Background and Importance. Sexual health is a fundamental aspect of overall quality of
life; a satisfying sexual relationship is associated with better physical, psychological,
and relationship health and well-being. In fact, people who maintain a satisfying, active
sex life over time live longer than those who report lower sexual frequency and
satisfaction. Yet problems with sexual function are extremely common, especially for
women: persistent difficulties with sexual desire and/or arousal that are personally
distressing-Sexual Interest/Arousal Disorder (SIAD9)-affects 7% to 23% of the general
population. SIAD is linked to greater healthcare costs, depressive symptoms, and lower
relationship satisfaction. Sexual desire-the key component in SIAD-is thought to be
embedded in, and influenced by, interpersonal factors, more so for women than for men.
Although theoretical and clinical models suggest a significant role for interpersonal
processes in SIAD, there is a striking neglect of these factors in available treatments.
Couple-based sex therapy is commonly used by clinicians, but no study to date has
assessed its efficacy for SIAD. The current proposal builds on our ongoing CIHR-funded
work examining interpersonal factors in SIAD, as well as the results of our pilot study.
Aims. The primary aim of this three-centre randomized clinical trial is to test the
prediction that a novel cognitive-behavioural couple therapy (CBCT) delivered online will
yield significantly greater improvements in primary outcomes of sexual desire and sexual
distress for women and individuals with SIAD post-treatment and 6-months later, compared
to a waitlist control group. Our secondary aim is to test the prediction that couples
receiving CBCT will report greater improvements in sexuality, relationship, and
psychological outcomes relative to the control group.
Methods/Approach/Expertise. The investigators will: (1) recruit an inclusive sample of
170 women diagnosed with SIAD via a clinical interview, and their partners; (2) randomize
couples to either the 16-session CBCT or a waitlist control group; (3) have couples
complete standardized, self-report measures at pre-treatment, post-treatment, and 6-month
follow-up as well as approximately every 4 weeks during the treatment period; (4) test
the efficacy of CBCT compared to the control group. Procedures will take place at
Dalhousie University, Université de Montréal, and the University of British Columbia.
Expected Outcomes. This clinical trial addresses the urgent need for an empirically
validated, accessible, couple-based treatment for the most prevalent sexual
dysfunction-SIAD. Results will be used by clinicians to provide affected couples with a
scientifically-based treatment option that will improve their sexual, relationship and
psychological well-being.
