A qualitative study of Australian psychologists’ diagnostic questioning of clients’ sexual functioning: motivations from practitioner perspectives

ABSTRACT

Objective

Sexual health problems can be pertinent to psychological function/diagnosis and psychologists are key players in treatment and education regarding sexual health. Despite this, little evidence exists to determine if sexual dysfunction is explored during routine client intake interviews, when the client does not present with relationship difficulties, or from a specialist referral for sexual dysfunction. We aimed to explore psychologists’ decision-making around questioning of client sexual functioning through the lens of the Dual-Processing Model.

Method

This qualitative study assessed 16 registered psychologists working within Australia who answered an online questionnaire around their beliefs and clinical experiences of sexual health practice.

Results

Data was analysed using thematic analysis, revealing multiple themes favouring sexual health investigation. Main themes included risk management, relevance to clinical presentations, scope of practice, positive beliefs about asking, and competency beliefs. Primary barriers against sexual health investigation included perceived incompetence, organisational constraints, concerns around damaging rapport, sexual health not being relevant to the client’s needs, and perceptions around unethical practice.

Conclusions

This paper challenged the applicability of the Dual Processing Model to psychological decision-making, and suggested personal biases influence Australian psychologists’ sexual health questioning.

KEY POINTS

What is already know about this topic:

1. Sexual functioning is a key component of biopsychosocial functioning.

2. It is largely unknown to what extent Australian psychologists routinely include questions regarding client’s sexual functioning.

3. Previous research has indicated barriers to questioning include taboo, perceived lack of competence, lack of training and clinical considerations.

What this topic adds:

1. Our study found limited evidence that decision-making models influenced Australian psychologists’ willingness to ask questions regarding client sexual function.

2. Perceived lack of competence, lack of training/mentorship and ethical considerations proved barriers for Australian psychologists.

3. Further, psychologists’ personal biases may hinder their service delivery regarding sexual health.

KEYWORDS:

• Qualitative
• sexual health
• psychology
• clinical questioning
• dual processing model
• biases

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data available within the article or its supplementary materials.

Additional information

Funding

This project was provided by the University of the Sunshine Coast.