Cognitive-Behavioural Therapy for Low Libido

(CBCT for SIAD Trial)

Recruiting at 2 trial locations

Overseen By Gillian K Hyslop, B.Sc.

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Dalhousie University

Disqualifiers: Pregnancy, No sexual experience, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 16 weeks

170 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you are currently undergoing treatment for SIAD or in couple or sex therapy, you would not be eligible to participate.

What data supports the effectiveness of the treatment Cognitive-Behavioural Couple Therapy for low libido?

Research shows that behavioral sex therapy can lead to significant positive changes in sexual satisfaction and frequency, which are maintained over time. Additionally, couple therapy has been found to improve sexual relationships, although the effects may diminish over time, suggesting that incorporating sex therapy techniques could enhance outcomes. ^{1 2 3 4 5}

Is cognitive-behavioral couple therapy safe for humans?

Cognitive-behavioral couple therapy (CBCT) has been widely studied and is generally considered safe for humans, with research showing it can improve relationship distress and individual psychological issues without significant safety concerns. ^{1 4 6 7 8}

How is Cognitive-Behavioural Couple Therapy different from other treatments for low libido?

Cognitive-Behavioural Couple Therapy (CBCT) is unique because it focuses on improving the overall quality and satisfaction of the sexual relationship rather than just increasing the frequency of intercourse. It also involves both partners in the treatment process, which can enhance relationship functioning and address the self-defeating cycle of negative anticipation and avoidance that often accompanies low libido. ^{2 3 5 6 9}

What is the purpose of this trial?

Sexual health is a fundamental aspect of quality of life; a satisfying sexual relationship is linked to 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: chronic difficulties with sexual desire and/or arousal that are personally upsetting-Sexual Interest/Arousal Disorder (SIAD)-affects 7% to 23% of the general population. SIAD is linked to more healthcare costs, depressive symptoms and anxiety, and lower relationship satisfaction. Experts suggest that relationship factors play a critical role in SIAD and couple-based sex therapy is a common approach used by clinicians. However, there are no treatment options available for couples that have been tested in research to confirm that they work. The goal of this three-centre randomized clinical trial is to evaluate the efficacy of a novel 16-session cognitive-behavioural couple therapy (CBCT), offered online to increase accessibility, for an inclusive sample of women with SIAD compared to a waitlist control group. The investigators expect that, compared to a waitlist control group, CBCT will lead to greater improvements in SIAD symptoms (e.g., higher sexual desire/arousal, lower sexual distress) and better sexual, relational, and psychological adjustment for both partners at post-treatment and 6-months later. Given that less than a third of those affected by SIAD access treatment, this study addresses the urgent need for an accessible couple-based treatment for the most common sexual dysfunction. Results will be used by clinicians to provide couples with a scientifically based, accessible treatment option, that will improve their sexual, relationship, and psychological health.

Eligibility Criteria

This trial is for couples where the woman experiences low libido, known as Sexual Interest/Arousal Disorder (SIAD). It's designed to help improve their sexual relationship and overall well-being. To participate, women must have SIAD that affects them personally.

Inclusion Criteria

I or my partner identify as a cisgender woman, trans woman, or were assigned female at birth.

One member of the couple must meet diagnostic criteria for SIAD

I have been living with my partner for at least one year.

Exclusion Criteria

I am currently in treatment for SIAD or attending couple/sex therapy.

Pregnancy, breastfeeding, or one year postpartum

No prior sexual experience

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive 16 sessions of cognitive-behavioural couple therapy (CBCT) delivered online

16 weeks

Sessions conducted online

Post-treatment

Assessment of primary and secondary outcomes immediately after treatment completion

2 weeks

Follow-up

Participants are monitored for improvements in SIAD symptoms and overall well-being

6 months

Treatment Details

Interventions

• Cognitive-Behavioural Couple Therapy

Trial Overview The study tests a new online cognitive-behavioral couple therapy (CBCT) over 16 sessions against a waitlist control group. The goal is to see if CBCT can boost sexual desire/arousal and reduce distress, improving sexual, relational, and psychological health.

Participant Groups

Group I: CBCT for SIAD Experimental Treatment 1 Intervention

16 sessions of cognitive-behavioural couple therapy.

Group II: Waitlist Active Control 1 Intervention

Description: The investigators selected a waitlist control comparison as the first step to establishing efficacy of the CBCT because there are no existing empirically validated couple-based treatments available for SIAD.

Who Is Running the Clinical Trial?

Dalhousie University

Lead Sponsor

Trials

177

Recruited

402,000+

Université de Montréal

Collaborator

Trials

223

Recruited

104,000+

University of British Columbia

Collaborator

Trials

1,506

Recruited

2,528,000+

Findings from Research

A study analyzing archival data from the Sex Therapy Center at Stony Brook found that behavioral sex therapy effectively improved sexual dysfunctions related to desire, with significant positive changes in marital adjustment and sexual satisfaction after treatment.

