worth, power imbalances, and religious beliefs. However, current literature and approaches to infidelity fail to address the traumatic impact of discovering infidelity within a …

Individuals And Couples With Infertility: Quality Of Life, Relationship Satisfaction, Resilience, Depression, And Shame, Niko C. Wilson, Sejal Barden

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This study examined the relationship between fertility-related quality of life, relationship satisfaction, resilience, depression, and shame in individuals and couples with infertility (N = 556). Using structural equation modeling (SEM) and the actor-partner interdependence model (APIM), the study assessed gender covariates and dyadic influences in couples (n = 52). SEM results showed fertility-related quality of life impacted resilience, depression, and shame, while its relational aspect influenced relationship satisfaction. APIM identified partner effects on relationship satisfaction and shame. Findings provide insights for counseling practices, promoting relationship well-being in couples facing infertility.

Development And Evaluation Of The Sex Positivity Inventory For Counselors, M. Ashley Burks, Jennifer Gerlach, Joshua C. Watson

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

The purpose of the study was to clarify the definition of sex positivity and identify sex-positive attitudes, knowledge, and skills through the development and evaluation of the Sex Positivity Inventory for Counselors (SPI-C). The exploratory factor analysis supported a six-factor, 34-item scale, accounting for 32.9% of the variance within the study. The SPI-C had an excellent internal consistency of 0.96 and consisted of the following factors: 1) Procedural Sex Positivity, 2) Comfortability with Sexuality, 3) Perceived Sex Positivity, 4) Fundamental Sex Education, 5) Sexological Worldview, and 6) Unconditional Positive Sexual Regard. Implications for practice, counselor education, and supervision are discussed.

The Counselor Educator’S Guide To Sex Positivity: Ten Strategies For Enhancing Teaching And Supervision, Lorraine J. Guth, Ashley R. Niccolai, Moirin Reynolds, Dana Kirkpatrick

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Despite positive shifts in cultural conversations surrounding sex, there is a lack of institutional focus on sexuality training in counselor education. This is surprising, given that sexuality is an inherently multicultural issue, and a sex positive framework aligns with counseling’s core values which include social justice, resilience, and wellness. We discuss the relevance of incorporating sex positivity in counselor education and provide ten strategies for counselor educators to integrate sex positivity into their teaching and supervision. These recommendations include engage in self-reflection to examine comfort with sexuality; examine curriculum to ensure sexuality objectives are infused in courses; use inclusive language; …

Transgender Meta-Analysis Study On Healthcare Affirming Care, Beck A. Munsey, Ryan Holliman

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This study explored the extent to which educational interventions impact knowledge, attitudes, and comfort, of healthcare providers in treating transgender patients through a meta-analysis. Twenty studies that met criteria for inclusion were selected for the study. Research suggests current methods of training healthcare professionals positively impacts knowledge, attitudes, and comfort, but does not decrease transphobia, leading to negative impacts on transgender patients’ care in healthcare settings. The authors highlight some ways training programs can add training modules for future researchers to look at specifically to attitudes and believes about healthcare professions serving transgender patients.

The Correlation Of Adverse Childhood Experiences And Pornography Consumption Among Males, Branden Henry, Corinne W. Bridges, Sidney L. Shaw

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Since 1999, significant research has been devoted to understanding how adverse childhood experiences (ACEs) correlate with a variety of negative health and behavioral outcomes. During this same time, pornography consumption had increased dramatically. Although there were studies that examined the relationship between various variables found in the ACEs questionnaire and pornography consumption, there were no studies that utilized the ACEs questionnaire to examine the relationship between ACEs and pornography consumption and age of exposure. The purpose of this cross-sectional, correlational study was to identify the relationship between ACEs, the age of exposure to pornography, and pornography consumption among adult males. …

Content Analysis Of U.S. State-Level Legislation Impacting Gender-Affirming Practice In Schools, Ashton Keys, Isabel C. Farrell, Amanda Dediego, Caroline Schreder, Kyle Neal, Whitney White

