Profiles of medical services use and health status in sex therapy clients: Associations with therapeutic alliance, attachment and trauma

Adults with sexual difficulties tend to report poorer health and higher health services utilization than individuals from community samples. Several correlates are related to greater use of health services, such as childhood interpersonal traumas, insecure attachment and level of therapeutic alliance. Although it is documented that clients presenting sexual difficulties and seeking sex therapy are likely to present these risk factors, health status and medical services use have not yet been empirically examined in this population. A total of 220 clients seeking sex therapy completed self-report questionnaires assessing childhood interpersonal traumas, attachment representations, therapeutic alliance, and sexual satisfaction. Five variables were used to identify their health status and medical services use: 1) annual number of medical consultations; 2) annual number of emergency room visits; 3) presence of chronic health problems; 4) frequency of medication intake; and 5) health status self-assessment. Hierarchical clustering analyses were conducted and three distinct profiles were identified according to the clients' health status and medical services use. The first profile (n = 106) was characterized by a good health and low use of medication and medical services. Compared to the other profiles, these clients report more secure attachment, stronger therapeutic alliance, and fewer traumas. The second profile (n = 73) showed the highest frequency of medical and emergency room consultations. These clients all reported a chronic health problem and a high rate of trauma. The third profile (n = 41) included clients using the most medication, but reporting a globally good health. These clients reported low levels of therapeutic alliance. Results provide a better understanding of the associations between sexual difficulties and health problems.