The therapy was equally effective for both male and female sexual issues, including low sexual desire and sexual aversion, indicating its broad applicability, although post-treatment results suggested only a minimally adequate sexual relationship rather than optimal intimacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment effectiveness for dysfunctions of sexual desire. Schover, LR., LoPiccolo, J.[2019]

Integrative Behavioral Couple Therapy and Traditional Behavioral Couple Therapy showed initial improvements in sexual dissatisfaction and frequency among 134 distressed couples, but these benefits diminished over a five-year follow-up period.

The effectiveness of couple therapy varied based on treatment type, gender, and whether sexual distress was a primary concern, suggesting that incorporating more sex-focused techniques could enhance long-term outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trajectories of Sexual Satisfaction and Frequency During and After Couple Therapy for Relationship Distress. Rothman, K., Cicila, LN., McGinn, M., et al.[2021]

In a study of 60 couples undergoing sex therapy for low sexual desire, 63.3% completed treatment, and 56.7% reported positive outcomes, highlighting the potential effectiveness of therapy in this area.

The male partner's motivation was a key factor in treatment completion, while younger couples and those with shorter sexual problems tended to have poorer outcomes, indicating the need for tailored approaches in therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low sexual desire: sex therapy results and prognostic factors. Hawton, K., Catalan, J., Fagg, J.[2019]

Couple therapy has been shown to significantly reduce relationship distress for many couples, with various therapeutic approaches yielding positive outcomes.

Despite the overall effectiveness, a notable number of couples do not experience significant improvements or may even worsen after therapy, highlighting the need for further research on factors influencing treatment success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Current status and future directions in couple therapy. Snyder, DK., Castellani, AM., Whisman, MA.[2011]

The study of 20 couples and 10 males without partners suggests that individuals with inhibited sexual desire have a better prognosis when their condition is not complicated by other sexual dysfunctions.

Therapeutic approaches should prioritize improving the quality and satisfaction of the overall sexual relationship rather than focusing solely on increasing intercourse frequency, as breaking the cycle of negative anticipation and avoidance is crucial for treatment success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Strategies and techniques for the treatment of inhibited sexual desire. McCarthy, BW.[2019]

Cognitive-behavioral couple therapy (CBCT) is effective in reducing relationship distress, with strong empirical support from multiple meta-analyses across trials in the U.S., Europe, and Australia.

When adapted for individual psychological issues, couple-based interventions using CBCT principles are at least as effective as individual cognitive behavioral therapy (CBT) and often yield better outcomes, particularly when both partners are involved in the treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions. Fischer, MS., Baucom, DH., Cohen, MJ.[2018]

A new 15-session couples group therapy program was developed to address both marital and sexual dysfunctions simultaneously, highlighting the importance of treating these issues together.

The therapy utilizes a cognitive-behavioral approach, which is structured to effectively tackle major themes related to marital and sexual challenges, demonstrating a comprehensive method for improving couples' relationships.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A group therapy format for the simultaneous treatment of marital and sexual dysfunctions: a case illustration. Metz, ME., Weiss, KE.[2018]

In a study involving 63 couples receiving cognitive behavioral couple-based treatment for depression (BCT-D), the recovery rate was 57%, which is higher than the 41% recovery rate for all treatments in the IAPT program in London.

BCT-D was effective for both partners in a couple, regardless of whether the nonclient partner had depression or relationship distress, indicating its potential to benefit both individuals simultaneously in a clinical setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Couple-based Intervention for Depression: An Effectiveness Study in the National Health Service in England. Baucom, DH., Fischer, MS., Worrell, M., et al.[2019]

A practical counseling approach was used to treat couples experiencing a lack of female sexual response, focusing on understanding relationship dynamics.

The quality of the general relationship and sexual attitudes were found to be predictive of treatment outcomes, while factors like age and chronicity did not influence results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Factors related to successful outcome in the treatment of sexually unresponsive women. Whitehead, A., Mathews, A.[2019]

References

1. England pubmed.ncbi.nlm.nih.gov

Treatment effectiveness for dysfunctions of sexual desire. [2019]

2. England pubmed.ncbi.nlm.nih.gov

Trajectories of Sexual Satisfaction and Frequency During and After Couple Therapy for Relationship Distress. [2021]

3. England pubmed.ncbi.nlm.nih.gov

Low sexual desire: sex therapy results and prognostic factors. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Current status and future directions in couple therapy. [2011]

5. England pubmed.ncbi.nlm.nih.gov

Strategies and techniques for the treatment of inhibited sexual desire. [2019]

6. United States pubmed.ncbi.nlm.nih.gov

Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions. [2018]

7. England pubmed.ncbi.nlm.nih.gov

A group therapy format for the simultaneous treatment of marital and sexual dysfunctions: a case illustration. [2018]

8. United States pubmed.ncbi.nlm.nih.gov

Couple-based Intervention for Depression: An Effectiveness Study in the National Health Service in England. [2019]

9. England pubmed.ncbi.nlm.nih.gov

Factors related to successful outcome in the treatment of sexually unresponsive women. [2019]