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

In recent years, there has been an increase in legislation that limits access to resources and affirming environments for LGBTQ+ individuals in the United States. This research aimed to identify trends in legislation at the state level impacting gender-affirming school counseling services in the United States. This study represents a content analysis of 225 pieces of state-level legislation from 2023 affecting LGBTQ+ youth in schools. Legislation largely created limitations on use of affirming pronouns for youth in school, availability of appropriate restrooms and changing facilities for transgender and gender expansive youth, and curriculum in schools addressing gender and sexuality.

Educating The Educators: Increased Sexuality Training For Counselor Educators, Joshua C. Taylor

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

A robust body of literature has identified the need for counselors-in-training (CITs) to receive additional training in sexuality counseling. Growing efforts to identify efficacious training strategies have also been well-documented in the literature. These suggested updates have implicitly increased the counselor educator's role in delivering strategies to promote sexual counseling competence for CITs. Unfortunately, there is a dearth of literature regarding the adequate preparation of counselor educators in providing sexuality education. This article will underscore the counselor educator’s role in facilitating competence in sexuality counseling for CITs and provide a model for infusing sexuality counseling into doctoral curriculum.

The State Of Sexuality Counseling Training In Counselor Education, Amber L. Pope, Matt B. Siroty, Stefan Vasic, Julia Lancaster

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Sexuality counseling training remains underdeveloped and lacks standardization across counselor education programs in the United States. We examined the integration of sexuality counseling in Clinical Mental Health Counseling (CMHC) programs. Out of 191 CMHC programs, 45% offered a standalone course and only 15.2% required one. We also performed summative and latent content analyses on the course descriptions to review the primary content of sexuality counseling courses. Content analysIs revealed course content largely focusing on sex positivity and inclusivity, though invalidating and potentially stigmatizing language persists. We conclude with implications for counselor education and future directions for research.

A Sex-Positive, Contextual Approach To Children’S Sexual Development, Ben T. Willis, Leah G. Talarico, Amber Pope

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Sexuality is a multifaceted topic that many counselors feel under-equipped to handle with their clients. Working with sexual aspects is often avoided, especially with younger clients. The purpose of this conceptual article is to provide a framework for understanding and working with children on sexuality-related topics. A positive, contextualized approach to sexuality is offered to understand, assess, and intervene with different developmental levels. We conclude with a case study to demonstrate application of the contextualized model in family counseling.

The Social Determinants Of Sexual And Reproductive Health In Integrative Sex And Couples Counseling: A Structural Competence Perspective, Ayla J. Goktan, Melissa C. Henry

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

The Multicultural and Social Justice Counseling Competencies (MSJCC; Ratts et al., 2015) call for counselors to address equity issues via social justice and advocacy. One equity issue relevant to counseling sexology is sexual and reproductive health inequities. This article applies the social determinants of sexual and reproductive health (SDSRH) to counseling sexology, specifically integrative sex and couples counseling, to address health inequities. A fictional case study incorporates the SDSRH from a cross-theoretical structural competence perspective. Future research should further elaborate SDSRH frameworks and evaluate the efficacy of their clinical applications.

Predictors Of Trauma Symptoms In Adults Living With Hiv: The Role Of Social Connectedness And Sexual Orientation, Melissa Zeligman, Taewon Kim, Jamian Coleman, Moneta Sinclair, Rico Curtis-Davidson

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Human immunodeficiency virus (HIV) has claimed over 740,000 lives in the United States since the 1980s, and further brought a host of mental health concerns, including posttraumatic stress disorder (PTSD), primarily brought on by the discrimination and stigma felt by people living with HIV (PLWHA). Social connectedness may serve as a buffer to the trauma often felt by PLWHA. However, rejection and discrimination can limit access to this needed support, especially for sexual minorities living with HIV. The present study (N = 396) examined relationships between social connectedness, trauma symptoms, and sexual orientation for PLWHA. Results showed that social …

