The treatment of orthodox jewish patients in sex therapy

Treatment of sexual disorders within a culturally distinct subpopulation requires familiarity with the beliefs and mores of that community. Differences between subgroups within orthodox Judaism can be substantial, especially regarding attitudes toward sexuality, reproduction, and modesty in behavior, speech, and dress. These factors can influence treatment and need to be understood. Traditional restrictions on intimate contact during portions of the menstrual cycle have the potential to enhance sexual intimacy, but may necessitate modifications of therapy technique to accommodate these guidelines. The rabbi has an important role in the treatment of orthodox patients, often serving as a culture broker, facilitating referrals and treatment. Orthodox patients view sexuality as one component of a complex matrix of values, traditions, and laws that give meaning and spirituality to all aspects of life, a perspective that may differ substantially from the prevailing attitudes of the general culture. This religious context must be made explicit and explored during therapy to avoid conflicts between therapy technique and Jewish law, build trust between the patient and the therapist, and maximize the engagement of the patient in treatment.