The PLISSIT Model in Sex Counseling
The PLISSIT model is a conceptual framework used by healthcare professionals, particularly those in the field of sexual health, to approach and address issues related to human sexuality. The acronym "PLISSIT" stands for Permission, Limited Information, Specific Suggestions, and Intensive Therapy. Developed by Jack Annon in 1976, this model provides a structured and systematic approach to discussing and managing sexual concerns and challenges faced by individuals and couples.
Permission (P):
The first level of the PLISSIT model, Permission, focuses on creating a safe and non-judgmental environment for individuals to discuss their sexual concerns openly. This step involves acknowledging and normalizing sexual feelings and behaviors, assuring the individual that it is acceptable and appropriate to seek help for their sexual issues. Providing permission to discuss these concerns is a fundamental step in breaking down barriers and initiating a productive dialogue. Some individuals and couples are comfortable diving right in, some need time to get to know the person, while others may never want to be completely open and we just speak in code and leave the rest as homework for self-exploration or to talk between partners.
Limited Information (LI):
In this stage, healthcare professionals provide basic, essential information about sexuality, anatomy, physiology, and sexual health. The information shared is tailored to the individual's specific concerns or questions. The goal is to empower individuals with accurate knowledge, dispel myths, and correct misconceptions about sexual health, ultimately aiding in a better understanding of their own bodies and sexual experiences. Sometimes, this may even involve sharing personal experiences or sending home resources for further research. Very often it is about just normalizing what people are going through.
Specific Suggestions (SS):
Building upon the foundation of permission and limited information, the Specific Suggestions stage offers targeted recommendations and strategies to address the individual's or couple's sexual concerns. These suggestions could encompass communication techniques, intimacy-building exercises, practical advice, or referrals to relevant specialists or resources. The aim is to provide actionable guidance that can help improve sexual well-being. There are very few times that I make specific suggestions at the beginning stages because I have just met the person. It may take some time just exploring the current issue or goal, the circumstances, and a person’s life story before jumping in to offer suggestions. I like to let my clients know everything I say is an invitation, you’re the master of your universe and the only one who can decide whether to try something or not.
Intensive Therapy (IT):
The final stage of the PLISSIT model, Intensive Therapy, is reserved for cases that require specialized, comprehensive intervention from qualified professionals. Individuals or couples facing severe or complex sexual issues may benefit from intensive therapeutic approaches, which can include psychotherapy, counseling, sexual education, or medical treatments. The focus is on comprehensive evaluation and tailored treatment plans to address underlying psychological, emotional, or physiological issues affecting sexuality. In my experience, I have encounter some clients who rather continue working on this special issues with me. Often, many of my clients either were in therapy in the past or are concurrently in therapy when they see me. Either way, this is something that you can revisit with your provider after a few sessions.
Conclusion:
The PLISSIT model is a valuable tool for healthcare professionals to approach and address sexual issues in a systematic and compassionate manner. By granting permission, providing limited information, offering specific suggestions, and, when necessary, suggesting intensive therapy, this model facilitates a nuanced approach to dealing with the diverse range of sexual concerns individuals or couples may face. Ultimately, the goal is to enhance sexual well-being and contribute to overall physical and emotional health.
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I am a PhD in Clinical Sexology candidate at Modern Sex Therapy Institutes and have a Master of Science in Educational Psychology. I work with individuals, couples, non-monogamous relationships, and groups in topics related to sexuality, emotional regulation, communication dynamics, and changing behaviors.