Association For Counseling Sexology And Sexual Wellness Exemplary Practices For Counseling Sexology And Sexual Wellness, Amber L. Pope, Brean'a M. Parker, Bianca R. Augustine, Clark D. Ausloos, Juliana J. Lytle

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

In this document, we present exemplary practices for counseling sexology and sexual wellness. These professional guidelines advance practice, research, and education in sexuality and sexual health within the counseling profession. The exemplary practices are grounded in critical theories to center the experiences of diverse clients, contextualize the role of culture, environment, and history in shaping our sexualities, and celebrate varied ways of being. We detail 12 exemplary practice areas for sexuality counseling across the following domains: a) attitudes, beliefs, & understanding of historical influences; b) knowledge; c) counseling skills; d) action and advocacy; and e) counselor education and supervision.

Objectification Of Others Scale: Confirmatory And Exploratory Factor Analysis In A Sample Of Emerging Adults, Zachary D. Bloom, Shedeh Tavakoli, Madelaine Romito

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

The objectification of others is an important phenomenon in the cycle of objectification. However, few instruments measure the construct of other-objectification. This study examines the psychometric properties of Objectification of Others Scale using a sample of emerging adults (N = 1,584). Two random subsamples (n = 792) of the dataset were used to conduct exploratory and confirmatory factor analyses, resulting in a two-factor model that explained 72.37% of the variance. We address limitations of the instrument and make recommendations for future research.

Does Medical School Prepare Doctors To Treat Sexual Health?, Sonjia Kenya, Breanne Young, Fabiola Joseph, Olveen Carrasquillo

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Does Medical School Prepare Doctors to Treat Sexual Health?

Abstract

Introduction: Sexual function is a normative process warranting the equal attention of preventive and treatment services throughout the lifespan. Despite growing recognition of the value of human sexuality in clinical settings, there is no standardized sexual wellness curriculum universally administered in medical schools. Accordingly, many current and future physicians feel underprepared when taking care of patients’ sexual health needs.

Methods: To strengthen sexual health knowledge among medical students in Miami, we conducted a brief workshop in February 2020 and March 2021. The workshop provided an introductory overview of the physiology …

Sexuality, Sex Education, And Intellectual Disability: Guidance For Counselors, Julie C. Hill, Jill M. Meyer, Lindsay E. Stokes, J.C. Ausmus, Brandon Worthey, Jamie Carney

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Sexual health and sexuality can be an important component of an individual’s identity. Sexual health and sexuality are a vital part of an individual’s quality of life and overall health and well-being. Individuals with intellectual disabilities have been viewed as asexual, lacking sexual interest, or have an inability to engage in sexual activity. These views have led to individuals with intellectual disabilities to be excluded from sexual education programs or lack appropriate knowledge of sexuality, sexual health, and healthy relationships. It is important for parents, medical providers, mental health professionals, and caregivers to have the knowledge needs to have conversations …

We Are Family: Queer And Transgender Family Building, Jennifer M. Gess, Nattalie Wolff-Tseng, Kaitlin J. Phelps, Madison Morley

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

LGBTQ+ people experience resiliency and discrimination when attempting to build families. There are massive systemic barriers and oppressive walls LGBTQ+ people face when forming either a blended family, trying at-home insemination, using assisted reproductive technology, working with a gestational carrier, or attempting to become a foster parent or adopt a child. Queer reproductive justice provides a foundation for counselors to support clients by using affirmative counseling, providing positive mandatory interactions clients are ordered to during family building, and advocating with and on behalf of their LGBTQ+ clients building families.

