Sex therapy worksheets that treat clients like adults.
Thirty-five evidence-informed sex therapy worksheets — Basson's responsive desire model, Bancroft & Janssen's Dual Control (SES/SIS), Masters & Johnson sensate focus, plus current work on arousal non-concordance, consent, pain, erection and orgasm concerns, body image, post-betrayal recovery, postpartum and menopause changes, SSRI side effects, chronic illness, trauma-informed consent rebuild, gender-affirming sexuality, sex after kids, novelty, long-distance, kink, and consensual nonmonogamy. Free, printable, and designed to actually get filled out.
Desire Discrepancy Map
Spontaneous vs responsive — not high vs low
Separate desire style from libido level; map the contexts that make responsive desire more likely.
Accelerators & Brakes (Dual Control)
SES / SIS — brake problems, not gas problems
Bancroft & Janssen's dual control model — name each partner's specific accelerators and brakes.
Sexual Genogram
Messages you inherited about sex
Map family, faith, and first-partner messages, then audit which stay in adult life.
Yes / No / Maybe List
The explicit conversation that replaces guessing
Fill out separately, compare together — a granular, revisitable map of what's on and off the table.
Erotic Templates & Turn-Ons Inventory
Name the ingredients out loud
Articulate sensory, relational, and fantasy ingredients that reliably move you toward arousal.
Sensate Focus — Stages 1–3 Log
Masters & Johnson's foundational protocol
Structured non-genital → genital → mutual touch log with anxiety ratings across sessions.
Consent Check-in Script
Before, during, and after — rolling consent
Short phrases that normalize check-ins so consent is a conversation, not a gate.
Initiation & Refusal Repair
Rewrite the script that hurts
Audit how initiation and 'no' currently sound; draft softer scripts with warm alternatives.
Sexual Communication Wheel
Six wedges — one conversation at a time
Break the 'we need to talk about sex' conversation into six low-stakes wedges.
Spectatoring Cognitive Map
The observer chair kills the moment
Map when the self-monitoring observer arrives and the pivot back into the body.
Sexual Pain — Pacing Plan
Un-learn the pain-fear cycle
Graded sub-threshold steps alongside a medical / pelvic-floor workup for dyspareunia and vaginismus.
Erection Concerns — Anxiety Loop
Trying harder is the trap
Map the situational erectile anxiety loop and install interruptions that let the body work.
Ejaculation Timing — Start-Stop / Squeeze
Awareness is the skill, timing is a byproduct
Semans and Masters & Johnson behavioral logs for lengthening ejaculatory latency.
Orgasm Difficulty Exploration
Curiosity beats the finish line
Sort lifelong vs situational, name what already works, design a low-pressure solo experiment.
Low Desire in Long-Term Partnership
Responsive desire needs a runway
Basson's responsive-desire model applied to long-term couples — design the runway.
Post-Betrayal Sexual Recovery
Bodies remember — pace accordingly
Staged reintroduction of touch and sex after infidelity or discovery, with partner-role clarity.
Body Image in the Bedroom
The critic isn't in the room with your partner
Map the body-critic's script and design environmental + attentional experiments.
Kink / BDSM Negotiation Frame
The negotiation is the safety
Before / during / after frame — limits, safe-words, health context, and aftercare.
Nonmonogamy Agreements Worksheet
Living document — expect to rewrite it
Structure, sexual-health, disclosure, time, and relational agreements for CNM relationships.
Aftercare & Repair Post-Sex
Land the plane on purpose
Design a simple after-ritual and a gentle repair path when something didn't quite land.
Arousal Non-Concordance
Body response is not desire's report card
Separate genital response from subjective wanting; undo the shame of a body that responded, or didn't.
Sexless Period — 4-Week Reset
Break the gravity of a long dry spell
Structured four-week runway with intercourse off the table — designed so nothing has to be a big deal.
Solo Sex — A Values-Neutral Audit
What it's actually for, without shame
Function audit of masturbation — pleasure, regulation, escape, habit — and whether the pattern fits the sex life you want.
Fantasy Audit
A fantasy is a need in costume
Name recurring fantasies without shame, decode the emotional need underneath, decide what to bring across the line.
Pornography Use Check-in
Function, not frequency
Values-neutral audit of pornography use — function, effects, fit with values and agreements.
Postpartum Sexual Recovery
There is no back — only forward
Body, identity, and relationship all rebuilding at once — plan the gentlest possible restart.
Menopause & Sexual Change
The manual gets rewritten, not thrown away
Perimenopause and menopause changes to arousal, tissue, desire — with medical adjuncts to raise with a clinician.
