Despite much progress in the past ten years, American medical schools have woefully inadequate sex education curricula. While some have a reasonable amount of lecture time, few have clinical opportunities for students to develop practical skills in working with patients who are struggling with sexual problems. It is my impression that the same is true in medical and gynecological residencies, as well as in graduate schools of psychology, counseling and social work. This book was specifically written to help fill that gap. This is a book for clinicians, and it will provide a wealth of practical clinical knowledge and skills in dealing with the gamut of patient's sexual concerns, problems and dilemmas. Twenty-four experts have contributed eighteen chapters which address both the common and unusual sexual issues encountered in practice. These include sexual concerns from childhood to old age; gender identity and sexual preference; sexual dysfunction, including that of the physically ill and disabled; counseling with students, premarital, marital, and divorced patients; fertility and infertility; and chap ters dealing with rape, incest and other sexual contacts between adults and children. Of particular importance are chapters on human sexuality in American minority popula tions, a chapter on alcohol, medication and other drugs, and a chapter on medical management of sexual problems in the gay population, a subject long-ignored by the profession. The focus on practical intervention and skill development is amplified by the concluding four appendixes devoted to patient management problems.

Inhalt

1. Sexual History Taking.- When to Amplify the Sexual History.- General Guidelines for Taking a Sexual History.- Taking a Sexual History.- Detailed Sexual History.- References.- 2. Problems in Sexual Functioning.- Evaluation.- Classification of Sexual Dysfunctions.- Treatment of Sexual Dysfunctions.- Treatment Follow-up.- References.- 3. Sexual Concerns of Childhood.- Parents' Sexual Concerns about Their Children.- Working Directly with Children's Sexual Concerns and Problems.- Summary.- References.- 4. Gender Identity and Sex-Role Stereotyping: Clinical Issues in Human Sexuality.- Sex-Role Stereotyping in Clinical Practice: Research Findings.- An Evolving Psychology of Sex Roles: Is Biology Destiny?.- The Acquisition of Sex Roles: Social-Learning Theories.- Psychoanalytic Theories and the Development of Gender Identity and Role.- Androgyny and Beyond.- Clinical Issues in Sex-Role Stereotyping and Sexual Functioning.- Conclusion.- References.- 5. Adolescent Sexuality and Pregnancy.- Adolescent Pregnancy.- The Dilemma of Pregnancy.- The Putative Father.- What the Future Holds.- Conclusion.- References.- 6. Sexual Counseling in Student Health.- Sexual Problems of Students.- Management of Specific Sexual Problems in Students.- Summary.- Appendix: Sources for Audiovisual Materials.- References.- 7. Gender-Identity Problems.- Cases.- Variation in Sex Role (Interests and Attitudes).- Gender Identity.- Evaluation.- Therapy.- Common Errors in Management.- Summary.- References.- 8. Incest and Other Sexual Contacts between Adults and Children.- Violent Sexual Assault of a Child by a Stranger.- Incidental, Nonviolent Sexual Contact with a Stranger.- Incidental or Occasional Contact with Someone Known to the Child.- Sexual Contact within the Family-Incest.- Methods ofIntervention.- Common Errors in Management.- Summary.- References.- 9. Premarital Counseling.- Counseling of the Sexually Inexperienced Couple.- Counseling of the Sexually Experienced Couple.- Counseling of Couples Who Are Already Pregnant.- Counseling of Midlife Couples Planning Marriage.- Counseling of Couples Planning Remarriage.- Counseling of Handicapped Couples Planning Marriage.- Summary.- References.- 10. Caring for Victims of Rape.- Myths and Misconceptions about Rape.- The Caregiver's Response: Common Errors in Interventions with Victims of Rape.- The Victim's Response to Rape and Its Effects upon the Relationship with the Caregiver.- Treatment Interventions in Rape.- Conclusion.- Appendix: Treatment Interventions in Rape.- References.- 11. Fertility, Infertility, and Sexuality.- Pregnancy and Sexuality.- Contraception and Sexuality.- Abortion and Sexuality.- Infertility and Sexuality.- Hysterectomy and. Sexuality.- References.- 12. Sexual Dysfunctions in the Physically Ill and Disabled.- Definition of the Problem.- Secondary Components to the Sexual Dysfunction.- Evaluation of the Problem.- Principles of Treatment.- Diseases and Disabilities That May Influence Sexual Function.- Management of Sexual Dysfunctions.- An Integrative Approach to the Management of Sexual Dysfunctions.- State-of-the-Art Management of Sexual Problems in the 1980s.- Development of the Sexual Management Team.- Summary.- References.- 13. Human Sexuality and the American Minority Experience.- Culture and the American Minority Experience.- Black Sexuality: Myth and Reality.- Psychosexual Issues in Asian Cultures.- Hispanic Americans.- The Culture of Poverty.- References.- 14. Separation and Divorce: Crisis and Development.- Multicausal Factors in Marital Crises.- Sex and FamilyLife.- Emotional and Physical Illness Resulting from the Stress of Separation and Divorce.- Phases of Separation and Divorce.- Sexual Patterns during Separation and Divorce.- Children and Divorce.- Summary.- References.- 15. Alcohol, Medications, and Other Drugs.- Folk Beliefs and Use of Drugs.- Available Knowledge Regarding Drugs and Sex.- Effects of Alcohol and Drug Abuse on Sexuality.- Prescribed Medications.- References.- 16. Aging and Sexuality.- Cultural Myths and Individual Attitudes.- Normal Sexuality.- The Components of Sexual Dysfunction.- Models of Assessment and Intervention.- Medications and Sexual Functioning.- Disease States that Affect Sexual Functioning in the Elderly.- Widowhood and Sexuality.- References.- 17. The Marital Relationship: Adapting an Old Model to Contemporary Needs.- A Dynamic Behavioral Communication Model of Marital Discord.- Types of Communication Deficits.- Requirements for Effective Communication and Relationship Satisfaction.- Contemporary Trends in Marital Intervention.- References.- 18. Gay Patients in the Medical Setting.- Objectives.- Myths and Facts.- The Clinical Interview.- Sexual Behaviors.- Sexual and Sex-Related Problems.- Interventions.- Referrals.- Conclusion.- Resources.- References.- Appendix A: Parent Patient Management Problem.- Appendix B: Spinal Cord Patient Management Problem.- Appendix C: Nursing Home Patient Management Problem.- Appendix D: Prostatitis Patient Management Problem.