Sex Therapy and Couples Therapy. What's the difference?

10th February 2026 | By:Shreya N Bharadwaj

When relationships feel difficult or intimacy starts to change, many people wonder, Do we need couples therapy or sex therapy?

While both approaches focus on relationships and connection, they work on different aspects of emotional and relational well-being. Sometimes they are used separately, and sometimes together

"Sex therapy and couples therapy aren’t about fixing what’s broken—they’re about understanding, connection, and growing together."

What is Couples Therapy?

Couples therapy focuses on the relationship as a whole. It looks at how two people communicate, handle conflict, express emotions, and stay connected over time. Rather than blaming one partner, couples therapy helps identify patterns that keep repeating and teaches healthier ways to respond to each other.

What Couples Therapy Addresses

Couples therapy commonly helps with:

• Frequent arguments or unresolved conflicts
• Communication gaps and misunderstandings
• Feeling emotionally distant or disconnected
• Trust issues or infidelity
• Parenting or family-related stress
• Financial stress affecting the relationship
• Decision-making about staying together or separating

In couples therapy, the therapist helps partners:

• Understand each other’s emotional needs
• Recognize triggers and conflict cycles
• Learn healthy communication and listening skills
• Express anger, hurt, or disappointment safely
• Build empathy and emotional safety

Couples therapy is not only for relationships in crisis. Many couples seek therapy to strengthen their bond, improve understanding, or prepare for major life changes like marriage or parenthood.

What is Sex Therapy?

Sex therapy focuses on sexual well-being and intimacy. It explores how emotions, thoughts, stress, past experiences, and relationship dynamics influence a person’s sexual life.

Sex therapy is completely talk-based. There is no physical contact or sexual activity involved in sessions.

What Sex Therapy Addresses

• “Low or mismatched sexual desire”
• "Anxiety or fear related to sex”
• “Pain or discomfort during intimacy”
• “Difficulty with arousal or orgasm"
• Performance anxiety
• Shame, guilt, or confusion around sex
• Intimacy changes after childbirth, illness, or trauma

Sex therapy can be for individuals or couples, depending on the concern.

Sex therapy looks beyond physical symptoms and explores:

• “Beliefs and conditioning around sex"
• "Emotional blocks and fear”
• “Body image and self-confidence”
• “Relationship dynamics affecting intimacy"
• "Stress, burnout, or mental health concerns"

Sex therapy can be for individuals or couples, depending on the concern.

Sometimes both the approaches overlap each other. For example

• “Ongoing fights in a relationship may start because sexual needs are not being met"
• "Sexual difficulties may develop due to emotional distance”
• “Trust issues can affect both intimacy and communication”

Which One Should a Person choose?

You can consider couples therapy if:

• “Conflicts keep repeating"
• "Communication feels tiring or unproductive”
• “You feel emotionally disconnected from your partner”
• You want to improve the relationship overall

You can consider sex therapy if:

• “Sexual concerns are causing distress"
• "Intimacy feels uncomfortable or anxiety-provoking”
• “You feel confused or ashamed about sexual issues”
• "Physical causes have been ruled out but concerns continue"