Sexual Health and the EA Professional: Developing an Understanding of Sexual Health and Taking Steps to Recognize Its Importance Can Improve the Treatment of Clients with Sexual Health Concerns

Article excerpt

The relationship between the work environment and sexual health issues is a taboo topic in the United States and most countries. The employee assistance professional, however, needs a basic understanding of sexual health to address clients' concerns and provide appropriate assessment and referral services.

Consider the following: It is estimated that approximately 3-6 percent of the U.S. population struggles with sexual compulsivity/addiction behavior problems (sash.net). The use of the Internet at work for virtual sex is well documented (Cooper 2002), while the rise of social networking to cope with loneliness highlights the striving for human connection (Hu 2008). One in four women and one in six men report some type of sexual assault in their lifetime (Elliot, Mok and Briere 2004). Meanwhile, the increasing use of erectile dysfunction medications by both men and women underscores the importance of sexual health concerns for clients.

Taken together, these data suggest that sexual health issues are significant. Furthermore, most researchers believe these statistics actually underreport the incidence of sexual health concerns.

When faced with a sexual health issue, accurate conceptualization and awareness are important for appropriate treatment and care. It is not expected that the EA professional will provide these services; however, the quality and effectiveness of any referral can be improved by an awareness and assessment of sexual health issues.

DEFINING AND CREATING SEXUAL HEALTH

The field of sexology has been engaged in an ongoing discussion for the past 25 years to define sexual health (see Edwards 2004). If EA professionals are to conceptualize sexual health, it is important that they have a working understanding and definition of it.

The World Health Organization (2002) published a definition that highlights the multi-dimensional nature of sexual health. Sexual health, according to WHO, is a "... state of physical, emotional, mental and social well-being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences free of coercion, discrimination and violence."

The major weakness of the sexual health field (and of the many definitions that have been advanced) is the relative newness of the concepts. The exact nature of, and relationship between, the many variables of sexual health are complex and not always understood.

The chicken-and-the-egg phenomenon regarding causality between sexual health issues and other concerns highlights the difficulty in conceptualizing and treating sexual health problems. For example, does one's sexual functioning contribute to depression and anxiety, thereby resulting in chemical dependency? Or does chemical dependency as a form of self-medication of anxiety lead to sexual functioning issues, thus creating relationship concerns and, ultimately, depression?

THE SEXUAL HEALTH MODEL

This multi-faceted reality highlights the need for increased awareness of sexual health by the EA professional. In an attempt to better understand the definition of sexual health, Robinson and others (2002) created a model of sexual health that has 10 components. Of the 10 components, seven are relevant for the EA professional:

1. Talking about sex is a cornerstone of the Sexual Health Model. Often, feelings of shame and fear about sexuality lead the client to withdraw and avoid any discussion of sexual concerns. Appropriate assessment questions (tempered by clinical judgment) should be posed to help increase the accuracy of treatment placement. For example, when working with someone with a chemical dependency problem, asking about the relationship between his or her chemical use and sexual behavior might provide information that leads to better treatment placement. …