The topic of sex makes many people uncomfortable. Compound that with a physical disability like spinal cord injury, and you may feel left in the dark. The sexABILITIES program is specifically designed to address common questions and concerns about sexual health and disability. In an environment free of judgement and packed full of education, we aim to empower clients to explore a fulfilling and healthy sexual and reproductive lifestyle. This program aims to destigmatize intimacy and provide resources and education on appropriate tools and equipment to increase the frequency and satisfaction of sexual encounters for people with SCI.
sexABILITIES is a multi-disciplinary team of marriage and family therapists, recreation therapists, and nurses that specialize in relationships, intimacy, sexuality, and sex for people with and without physical disabilities. In our society, it is often taboo to discuss the nature of these topics, but a physical disability does not dehumanize a person. People with disabilities still have the same physical and emotional needs and desires. Therefore it is essential for our clients to have a trustworthy, respectable, and comforting experience.
sexABILITIES offers clients a safe and welcoming environment to explore the challenges they face in relationships, intimacy, sexuality, and sex that may be compounded by disability. Some issues we frequently address include but are not limited to: communication, emotional expression, intimacy techniques (positioning). Physical disability affects the entire human body and has the potential to lead to emotional and psychological burdens. At sexABILITIES, we utilize various modalities and techniques in effort to assist our clients to obtain a healthy intimate lifestyle.
· Explore the impact of SCI on sexual health and participation
· The importance of healthy relationships and sexual health
· Identify goals unique to the client/couple ify goals unique to the client/couple
· Psychosocial, emotional, physiological & physical difficulties
· Pharmacology (side effects & benefits)
· We address the barriers of participation through psychoeducation. We also discuss the use of adaptive equipment and pharmacology. Erotic toys may be useful to overcome physical difficulties, but individuals with SCI may feel embarrassed or have a lack of knowledge on which products would be appropriate for their needs
· Increase confidence to enter/re-enter the dating scene
· Self-esteem plays an important role in dating. It will not be unusual for people to have questions about your personal story. Understanding your personal boundaries and how to prepare yourself for the dating scene are explored through discussion and role-play activities
· Assertiveness training
· Caretaker stress management
· In a relationship with a person with SCI, roles may change. It is imperative for each person to learn how to effectively communicate their needs assertively versus being demanding. It is equally as essential for caretakers to implement effective stress management techniques for your personal health as well as the heath of the relationship
· Bowel, bladder and erectile dysfunction are the most common barriers to participation
· Learn correct technique
· Description & demonstration of procedures
· Common errors & inhibitions
· Males are more likely to require pharmacological and adaptive equipment modalities as well as more in-depth training for catheter management for increasing sexual participation.
· Women may require more psychological and adaptive equipment for positioning for participation. Understanding and being able to communicate your needs is essential for health, safety, comfortability and confidence to participation
· Physical & psychological barriers
· Conception (natural, IUI, IVF, etc.)
· Surrogacy, adoption, etc
· Depending on level of injury and intricacies of your situation, childbearing and rearing may become an additional area of stress. It is important to learn what resources and options are available as well as being mentally prepared to handle such options
Sexual health and education is an essential part of balanced rehabilitation programs for people with spinal cord injury because of the relationship to and impact on self-esteem, body image and motivation (Yun & Zubir, 2000). There is a need for specialized programming in the physical rehabilitation setting to educate and train marriage and family therapists as well as the multidisciplinary healthcare team to enhance their competence and confidence in addressing relationship and intimacy issues for people with SCI.
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