Sexual Activity & Intimacy: Application

OT Role Fulfillment 

The application of OT to address sexual dysfunction and challenges with intimacy can be done through a variety of roles and approaches. Below are some examples and ideas to help you envision just a few of the possibilities. 


  • Compose articles or create educational resources and submit to OT websites, magazines, or journals
  • Include the topic of sex and intimacy in your OT blog or podcast
  • Share/disperse resources on social media platforms or at your facility to provide information 


  • Include information on OT's role regarding sexual participation and intimacy in OT curriculum
  • Educate students on available models to address sexual activity, practice implementation
  • Serve as a fieldwork educator if knowledgeable about OT application for sexual activity
  • Educate students on how to collaborate with other OTs regarding sexual activity, especially if uncomfortable addressing issue themself


  • Create and sell client handouts with drawn illustrations to address sex and intimacy needs
  • Create and sell an educational phone/tablet application for OT's
  • Write and sell a book on the homeless population and OT application
  • Create your own consulting business

Leader / Administration

  • Host an in-service for fellow OTs at your organization on how to address sexual activity at your organization
  • Advertise yourself as an OT comfortable addressing sexuality with clients and encourage your fellow OT's to reach out to you for collaboration

Policy Developer

  • Propose/support policies that support adaptive equipment utilized for sexual participation to be covered by insurances
  • Propose/support organization policies that ensure sexual issues are being addressed at your facility


  • Conduct research while practicing as a consultant 
  • Conduct a national research project to identify the current practices and applications of OT services
  • Conduct research to identify common unmet needs for specific populations as it relates to sex and intimacy


  • Lead support groups to address sex and intimacy-related topics (i.e. for clients with chronic disease, TBI, CVA, etc.)
  • See treatment ideas below 

Direct Service Provider

  • Individually evaluate, assess, and address identified areas of need 
  • See treatment ideas below 

Suggested Frameworks & Models

  • EX-PLISSIT Model
  • Model of Human Occupation (MOHO)
  • Person-Environment-Occupation-Performance Model (PEOP)
  • PLISSIT Model
  • Recognition Model

Suggested Assessments

  • Sexual Expression/Activity Eval
  • Sexual Interest and Satisfaction Scale

Treatment Ideas

  • Adaptive personal pleasure devices ("sex toys") and personal lubricants 
  • Adaptations to their sexual aids (velcro, loops, universal cuffs, etc.)
  • Address trauma-related issues; refer out if needed
  • Balance issues 
  • Bowel management
  • Communication skills to express wants, desires, interests, emotions, expectations, etc. 
  • Creating an environment to support sex and intimacy
  • Culturally appropriate behavior surrounding dating, sex, and intimacy (consent, pacing, communication, etc.)
  • Education on erectile dysfunction and available treatments (penile implant, penis pump, penis support sleeves, penile injections, oral medications, mindfulness)
  • Education on how conditions may affect sex and intimacy (hormonal imbalances, muscle atrophy, limited ROM, etc.)
  • Education on hygiene, dress, manner, etc.  
  • Education on identifying new erogenous zones
  • Education on masturbation 
  • Education on vaginal pain, dryness, and/or atrophy causes and solutions; refer out if needed
  • Education regarding family planning
  • Education on energy conservation, alteration of daily routines
  • Electric blanket for thermoregulation support
  • Engaging couples in sharing of personally meaningful ideas/thoughts (hopes, dreams, etc.)
  • Exploration of non-sexual touch
  • Expressions of gratitude 
  • Health management of conditions that may be affecting sex and intimacy (i.e. depression, etc.); refer out if needed
  • Identification of core values, ethics, and morals
  • Identifying oneself's and partner's love languages 
  • Increasing independence in other areas to create opportunities for privacy (community mobility, etc.)
  • Mind-body connection
  • Pain management
  • Performance anxiety
  • Plan date nights with respect to accommodations to new disability or preferences
  • Positioning equipment (wedges, support pillows, J pillow, bolster, Liberator, swing, intimacy rider, etc.)
  • Positioning to reduce pain, improve comfort, and facilitate desired positions
  • Role-play discussions
  • Self-esteem, body image issues
  • Sensate Focus to improve intimacy and comfortability
  • Sexual education
  • Support groups