Serving the Community, Enriching the Profession

by Mary Hrovat

If you needed advice or counseling regarding sex, where would you go? The complex interplay of emotions, physical factors, and patterns of behavior in interpersonal relationships involved in sexuality can make this a tough question to answer. One purpose of the Kinsey Institute's Sexual Health Clinic, according to Dr. John Bancroft, a clinical professor of psychiatry at Indiana University Bloomington and director of the institute, is to offer "a specialized service to the local population that they would have considerable difficulty getting anywhere else." To help make these specialized services accessible to individuals of all income levels, fees at the clinic have been kept to a minimum since medical insurance often does not cover treatment of sexual problems.

The clinic, which has been operating in the IU Health Center on the Bloomington campus since 1996, offers a holistic approach to sexual health. Bancroft, who runs the clinic, has twenty-six years of experience with sex therapy, as well as a varied and extensive research background. During the past year, Bancroft has been working with Carol McCord, a trained medical social worker who was eager to study with Bancroft and who has now advanced to working on her own. In addition, Erick Janssen, an assistant scientist on the Kinsey Institute staff, helps with diagnostic procedures. Assessment at the clinic involves "weighing the relative importance of psychological and physical factors in each case, then planning the treatment accordingly," Bancroft says. This psychosomatic approach is a rarity in health care in this country, according to Bancroft.

The clinic staff sees individuals and couples about a variety of issues of sexuality, including sexual interests, sexual compatibility, and gender identity. Some patients need only reassurance or advice, while some may benefit from medication or other practical ways of dealing with their sexual dysfunction. Others embark on a course of therapy that typically can last from four to six months, with visits to the clinic spaced further and further apart as the couple or individual gains a better understanding of and is better able to cope with the problem.

The clinic is open one afternoon a week, although there are plans to extend the hours as more staff join the clinic. Bancroft has trained health professionals throughout most of his career and plans to continue such training in this clinic. He believes that the best training method is to work in cotherapy. Three new trainees, all with clinical or counseling experience, will be joining the clinic in September. In addition, Cindy Graham, an adjunct assistant professor of psychology at IUB, an experienced sex therapist, and Bancroft's wife, is starting a practicum on sex therapy in the fall semester for three graduate students in clinical psychology. This practicum will be linked to the clinic.

Besides existing to serve the public and to provide a setting for training professionals, another purpose of the clinic is to contribute to the research activities of the Kinsey Institute in ways that benefit both clients and researchers. In some cases, the clinic reduces or eliminates fees for clients who participate in such research. One example of this is the use of the RigiScan to monitor nocturnal erections. The presence or absence of nocturnal penile tumescence is an indicator of whether erectile difficulties are organic (due to physical causes) or psychogenic (due to psychological factors). Clients take the RigiScan home for two nights and record data, which Kinsey Institute researchers download from the RigiScan to the computers at the institute. The normal charge for this diagnostic procedure is $250 (substantially less than at most other clinics), but clients who agree to have the results of this diagnostic assessment used as part of a research study being conducted by Janssen are not charged for this service. Therapists also offer men with sexual dysfunction problems who attend the clinic the opportunity to complete a research questionnaire that Janssen has developed. The clinic waives half of the fee for the first consultation for men who complete the questionnaire.

The objectives of the clinic are interwoven with the research objectives of the institute, which center around the complex connections between the psychological and physical components of sexuality. Commenting on the clinic and its focus on sexual dysfunction, Bancroft notes, "it's hard to think of an area of clinical care where this comprehensively psychosomatic approach is more needed." Kinsey