Electronic Theses and Dissertations




Jami Voss



Document Type


Degree Name

Doctor of Philosophy


Counseling Psychology

Committee Chair

Sara K. Bridges

Committee Member

Douglas C Strohmer

Committee Member

Nancy Nishimura

Committee Member

Elin Ovrebo


Sex is a fundamental aspect of human functioning but a topic that often involves myths, embarrassment, and silence, particularly related to alternative sexual behaviors, such as consensual paraphilias; bondage and discipline, domination and submission, sadism and masochism (BDSM); and polyamory. Because clients who live alternative sexual lifestyles seek mental health services, it is important for clinicians to be prepared to work with this population. This study used the Delphi Method to understand the needs of these clients from the perspective of those who currently work with this population as well as the competencies and training necessary to be a kink aware professional. Professionals who have expertise in working with clients who live alternative sexual lifestyles were asked open-ended questions followed by rounds of surveys in order to establish consensus. Participants agreed that kink clients come to therapy with unique presenting concerns (e.g., discrimination, stigma) as well as similar presenting concerns as their non-kink peers (e.g., depression, anxiety). Therefore, therapists need to be skilled practitioners who are knowledgeable about alternative sexual lifestyles. Additionally, participants agreed that therapist cultural competency, positive attitudes, comfort with sexual topics, and knowledge of their competency limits are important for work with this population. Participants reported limited availability of training related to alternative sexual lifestyles but identified several formal and informal sources of information, such as professional conferences, readings, courses, and community events for alterative sexual lifestyles, as ways therapists can increase their competency. Limitations and future directions were also discussed.


Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to the local University of Memphis Electronic Theses & dissertation (ETD) Repository.