Handbook of Clinical Sexuality for Mental Health Professionals, 2nd ed

Handbook of Clinical Sexuality for Mental Health Professionals, 2nd ed

edited by Stephen B. Levine, MD; Candace B. Risen, LISW; and Stanley E. Althof, PhD. Routledge, New York, NY, 2010, 517 pages, $68.89 (paper), $130.00 (hardcover).

Mental health providers, including social workers, psychologists, and psychiatrists, all endure myriad hours of lectures and supervision during training. After formal training is over, many continue to get supervision and assistance on difficult cases, seeking experts’ insights into challenging patient issues.

The second edition of Stephen Levine’s Handbook of Clinical Sexuality for Mental Health Professionals effectively puts these experts in the reader’s living room, office, or supervisory session. This unique and meaningful text personalizes the experience of working with patients struggling with clinical issues of sexuality. Chapters are written from a first-person perspective and typically start with a "mini-bio" or explanation from the author(s) detailing what inspires their work. After thorough discussions of pertinent material, chapters often conclude with summaries of important points and routinely include authors’ wishes of "Good luck!" for the reader. This engenders a sense of encouragement and belonging, such that the reader feels that he or she has become a colleague with the author(s) and that all are in pursuit of the same goals: sensitive, comprehensive, and effective patient care. Throughout this volume, the authors are refreshingly transparent about their own therapeutic successes and failures, their evolving viewpoints over time, and their thoughts about various diagnostic criteria (particularly as related to the DSM framework). Historical perspectives are also particularly helpful for readers who do not have the benefit of the authors’ vast experiences. However, the true gems of this text are the vignettes that punctuate each chapter. These glimpses into patient experiences are invaluable for readers and help foster the "supervisory" feeling of this text by providing excellent examples of patient struggles and therapist responses.

Section I, Being a Therapist, covers the basics of how to listen actively and empathetically to patient stories and how to manage boundary issues when patients discuss intimate, provocative, or possibly embarrassing parts of their private lives. This section helps the reader face his or her fears of discussing sexual topics and sets the tone for the rest of the book. Core chapters that follow address basic development; definitions of love, sexual desire, and intimacy; issues of infidelity; sexual trauma and its ramifications; and male- and female-specific issues regarding sexual dysfunction.

Particularly meaningful chapters address sexual issues of the young and the old, sexual side effects of medications (more vast than even the most medically focused practitioners may realize), sexual ramifications of cancer survival, and paraphilias (where distinctions between paraphilic patients and criminals are aptly drawn). The chapters on sexuality in those with intellectual and other mental disabilities are especially poignant. One of the new chapters in this second edition, "The Gay and Lesbian Experience," provides basic and thoughtful definitions for clinicians and strives to debunk common misconceptions about gay and lesbian lifestyles. It also reminds readers to be vigilant regarding certain issues, including sexual struggles in adolescents and the tragedy of teen suicide.

Criticisms of this volume are few, given the complete and sensitive attention paid to so many critical topics in clinical sexuality. In the section Sexual Identity Struggles, some confusion may ensue regarding the differences between sexual orientation, sexual preference, and sexual activities. One hopes that readers are paying extremely close attention to the fact that orientation is not a choice, although preferences and specific sexual activities are. The only other criticism of this important section might be its placement in the book—it is the sixth of 7 sections. Placement of these topics earlier in the book might set a more inclusive and balanced tone for the entire work. Throughout this volume, however, it is palpably evident how strongly the authors feel about helping their patients and how the authors’ lives have been changed and enhanced by their work. The chapters provide stark, sometimes difficult, lessons about how critical it is to investigate sexuality and sexual issues with every patient—and how patients’ clinical outcomes can be shortchanged if clinicians fail to do so.

As noted in the preface to the first edition, included again at the beginning of this work, Stephen Levine’s goal was to provide an accessible, personal, and useful volume for mental health professionals seeking to treat patients with sexual health, relationship, or sexuality issues. Dr Levine, his associate editors, and his coauthors again have succeeded masterfully. This book should be a welcome addition to any mental health practitioner’s library.

Jeanne M. Lackamp, MD

[email protected]

Author affiliation: Case Western Reserve University School of Medicine, Cleveland, Ohio.

Potential conflicts of interest: None reported.

doi:10.4088/JCP.11bk07592

© Copyright 2012 Physicians Postgraduate Press, Inc.