In our combined 30 years of experience training systemic therapists, we have often encountered students and colleagues who assume they need to (or perhaps simply prefer to) refer to other clinicians those clients who raise sexual issues in therapy. We think this is unfortunate, given that a systemic framework offers a unique and generative foundation from which to create positive sexual change for clients. Additionally, many brief therapists have been trained to never consider as a clinical issue a topic that clients themselves do not raise; this path unfortunately may give clients the impression that we are unwilling to address issues of intimacy. Because sex is both a physical expression and a passionate one, we may indeed be uncomfortable entering the bedroom with our clients. After all, we don't "know them that well." As one student commented recently, "What do you expect me to do? Just ask them, 'how's your sex life?' I can't do that!" However, the dramatic potential for sex to enhance intimacy and create new layers of passion renders the topic an enormous resource.

A number of different approaches to sex therapy have been proffered in the last thirty years, from behavioral (Wolpe, 1966), cognitive-behavioral (Ellis, 1966), quasi-behavioral (Masters & Johnson, 1966), and multimodal (Lazarus, 1988), to psychodynamic (Kaplan, 1979), Bowenian (Schnarch, 1991), object-relations (Scharff, 1982), hypnotic (Araoz, 1982), pharmacological (Kaplan, 1987), and systemic (LoPiccolo, 1989; Sanders & Tomm, 1989) orientations. However, prior to the publication of Quickies, few authors working in the Ericksonian-influenced tradition of brief therapy�for example, MRI (Watzlawick, Weakland, & Fisch, 1974), strategic (Haley, 1976), or solution-focused (deShazer, 1988) approaches�have specifically discussed the treatment of sexual difficulties (see, though, Erickson, 1991a, 1991b; Haley, 1986; Hudson & O'Hanlon, 1991). The previous absence of a well-delineated brief-therapy contribution to sex therapy may have had to do with the brief-therapy assumption that an interactive approach is simply applicable to all problems.

We find that traditional approaches to sex therapy are often pathologizing of people and their problems. We prefer to access the expertise and wisdom of our clients, pointing them away from seemingly terminal diagnoses and toward creative conversations that can allow new understandings of and possibilities for sexual desires and behaviors.

As family therapists, we are legally and ethically permitted to work with individuals and couples who request our help regarding their sexuality, but the designation "sex therapist" is reserved, at least in Florida, for those professionals who have completed a state-approved course of study in this specialization. We thus do not hold ourselves out as sex therapists, but rather as brief therapists who work with sexual issues.

References

Araoz, D. L. (1982). Hypnosis and sex therapy. New York: Brunner/Mazel.

de Shazer, S. (1988). Clues: Investigating solutions in brief therapy. New York: Norton

Ellis, A. (1966). Sex without guilt. New York: Lancer Books.

Erickson, M. H. (Speaker). (1991a). Sex therapy: The female. [J. Haley & M. Richeport, Eds.]. [Cassette Recording]. New York: Norton.

Erickson, M. H. (Speaker). (1991b). Sex therapy: The male. [J. Haley & M. Richeport, Eds.]. [Cassette Recording]. New York: Norton.

Haley, J. (1976). Problem-solving therapy. New York: Harper & Row.

Haley, J. (1986). Uncommon therapy: The psychiatric techniques of Milton H. Erickson, M.D. New York: Norton.

Hudson, P. O. & O'Hanlon, W. H. (1991). Rewriting love stories. New York: Norton.

Kaplan, H. S. (1979). Disorders of sexual desire and other new concepts and techniques in sex therapy. New York:   Brunner/Mazel.

Kaplan, H. S. (1987). Sexual aversion, sexual phobias and panic disorder. New York: Brunner/Mazel.

Lazarus, A. (1988). A multimodal perspective on problems of sexual desire. In S. R. Leiblum & R. C. Rosen (Eds.), Sexual desire disorders. New York: Guilford.

LoPiccolo, J. (Speaker). (1989). The reunification of sexual and marital therapy (Cassette Recording No. 89-08). Minneapolis, MN: National Council on Family Relations.

Masters, W. H., & Johnson, V. E. (1966). Human sexual response. Boston: Little, Brown.

Sanders, G. & Tomm, K. (1989). A cybernetic-systemic approach to problems in sexual functioning. In D. Kantor & B.

Okun, (Eds.), Intimate environments (pp. 346-380). New York: Guilford Press.

Scharff, D. E. (1982). The sexual relationship: An object relations view of sex and the family. Boston: Routledge & Kegan Paul.

Schnarch, D. M. (1991). Constructing the sexual crucible. New York: Norton.

Watzlawick, P., Weakland, J. H., & Fisch, R. (1974). Change: Principles of problem formation and problem resolution. New York: Norton.

Wolpe, J. (1966). Psychotherapy by reciprocal inhibition. Stanford: Stanford University Press.