The distinction is often less about the topic itself and more about the structure and goals of the work.

Consultation is typically more focused, structured, and formulation-driven. Couples often seek consultation when they are looking for specialized expertise around a specific sexual health concern, medical issue, or relational dynamic and want targeted guidance or clarification. Consultation may also occur alongside ongoing work with another couples therapist.

Sex therapy tends to involve broader or ongoing therapeutic work focused on relational patterns, emotional dynamics, communication, intimacy, and sexual functioning over time.

In practice, there is often overlap between the two. Recommendations are discussed collaboratively based on your concerns, goals, and the type of support that is likely to be most helpful.

Couples consultation is often helpful for partners who:

• Are navigating sexual concerns influenced by medical or health conditions

• Have previously participated in therapy and want specialized sexual health expertise

• Are working with a primary couples therapist and would benefit from focused consultation

• Are seeking clarity and direction rather than ongoing weekly therapy

Consultation is typically conducted over 4–6 sessions. This structure allows time for assessment, discussion, and development of practical next steps while keeping the work focused and time-limited.

Often, yes. While this work is frequently structured and focused in nature, some couples benefit from ongoing therapy depending on the complexity of the concerns and goals of treatment. Recommendations are discussed collaboratively over time.

Couples consultation is designed for partners seeking focused, short-term guidance around complex sexual health concerns rather than ongoing weekly couples therapy. This work is often a good fit for couples who are motivated to better understand their situation, open to reflection and feedback, and interested in integrating medical, relational, or psychological factors affecting sexual intimacy.

Many couples who seek consultation are already working with a therapist or have previously participated in therapy and are looking for specialized sexual health expertise or a clearer clinical direction.

To help determine whether this format is appropriate, Madelyn offers a brief 15-minute consultation call prior to scheduling. This conversation allows couples to ask questions, describe their goals, and ensure that the consultation model aligns with their needs.

Services are provided on a private-pay basis and insurance is not accepted. Documentation can be provided upon request for couples who wish to pursue possible out-of-network reimbursement.

Couples consultation can be conducted either in person or virtually. However, in-person sessions are generally preferred, as this format allows for deeper observation of relational dynamics and often enhances the quality of consultation. Virtual sessions remain available when travel or scheduling make in-person meetings difficult.