Book Review: Sexual Disorders: Perspectives on Diagnosis and Treatment

Treating sexual disorders can be a multifaceted clinical challenge that clinicians need to know how to address. To appropriately treat these disorders, clinicians must take into consideration not only the client’s presenting problem but also their history, physical health, past and current relationships, and behaviors in a multicultural context. Diagnosing and treating these disorders are important mental health issues that are embedded in a complex web of bio-psycho-social influencing factors. Sexual disorders can occur in any of the three phases of the sexual cycle, which include desire, arousal, and orgasm and can have both personal and interpersonal consequences for clients (Masters & Johnson, 1970). In addition, sexual disorders can occur during any phase of the life cycle and can be either permanent or temporary. These disorders can arise for a variety of reasons, for which a multimodel or eclectic clinical approach of treatment may be most appropriate. To provide the best practice treatment for clients, sexual disorders must be considered in a multicultural context that are often excluded from formal higher education environments and clinical training. Although this formal training is not currently offered by most graduate counseling or therapy programs, clinicians learn specific clinical approaches through independent research and reading to better assist their clients with sexual complaints. Despite the absence of sexual health from many higher education graduate programs, there is certainly no lack of information about sex from sources such as the media and Internet. Yet when a client complains of a sexual problem, it is the job of the clinician to organize all of the information, or misinformation, available to best assist their client. Peter Fagan’s Sexual Disorders: Perspectives on Diagnosis and Treatment offers clinicians a nosology of sexual health disorders and behaviors to assist in the evaluation and treatment of these often-overlooked clinical issues. In this text, readers are provided with four perspectives from which they may view clients’ sexual complaints including the disease, dimension, behavior, and life story perspectives. These four perspectives are an extension of the work of McHugh and Slavney (1998), who wrote The Perspectives of Psychiatry, which was originally applied to psychiatric disorders. Rather than highlight disparities, McHugh and Slavney sought to integrate the treatment modalities of different mental health disciplines including counseling, psychiatry, social workers, and psychology. This integration provides opportunities for multiperspective discussion and debate of clinical cases without competing for “the right” treatment modality. It allows clinicians to work as part of an interdisciplinary team to provide the most appropriate treatment for each individual case. Fagan’s work extends this model of integration of the four clinical perspectives to the specific topic of sexual disorders. Fagan’s book consists of seven chapters that can be conceptualized into four sections. The first section includes a basic overview of the four most common clinical perspectives currently used to treat sexual disorders. This allows the reader to become more familiar with each perspective, without being inundated with too much information, and to understand how each perspective relates to the therapeutic process. The text also offers clinical examples that demonstrate how to apply each perspective to particular cases. In the Introduction, as well as the subsequent chapters, Fagan provides an overview in table format that compares and contrasts several dimensions of the four perspectives, which helps to clarify the logic, client responsibilities, and associated treatment goals of each perspective. This table serves as a reminder of the other perspectives and of the goal to integrate aspects of each into the therapeutic process as the reader delves into more detail about one specific perspective. This table is an excellent resource