Can A Course On Sexuality Counseling Increase Empathy When Working With Sex- And Gender-Minoritized Individuals?, Betty Cardona, Robinder P. Bedi

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This study examined whether a sexuality counseling course could increase self-perceived empathy for working with Sex and Gender minoritized (SGM)individuals. Forty-two students enrolled in a sexuality counseling course completed empathy assessments prior to starting the course and after completing it. Statistically significant increases in empathy towards gay/lesbian, bisexual, and transgender individuals were found (moderate to a large effect sizes). Results indicate that, at least under some circumstances, empathy levels for SGM individuals in counselors-in-training (CITs) could be increased through coursework. Increases in practitioner empathy for SGM individuals can translate into lower uniliteral termination rates and better counseling and psychotherapy outcomes.

Sexological Ecosystemic Assessment: A Systems Approach To Understanding Sexual Issues In Individuals And Couples, Stephanie Buehler

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Sexuality is a complex construct made up of the influence of systems upon the individual and counterinfluence of the individual upon systems, which can make sexual history taking problematic. The adaptation of Bronfenbrenner’s developmental ecological systems model has been employed to create a Sexological Ecosystemic Assessment. The Sexological Ecosystemic Assessment is described as a means of gathering and organizing information about an individual’s sexual development and current sexual expression across five subsystems that range from the microsystem, wherein interactions take place among and between family members and close caregivers, to the chronosystem, which is the effect of time across the …

Special Issue 2022 Full Issue, Journal Of Counseling Sexology & Sexual Wellness: Research Education, And Practice Jcssw

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

No abstract provided.

Transgender College Athletes: A Special Commentary, Sonja Lund, Tiffany M. Bordonada

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Recently, multiple bills from various states have attempted to ban transgender athletes from participating in sports. Guided by misinformation, these bills and policies set a dangerous precedent that is overall harmful to the well-being of trans athletes. This article discusses clinical, research, training, and advocacy priorities that should be addressed to protect the rights of trans athletes.

Sex-Positive Clinical Supervision: A Special Commentary, Beda A. Bjorn

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This commentary focuses on clinical competencies, research frameworks, training implications that elevate the meta-competence awareness for the clinical supervisor. There is an identified need to expand sex-positive clinical supervision guidelines. The supervisory setting is created for the safety and personal-professional growth of the supervisee, where it is an opportunity to conceptualize the thematic development of our clinical evolution. In this space, we set a foundation for clinical frameworks to guide the applicability of specific intervention methods and strategies that allow for the critical formulation of a healthy therapeutic outcome. Without established and robust sex-positive frameworks in supervision, the clinical supervisor …

Supporting Mental, Emotional, And Sexual Wellness For Lgbtq+ College Students: A Special Commentary, Devyn Savitsky, Madeleine Stevens, Mahmoud Yacoub

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

This brief commentary addresses the importance of campus-wide sexual health initiatives for lesbian, gay, bisexual, trans, queer, and other sexual and affectional identities (LGBTQ+) college students. LGBTQ+ college students in the emerging adulthood life stage are particularly susceptible to stigmatized, inequitable physical and mental healthcare, making the need for intentional and affirming support from college counselors, on-campus healthcare providers, and student affairs professionals essential. This article addresses LGBTQ+ friendly communication strategies, specific counseling modalities for work surrounding LGBTQ+ college student sexual health, implications for counselor education and supervision, as well as ongoing research priorities for college counselors. Because sexual health …

Abstinence-Only Sex Education In Public Schools: A Special Commentary, Julianna Williams

Journal of Counseling Sexology & Sexual Wellness: Research, Practice, and Education

Abstinence Only Until Marriage (AOUM) programs, also known as Sexual Risk Avoidance (SRA) programs, are non-comprehensive, religion and values-based programs that are still widely used, and supported by government funding, in schools around the United States of America. Content of these programs include messages of misogyny, heteronormativity, and racism, among others. Existing research has indicated that sex education programs lack efficacy in prevention or reduction in teen pregnancy and STI infection. However, little research has investigated the potentially harmful impact of biased messaging to long term sexual and mental health and well-being. In this commentary, I highlight some of the …