(Leslie Schover, 1992) Updated 2009, J. Baker

1. Defining the problem

Clinical Interview of the patient.  Develop rapport / Used to Assist in defining the problem as experienced by the patient

If interviewing a couple, get each partner's perspective on the problem:  Summarize both points of view, without taking sides.

If interviewing an individual, be sure to keep the questions focused on the person in front of you.

Remind them that this is a volunteer experience and they can stop the interview at anytime.

After getting the problem defined (which is where most health care professionals stop) go on to the more explicit questions which are designed to familiarize the interviewer with hearing this kind of information and increase comfort level for your future patients.  Please do not ask these questions verbatim, they should be a natural part of your interview that flows with the patient disclosing at their own comfort level.

2. Assessing sexual activity

a. Frequency: How often is the individual/couple having sex? How often is each partner in a sexy mood or interested in having sex? What helps them to get in the mood for sex? What gets in the way?

b. Initiation: Who usually starts things sexually? How does each partner initiate sex?   How do they feel about their mate's initiations? How do they respond? Can they tell if their mate is in a sexy mood? How? What happens if one partner is reluctant to have sex?

c. Behavioral repertoire: Is there a routine sequence of events in their sexual encounter? How do they start touching or kissing? What usually happens next? Do they have a routine they follow? What kinds of touching and positions for intercourse do they prefer? Are there any sexual activities that one partner enjoys but the other does not?  (These are the most difficult question to ask as it is likely to feel too intrusive, yet can give the interviewer a more complete picture of the problem).

d. Communication: How do they communicate when they want to have a sexual encounter?  If they would like a particular kind of stimulation during sex, what do they do? How does the partner usually respond? Do they feel they have a good idea of what the partner likes sexually? How have they learned about their partner's preferences?

e. Negative effect: Does either person ever have an unpleasant emotional reaction to sex? What is that about? How do they feel happens if something does wrong sexually (such as not reaching orgasm, or rapid ejaculation)? What kinds of things get in the way of having time for sex? Is there anything about their sex life which acts as a turn-off for either partner?

3. Assessing other sexual dysfunctions

a. Desire: How often do they notice a desire for sex? Do they have sexual thoughts or daydreams? When do they think about having sex, what feelings or self- statements come to mind? Does sex sometimes seem like too much work or effort? How do they each feel about erotic materials, like sexy movies or magazines? Do they find erotica arousing?

b. Arousal: Does each partner feel mentally turned on during sex? What helps them feel aroused? What gets in the way? Is the male partner able to achieve and maintain erections most of the time? Does the female partner lubricate sufficiently for comfortable intercourse, and does she notice other physical signs of arousal?

c. Orgasm: What kinds of stimulation produce orgasm for each partner? Is there a problem for either partner with reaching orgasm too quickly or too slowly? Are they satisfied with the pleasure they derive from orgasm?

d. Coital pain: Is there any difficulty with penetrating for intercourse due to tightness of the vaginal muscles or pain? Does either partner feel pain in the genitals during sexual activity? Is there pain with orgasm?

4. Assessing sexual dissatisfactions

a. If there is disagreement on how often to have sex, what is each partner's ideal frequency? Is there anything other than sex which would be equally satisfying as a substitute couple activity? How does the less satisfied partner avoid having sex?

b. If there is disagreement on the variety or range of sexual techniques, do they disagree about who should initiate sex? How do they broach the subject of trying something new? What makes either partner reluctant to vary the sexual routine? What are the concerns about the activity asked for by the partner?

5. Assessing nonsexual expression of affection

a. How often does the couple hug or kiss? Does one partner enjoy physical contact more than the other? Has physical affection decreased since the sexual problem began?

b. How does each partner express caring for each other?

c. Are there issues of sexual or social jealousy? How confidant does each feel of the partner's love?

6. Assessing marital relationship issues

a. Conflict: How often does the couple have a disagreement? How does each partner express anger? What issues are likely to cause conflict? Has either partner ever threatened to leave or taken steps to do so?

b. Strengths: How much time do they spend together? What activities do they enjoy together? Do they socialize together as a couple? How do they negotiate various types of decisions?

c. Family relationships: If the couple has children, how has this impacted on their relationship? Do they agree on childcare and discipline? Do they want more children in the future? What kind of contraception are they using? How well do they get along with the two families of origin?