An Introduction to the
DEC-R Model
Understanding DEC-R Skills
¤ Dialogue—Educate—Coach—Refer
¤ Not sequential
¤ Will utilize all of DEC-R over and over at different times
throughout sex therapy
¤ All therapists need these basic skills to be an effective
counselor because sexuality is such a core part of life
and relationships.
Effective Dialogue:
Stems from Therapistʼs Growth
¤ The people you help will reflect your discomfort.
¤ You can only take someone as far as you have
been willing to grow and learn.
¤ Create your own sexual theology as you integrate
Godʼs sexual principles into your life and
counseling.
¤ Possess and make peace with your own sexuality.
¤ Develop character and sexual integrity.
Dialogue
¤ The counselor is responsible for beginning and
continuing the sexual dialogue---you give
permission and help them to become more
comfortable talking about sexuality.
¤ If YOU donʼt begin the dialogue, it wonʼt
happen.
¤ This helps them create a vocabulary by your
modeling. (Have them read books and
practice saying words out loud.)
Beginning the Dialogue
¤ The magic question:
“How is the sexual part of your life/
relationship?”
DEC-R: Educate
¤ Help clients create their theology of sexuality and
intimacy.
¤ Teach basic anatomy and sexual function.
¤ Help clients understand myths and unrealistic
expectations as you challenge them with facts.
¤ Help clients understand basic gender differences.
¤ Therapists should gain a knowledge of different
populations and basic issues.
Myths vs Facts
Females
¤ Womenʼs sexual desire should be like menʼs sexual
desire.
¤ Women donʼt enjoy sex as much as men.
¤ My body never measures up.
¤ My breasts are too big or too small.
¤ Men should know how I feel and think.
¤ I should always desire an orgasm.
Males
¤ Men know all about sex.
¤ The size of my penis determines my manliness and ability
as a lover.
¤ Men are always horny and erections come instantly.
¤ Sex equals intimacy.
¤ The Nympho Fantasy: if I had the right woman she would
want sex all the time and react just like I do (as a man).
Damage of Myths
¤ These myths misinform clients.
¤ Clients shape their expectations about cultural myths.
¤ When clients aim to achieve myths they tend to
experience failure, anxiety, and/or fatigue in the pursuit.
DEC-R: Coach
¤ Self-help coaching with specific dysfunctions---
¤ not intensive therapy and more behavioral with
advising
¤ different from the discipline of Life Coaching
¤ creating vision and establishing goals for clients
¤ Effective coaching utilizes a good manual and
understands basic counseling techniques /
Protocols
Coaching With a Manual
¤ Utilize a manual that can gives basic treatments for various
sexual dysfunctions or skill building for intimacy enhancement
¤ Further training needed to use manuals and understand protocols
¤ Assist clients in following the steps of the protocols.
¤ Encourage that it takes time and energy like any homework
and change assignments.
¤ Usually clients need a coach and cannot do sexual self-help on
their own.
Basic Skills in Cognitive-Behavioral Sex
Therapy and Coaching
¤ Troubleshooting the problem and history-taking
¤ Conditioning and Desensitizing
¤ Building in small increments and going slowly so as not to sabotage
¤ Cognitive Restructuring
¤ Sensate Focus Exercises
¤ Kegel Exercises
¤ Processing Sexual Accelerators & Brakes
¤ Coaching into Deeper Emotional Connection
DEC-R: Referral
¤ Referral is the most important part of sex
therapy as medical and other needed
resources are employed.
¤ Referral should take place within all three parts
of Dialogue, Education and Coaching
When to Make a Referral
¤ Accessing medical and other professional help
to assist therapy
¤ Referring when additional training and skill level
is warranted
¤ Keeping yourself safe
Where to Make a Referral
¤ Physicians (may downplay the problem) -
develop a network of trusted and known
professionals to refer to
¤ Specialized psychotherapy professionals for
specific issues
¤ Groups and church and community resources
(also known and trusted)
¤ Professional sex therapists if you are not one
How to Make a Referral
¤ Coach clients on why you are making a
referral.
¤ Tell them what information to be sure and tell
the professional resource to get the needed
help.
¤ Follow through and donʼt assume they will
make contact---assist and follow up (ethically).
¤ Let them know you will assist with another
referral if the first is not a good fit.
Useful References
¤ Celebration of Sex, Douglas Rosenau
¤ Celebration of Sex over 50, Douglas Rosenau, Jim and
Carolyn Childerston
¤ Secrets of Eve, Hart, Weber & Debra Taylor
¤ When Two Become One, Christopher and Rachel McCluskey
¤ Restoring the Pleasure, Clifford and Joyce Penner
¤ Soul Virgins, Rosenau and Wilson
¤ Sexual Identity, Mark Yarhouse and Lori Burkett
¤ Healing the Wounds of Sexual Addiction, Mark Laaser
¤ When Sex Hurts by Goldstein, Pukall, and Goldstein
