CLINICAL HANDBOOK OF SCHIZOPHRENIA

608 VIII. SPECIAL TOPICSTABLE 59.1. UCLA Sex Education CourseSession1. Your sexual identity andself-esteem2. Think of your sexualpartner as a person3. Male and female reproductiveanatomy andphysiology4. Your strengths as a partnerand date5. Pleasure, not performance,as the focus of sex6. Birth control and the preventionof sexuallytransmitted diseases7. Open communicationwith sexual partners8. Human sexual responseand sexual dysfunctionsExerciseMake a collage of your sexual identity (magazines, includingPlayboy and other sexually explicit magazines, were made availablefor cutting and pasting), then present your collage and discuss it interms of how your feel about your sexual self.List and share three characteristics of someone you would like todate and role-play introducing yourself to such a person.Slide shows with questions, answers, and discussion of reproductiveanatomy and physiology.Share personal experiences of dates and any sexual feelings or experiencesthat occurred. Write a classified ad about your positive qualitiesto attract a dating partner.Sensate focus by using talcum powder and having participants rubeach other’s hands while guiding their partner with positive and correctivefeedback.Assignment to go to a pharmacy, write down the different types ofcontraception available, and bring the list back to the next groupsession.Educational video showing communication between sexual partnersabout what they did and did not like in a previous sexual encounter.Participants then discuss the communication skills they see.Educational video on human sexual response as it is affected by adverseeffects of physical diseases, medication, stress, or anxiety. Participantsthen discuss the video.date have demonstrated the feasibility of their use and participants’ enthusiasm for thesubject matter. Given the apparent need for this type of material, practitioners’ difficultieswith expressing sexual material cannot fully explain the relative rarity of such programs.Perhaps another contributing factor is that deficiencies in vital areas of social functioningof many individuals with serious mental illness potentially obscure from the clinician’sview the importance of their sexuality. It is not surprising, therefore, that sexuality issuesfrequently arise in the context of social skills training, because this modality is geared towardeliciting the goals and desires of participants. As such, skills training technology is aplace to start when constructing a program to provide explicit instructions to individualswith serious mental illness in the realms of friendship, dating, intimacy, and sexuality.Skills training closes the gap between the individual’s current skills and those neededfor improved functioning. The methods used to teach friendship, and safe and satisfyingsex are based on motivational enhancement and behavioral learning principles:• Ensure that patients “buy into” the module through identifying its relevance totheir own personal goals.• Understand the benefits to patients of learning the skills from a personal frame ofrelevance.• Specify the know-how and skills to be trained; check for understanding.• Demonstrate the skills. Learn by watching videotaped models and answering patients’questions to ensure that they have internalized the skills.• Have patients practice the skills until they can perform them competently. Provide