Clinical reviews editorial: discovering connections

Abstract

We have all been there – reading through multiple content tables, scanning abstracts... looking for a semi-quick answer to the question, “Is this article going to give me a good suggestion for helping with my clients’ concerns?” As sexologists, it is always a bit of a battle to bridge the gap between research and practice. This is true for many disciplines, but in the field of sex we often find ourselves mixing the two and yet not distinctly identifying how a research outcome can be applied in “real life,” nor how a clinical application can be applied to (or from) the next big break through. While a brief editorial is not able to cover or explain all of the applications – a summary of sorts may be beneficial, especially if it attempts to bridge a connection. In this issue of Sexual and Relationship Therapy, there is a wide range of articles spanning topics such as menopause, desire and functioning, teaching sex therapy, transgender relationships, sex workers, and assessments. There are qualitative, quantitative, and even mixed methods studies represented – all providing incredible insight. As I reviewed the articles in this issue, I saw a very general overlap related to permission-based work in sexual and relationship therapy, which will be the theme of this first Clinical Reviews Editorial. Permission-based therapy and interventions is nothing new, but the way in which it is being adapted to today’s clientele is under development (Belous et al., 2019a). Historically, permission was utilized in sex therapy to free clients from the burden of social oppression by providing the “okay” to engage in sexual experiences that they were interested in – we know this as the first stage/step of the PLISSIT [permission, limited information, specific suggestions, and intensive therapy] model developed by Jack Anon in 1976. This original model was expanded in 2007 by Taylor and Davis to incorporate an extended version of permission throughout the model – giving permission (and getting it) at each step. This type of work, where a client’s autonomy and ability to retain their own power of choice, is incredibly important to ensuring positive outcomes and effective treatment. Permission work includes honoring the client’s ability to choose what to disclose, at what pace, and ensuring continued consent in the conversation and therapy process. It is actually a quite simple task and is directly related to enthusiastic consent in sexual activity practices (Coy et al., 2016). Throughout, and often, the therapist should gain the permission, check in with the client that the topic is still okay and that they are willing to continue, and that everything is going in a direction in which they are comfortable. If the client is not comfortable or unwilling to continue – their wishes should be honored, and a pause is placed on the therapy topic until the client is