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SEXUAL HEALTH Abel Villarreal MOT, OTR Raul Rosales OTR Lauren Partridge COTA.

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Presentation on theme: "SEXUAL HEALTH Abel Villarreal MOT, OTR Raul Rosales OTR Lauren Partridge COTA."— Presentation transcript:

1 SEXUAL HEALTH Abel Villarreal MOT, OTR Raul Rosales OTR Lauren Partridge COTA

2 SEXUAL HEALTH Objectives Increase knowledge of sexual health as it relates to a specific diagnosis. Increase competence in recognizing and assessing sexual health deficits. Increase competence in developing treatment intervention for an disabled individual with a sexual concern. Increase confidence in addressing sexual health issues.

3 PRE TEST Does bibliotherapy help erectile dysfunction. What is vaginismus? Which level of spinal cord is responsible for erections and lubrication. Would an individual with a CVA have difficulties with reflexogenic sexual components. Do women team rope?

4 SEXUAL HEALTH AOTA Frame Work- Domain- Process 3 rd Edition

5 FRAMEWORK DOMAIN & PROCESS 3 rd Edition Occupations Sexual Activity: engaging in activities that result in sexual satisfaction and/or meet relation or reproductive needs.

6 SEXUAL HEALTH AND OT E.M. Andamo states that “ sexual function should be included in the OT evaluation as it relates to the identification of the patient’s abilities and limitations in his daily living necessary for the resumption of his various roles.”

7 SEXUAL HEALTH AND OT Couldrick L., argues “with awareness and skill development, OT practitioners can affirm sexual identity, they can listen, and, with sometimes simple measures, they can address issues that fall within their professional roles.”

8 SEXUAL HEALTH World Health Organization Defines sexuality as a central aspect of being human throughout life and encompasses sex, gender identities and roles, sexual orientation, pleasure, intimacy, and reproduction.


10 JAR

11 FRAMEWORK CLIENT FACTORS Values, beliefs, spirituality Body functions: Body structures

12 SEXUAL HEALTH Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles, and relationships.

13 CLIENT FACTORS Values - Acquired beliefs and commitments derived from culture, about what is good, right, and important to do Beliefs - Cognitive content held as true by or about the client Spirituality - “The aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred”

14 PERFORMANCE SKILLS Positions - positions self an effective distance from task objects and without evidence of awkward body positioning Bends - Flexes or rotates the trunk as appropriate to the task to grasp or place task objects out of reach or when sitting down Manipulates - Uses dexterous finger movements, without evidence of fumbling, when manipulating task objects Coordinates -Uses two or more body parts together to manipulate, hold, and/or stabilize task objects

15 GROUP ACTIVITIES Values and beliefs: Group 1: Masturbation Group 2: Prostitution Group 3: Thoughts about MR clients having sex Group 4: Thoughts about SCI females having babies Group 5: Oral sex


17 SEXUAL HEALTH Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, ethical, legal, historical, and religious and spiritual factors


19 RIDDLE What is greater than God, more evil than the devil, the poor have it, the rich don’t need it, and if you eat it you’ll die?

20 SEXUAL HEALTH Normal Human Sexual Response Phase 1: Excitement (desire) Phase 2: Plateau (arousal) Phase 3: Orgasm Phase 4: Resolution


22 NORMAL SEXUAL RESPONSE Excitement Phase: physiologic reactions occur as a result of somatosensory or psychogenic stimulation. In females, the nipples become erect, the vagina swells and becomes lubricated, the clitoris and the labia minora and majora swell. In males, the penis grows erect and the testes rise.

23 NORMAL SEXUAL RESPONSE Plateau phase: respiration increases, blood pressure and heart rate increase. In females the orgasmic platform forms having vasocongestion of the outer two thirds of the vagina. In males the Cowper’s gland secretes preejaculatory fluid.

24 NORMAL SEXUAL RESPONSE Orgasm Phase: In both sexes, peak pulse rate, blood pressure and respiration increase as does muscle tone. Resolution Phase: Return to pre-excitement status reduction in blood pressure, heart rate, and respiration.

25 NEUROLOGIC FUNCTION Autonomic Nervous System Parasympathetic Nervous System: “rest and digest” Sympathetic Nervous System: “fight or flight”

26 NEUROLOGIC FUNCTION PNS : excitatory pathways: either through psychogenic (originating in brain) or reflexogenic (direct stimulation of the penis) the excitatory nerves in the penis respond by releasing proerectile neurotransmitters. These chemical messengers signal smooth muscles of the penile arteries to relax and fill with blood, resulting in an erection.

27 NEUROLOGICAL FUNCTION PNS: cause release of secretions in the female that decrease friction, the PNS innervate the fallopian tubes, which help peristaltic contractions and movement of the oocyte to the uterus for implantation. The secretions from the female genital tract aids in semen migration, thus playing a huge role in reproduction.


29 DISABILITY Medical Conditions that affect sexuality: Among older Pts: total hip replacement, stroke, CABG, related amputations, fxs Among younger Pts: SCI, TBI, CA, MS, and Guillian-Barre

30 DISABILITY Psychosocial Disorders: Depression Anxiety Body Image

31 EVALUATION OF SEXUAL DYSFUNCTION Sexual Hx: Physical Disabilities: Psychosocial Hx:

32 TREATMENT INTERVENTION Communication Clarifications Questionnaire Physical treatments Psychosocial treatments Nutrition

33 EARLY PLISSIT MODEL Permission To perform this level of sexuality intervention, the therapist should do the following: Acknowledge the sexuality of all persons Be comfortable with his or her own sexuality Limited Information To provide this level of intervention, the therapist should fulfill the criteria listed for Permission and do the following: Have a basic understanding of human sexuality and its many variations. Understand the physiology of human sexual response.

34 PLISSIT MODEL Specific Suggestions To perform this level of intervention, the therapist should fulfill the criteria for Permission and Limited Information and do the following: Be familiar with various sexual activities Be comfortable discussing specific sexual activities Intensive Therapy To perform this level of sexuality intervention, the therapist should fulfill the criteria for Permission, Limited Information, Specific suggestions and do the following: Have formal training in sex therapy, sexuality counseling, or psychotherapy

35 AASECT REQUIREMENTS requirements-sex-therapist-certification requirements-sex-therapist-certification


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