Clinical psychologists’ views about talking to people with psychosis about sexuality and intimacy: a Q-methodological study

Abstract

Sexual and relationship needs of people with psychosis are generally overlooked despite established psychosocial benefits and reduced risk of relapse. Despite mental health professionals’ reluctance to initiate conversations about sexuality and intimacy with service-users, people with psychosis and their support networks have indicated their desire for professionals to address intimate topics. Clinical psychologists are specifically trained to address complex psychological issues; however, no research to date has explored their views around discussing sexuality and intimacy. Q-methodology was used to explore clinical psychologists’ personal and professional views about discussing sexuality and intimacy with people with psychosis. 27 clinical psychologists completed Q-sorts. Varimax rotation revealed three factors with distinct views; a majority perspective that highlighted the normality of sexuality and intimacy for people with psychosis and the acceptability of such conversations in clinical work for practitioners, a view focused on concerns about the appropriateness of discussing sexuality and the possibility that conversations could lead to increased risk, and a view that related to concerns about competency in addressing intimate subjects. The practical and clinical implications are discussed in terms of training need and limited access to sexual health services.

Keywords:

• Intimate relationships
• sexual need
• psychosis
• mental health
• discussing sexuality
• psychological assessment

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Notes on contributors

Daniel J. L. Southall

Daniel J. L. Southall is a clinical psychologist working in adult acute inpatient services. His main interests are in the psychological and social factors underpinning recovery from psychosis.

Helen A. Combes

Helen A. Combes is a clinical psychologist and principal clinical lecturer at Staffordshire University. Her main interests are in sexuality and people with learning disabilities and the application of single-case methodology, in particular Q-methodology.