The last taboo? Exploring clinical psychologists’ attitudes towards older adult sexuality

Aims: To explore the experiences of trainee clinical psychologists and clinical psychologists who have qualified in the last 5 years of talking to older adult about sex, sexual health and sexuality. This thesis will explore (1) The training neophyte clinical psychologists received concerning sexual health through their programme of study and through clinical practice (2) How neophyte clinical psychologists have found exploring and addressing sexual health through their clinical practice and as part of a multi-disciplinary team (3) Adaptions made to case formulation as a result of sexual health issues being raised (4) The modalities favoured by the clinician to formulate and use therapeutically (5) The impact this has on their ability to integrate sexual health issues into both formulations and their clinical practice. Background: It is unclear the level of consideration that is given to older adult sex, sexual health and sexuality by clinical psychologists and on clinical psychology doctorate courses. This may impact how often trainee and clinical psychologists consider and discuss the sex lives of older adults. Healthcare professionals have been shown to struggle to know what their role is when discussing sex with the older adult population. However, there is limited research exploring topic with newly qualified clinical psychologists and trainee clinical psychologists in the United Kingdom. Methodology: A reflexive thematic analysis design was used to explore and analyse 15 semi-structured interviews of trainee and qualified clinical psychologists on their experiences of speaking about sex, sexual health and sexuality with older adults in a clinical setting. MDT discussions, supervision and training will also be considered. Results: The reflexive thematic analysis identified four main themes and 23 sub themes from the interviews: (1) Who am I and who are you? (2) I am a psychologist I should know what to do (3) How can we possibly talk about this? (4) You shouldn’t be having or 7 talking about sex. Conclusion: The themes that have been identified in this project highlight the different barriers clinicians face when exploring sex, sexual health and sexuality with older adults. Barriers were felt to include their own and the client’s background and the personal views around sex and cultural factors and how this interacts and conflicts between clinicians’ personal and cultural views of sex. The service clinicians work in and the views of their supervisor can also alter the ease with which they broach the topic, as can the quality and time training clinicians received on the topic.