What is sex surrogate therapy?
Sex surrogate therapy has been recognised as a legitimate form of sex therapy ever since the famous pioneers of sexual therapy, William H. Masters and Virginia Johnston, began the practice with their elite clientele in St. Louis in the United States in the 1950s. The therapist matches the client with a specially trained partner so that they can learn the skills that are the basis of a healthy sexual relationship. The aim of this therapy is to help single people who, though they may have well-developed inter-personal skills, have a significant lack of sexual confidence and/or experience which causes them strong anxiety and has made them fearful of intimacy.

This can often be related to negative childhood experiences and may manifest in a variety of physical problems such as erection difficulties, premature ejaculation and difficulty reaching orgasm. Surrogate therapy is particularly effective for specialised problems such as sexual phobias, and issues relating to illness and disability.

The process is as follows:

1.The client discusses their problem with a highly trained and experienced professional therapist who does a thorough assessment and then devises a unique treatment program for their needs.

2. The program involves a number of one-to-one sessions between the client and a specially trained sexual partner or surrogate who has not previously been told the exact nature of the client’s problem. Unlike a traditional sex worker, who is merely providing a service, the surrogate’s role is to build a rapport with the client and together the two engage in sexual activity. In this safe environment the surrogate can counsel, teach and encourage, providing the client with gentle but honest feedback, something they may not have experienced previously. As more trust develops over the sessions and the client’s self-esteem grows, the pair may build up gradually, usually over about 10 hours, to sexual intercourse. Each session last for one hour. The number of sessions can range from three to 20 and they are usually conducted weekly.

3. After each session the therapist is given detailed feedback in writing by the surrogate. This feedback allows the therapist, in a separate one-hour meeting with the client, to make the client more aware of unconscious feelings and behaviour that the surrogate has detected and which may relate to previous relationship difficulties. For example, unconscious anxieties and habits that dampen the mood for lovemaking but may only be evident in private encounters become apparent and can be gently examined. This feedback and discussion process helps the therapist by indicating what further exercises and activities may be useful to suggest for the next surrogate session.

Who are the surrogates?
The uniquely healing nature of sex surrogate therapy depends largely on a genuine relationship developing between the surrogate and the client, so only the most caring, responsible and well-adjusted people are selected to be trained for such a delicate role. As they are in a such a trusted position they are required to demonstrate a strong understanding of ethics regarding duty of care for their potential therapy clients. Indeed, sex surrogate therapy is conducted according to the International Professional Surrogates Association, an organisation upholding the highest ethical and professional standards so that the client’s interests, safety and confidentiality are paramount. So far all the surrogates we have appointed have been from professional fields, for example counsellors, naturopaths, medical workers and teachers. Most have a counselling background and some have disability training, especially those with a medical background. We ensure that all surrogates receive training in the specifics of sexual dysfunction and sexuality issues.

Who is the chief therapist?
The chief therapist is Dr Brian Hickman B.B.Sc (Hons) Phd. (La Trobe University). Dr Hickman has been a registered psychologist and specialist sex therapist for nearly 20 years. Some of his positions have included:
• Educator with the Victorian Family Planning Association
• Senior Psychologist with the Victorian AIDS Council
• Researcher with the National Centre for HIV Social Research
• Psychologist in private practice at the Whole Health Clinic
• Lecturer at the Australian College of Natural Medicine
• Lecturer at the Melbourne Sexual Health Centre
• Media Spokesperson for the Australian Psychological Society
• President of the Australian Society of Sex Educators Researchers and Therapists (ASSERT), Victoria.

What if I fall in love?
Because it encourages strong attachment, the therapy is widely regarded as controversial, even in the sex therapy profession itself, but it is precisely this attachment that makes it so effective. Indeed, such a close relationship often leads to very powerful – even life-changing – feelings which the client may not have experienced before, and it is these feelings which have such a profound improvement on someone’s capacity to enjoy one of the greatest pleasures in life – a loving sexual relationship. Because sex surrogate therapy encourages such deep involvement and can create such strong responses there are strict rules and boundaries which exist for the client’s benefit. For example, the meetings follow a session plan and are strictly one hour in length. The strong feelings which emerge are worked through as part of the process and then towards the end of the therapy the client is encouraged, through specific exercises, to make a transition into the outside world. Here the client can use their new confidence and skills in real life situations to take healthy risks and develop new relationships.

Who is suitable for sex surrogate therapy?
Many of the clients presenting for surrogate therapy require counselling for anxiety disorders, depression and relationship break-ups before they are ready to proceed. Some resolve their anxiety or depression with short-term counselling and then do not require sex surrogate therapy. Sex surrogate therapy is only used in cases where all other techniques, for example the traditional talking-only and drug-related methods, have already been attempted and have failed. This therapy is, however, used in conjunction with these other methods and may include sex education via DVD, relationship counselling, cognitive behavioural therapy (CBT) and psychotherapy, as well as pharmacological aids, for example Viagra. Sex surrogate therapy clients must be over 18 years and pass a rigid assessment interview with a specialist psychologist or sex therapist. Sex surrogate therapy is a last resort for people who have often been to many other therapists, sometimes on a long-term basis. They may have even resolved a number of other psychological issues, for example those relating to early childhood or trauma – but not the specifically sexual one. Now people need not give up hope as we have a 90% success rate.

Is surrogate sex therapy conducted according to safe sex guidelines?
All contact between surrogate and client is conducted according to safe sex guidelines, even when medical checkups clear both parties of any infections or diseases.

What is the cost?
The first assessment interview is $200. Two one-hour sessions per week, one with the surrogate and one with the therapist, are $320 per session i.e.$640 per week. The number of surrogate sessions usually ranges from 3 - 20.