Medication Sexual Side Effects
It's chemistry, not attraction
Identify medication-related desire, arousal, and orgasm changes; script for talking to the prescriber.
Chronic Illness & Disability — Erotic Redesign
The body you have, not the one you had
Pain, fatigue, mobility, dysautonomia — design an erotic life that respects the actual body.
Trauma-Informed Consent Rebuild
A real yes has room for a real no
Reclaim body-level yes / no / freeze signals in low-stakes contexts before rebuilding them in intimate ones.
Queer / LGBTQ+ — Coming Home to the Body
Design from scratch, not from the old script
Name what you rehearsed vs what's true; build the erotic life that actually fits.
Gender-Affirming Sexuality Map
Language, sensation, and communication after transition
Living map of body language, sensation, and partner communication for trans and non-binary clients.
Sex After Kids — Logistics
Most 'desire' problems here are logistics problems
Locking doors, touch budgets, scheduled vs spontaneous — fix the container first.
Novelty & Play Menu
Long-term desire needs new information
Micro-experiments and medium-stakes experiments for over-familiar long-term couples.
Long-Distance Erotic Connection
Distance changes the medium, not the possibility
Build the container for erotic life across distance so the thread doesn't quietly die.
What this section covers
Sex therapy sits at the intersection of couples work, trauma-informed care, medical liaison, and cognitive-behavioral skill-building. This library reflects that. You'll find assessment tools (sexual genogram, dual control mapping), communication frames (yes/no/maybe list, consent check-in script, sexual communication wheel), and behavioral protocols with real clinical weight (sensate focus stages, start-stop and squeeze for ejaculatory concerns, graded pacing for sexual pain).
The material is direct without being clinical-cold, and consent-forward throughout. Every worksheet is designed for adults; nothing collects PII, and language is inclusive of relationship structure, gender, and orientation.
How clinicians tend to sequence these
For couples presenting with desire discrepancy, the sequence typically begins with the Desire Discrepancy Map and Dual Control (Accelerators & Brakes) as psychoeducation — reframing the problem from 'high vs low libido' to spontaneous vs responsive desire and identifying each partner's specific brakes. From there, the Sexual Communication Wheel and Initiation & Refusal Repair open the conversation, and Low Desire in Long-Term Partnership designs the responsive-desire runway.
For performance-anxiety presentations (erectile difficulty, anorgasmia, spectatoring), the Spectatoring Cognitive Map plus Sensate Focus Stages 1–3 form the backbone; the Erection Anxiety Loop and Ejaculation Timing Skills sheets add specificity. For sexual pain, the Pacing Plan runs alongside pelvic-floor PT and GYN workup — never in isolation.
For post-betrayal work, the Post-Betrayal Sexual Recovery sheet stages reintroduction of touch on the hurt partner's timeline. Kink Negotiation and Nonmonogamy Agreements support explicit-agreement work with clients whose relationship structures require them. The Aftercare & Repair sheet is short but underused — the 30 minutes after sex quietly shape the whole erotic life of the relationship.
Free to print, send, or use in session
Every sheet is free to print as a PDF and free to send as a secure link from a TherapistAssist account. No watermarks. No per-client limits. Designed to look and feel like real clinical material — because that's what your clients deserve.
Frequently asked questions
Are these worksheets appropriate for clients without a sex-therapy specialty?+
Most are — the psychoeducation and communication sheets (Dual Control, Yes/No/Maybe, Consent Check-in, Sexual Communication Wheel, Aftercare) work well in generalist couples and individual practice. The specialized behavioral protocols (Sensate Focus, Pain Pacing, Ejaculation Timing) are best used with training or supervision, or as adjuncts to referral. If you're outside your scope, refer to an AASECT-certified sex therapist.
Do these worksheets contain explicit content?+
The language is direct — this is sex therapy — but there is no imagery, and nothing gratuitous. Every sheet is written to be readable in a clinical setting, given to an adult client, and completed at home without embarrassment.
Are they inclusive of LGBTQ+ clients and nonmonogamous relationships?+
Yes. Language is gender-neutral where possible; relationship structure is left open unless the sheet is specifically about a structure (e.g., the Nonmonogamy Agreements sheet). Nothing in the library assumes heterosexuality, cisgender identity, or monogamy.
Can I use these with clients presenting with sexual pain or medical concerns?+
The Sexual Pain — Pacing Plan and Erection Concerns — Anxiety Loop sheets explicitly note that they run alongside medical workup, not in place of it. Persistent pelvic pain warrants GYN and pelvic-floor PT; sudden erectile changes warrant a physician visit. These are psychotherapy adjuncts.