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Publication Date



UM campus only

Embargo Period


Degree Type


Degree Name

Doctor of Philosophy (PHD)


Psychology (Arts and Sciences)

Date of Defense


First Committee Member

Brian D. Doss

Second Committee Member

Maria M Llabre

Third Committee Member

Amy Weisman de Mamani

Fourth Committee Member

Franklin H. Foote

Fifth Committee Member

Blaine J. Fowers


Sex is a fundamental component of romantic relationships. With an estimated 50% of couples reporting dissatisfaction with some aspect of their sexual life (Metz & McCarthy, 2007), low levels of sexual satisfaction is one of the most discussed issues in couple therapy (Lamarre & Lussier, 2007). Despite the frequency of this presenting problem, many couple therapy modalities do not address sexual satisfaction in any explicit way. This study investigated trajectories of sexual dissatisfaction during couple therapy using a sample of 134 couples that participated in a randomized comparison of two couple therapies. Seventy one percent of couples enrolled in this trial included at least one partner with clinically significant sexual dissatisfaction. Data were collected prior to receiving couple therapy and 13 and 26 weeks later. Results suggest that couple therapy produces statistically significant decreases in sexual dissatisfaction for men and women with clinically significant sexual dissatisfaction prior to entering treatment. However, men and women who were not sexually dissatisfied pre-treatment demonstrated increased sexual dissatisfaction during therapy. Contrary to expectations, gender did not influence change in sexual satisfaction. Change in the majority of the sample failed to meet standards for clinically significant change, despite statistical significance. Significant associations between change in sexual dissatisfaction and change in relationship satisfaction and quality of communication suggest that traditional couple therapy may lead to modest decreases in sexual dissatisfaction through treatment’s impact on other areas of couple functioning. Thus, treatment effects are most likely attenuated by the lack of direct focus on sexual dissatisfaction. Additionally, couples that were not sexually distressed prior to initiating treatment demonstrated significant increases in sexual dissatisfaction. This may suggest that, as some areas of couple functioning improve (e.g. communication, problem-solving), other areas of couple functioning that have failed to improve, like sexual dissatisfaction, may emerge as more distressing over the course of treatment. Thus, traditional couple therapy does not seem to adequately impact sexual dissatisfaction and that incorporation of sex therapy techniques into traditional couple therapy may increase efficacy for treating sexual dissatisfaction.


sexual satisfaction, couple therapy, sex, relationship functioning