online couples therapy for sex problems in california
Couples Therapy for Real Conversations and Lasting Change
Couples Therapy
Couples therapy is here for you when you're feeling stuck in the same arguments, needing to build intimacy, drifting apart emotionally or sexually, or facing big life changes together. Whether you're working through broken trust, navigating different intimacy needs, or simply wanting to feel closer again, this is a space where both of you can be heard and understood. As a couples intimacy therapist, I am here to help you rediscover your connection, heal after conflict, and build the relationship you both want, with compassion, clarity, and care every step of the way.
You may benefit from couples therapy if:
– You’re having recurring conflicts or communication breakdowns that feel hard to resolve
– You’re feeling emotionally or sexually disconnected from your partner
– You’re navigating a major transition, rupture, or shift in the structure of your relationship
$230 per session
FREQUENTLY ASKED QUESTIONS
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The Therapy Journey: Your Pace, Your Progress
There's no one-size-fits-all answer to how long therapy lasts. Every individual and relationship is unique, so the duration of therapy varies depending on your specific needs and goals.
What to Expect
Noticeable Progress: Many clients start seeing positive changes in their relationships and themselves within a few months.
Deeper Work Takes Time: For more complex issues or deeper exploration, therapy may require a longer commitment.
Safety, Empowerment, and Understanding: My priority is to create a safe and supportive environment where you feel empowered and understand the therapeutic process. Building trust and mutual respect takes time, and I never rush that process.
Commitment to the Work: The most successful clients are those who are actively engaged and willing to invest the time and effort needed for personal and relational growth.
Your Unique Journey
The length of your therapy journey is ultimately up to you. Together, we'll establish a pace that feels comfortable and productive, ensuring you have the time and space necessary for meaningful change.
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I am currently not in-network with any insurance providers. However, I'm happy to provide you with a statement of services, also known as a "superbill," that you can submit to your insurance company for potential reimbursement.
Important Considerations:
PPO vs. HMO Plans: PPO plans typically offer some coverage for out-of-network providers, while HMO plans generally do not.
Contact Your Insurance: It's crucial to contact your insurance company directly to understand your specific out-of-network benefits. Ask the following questions:
Are out-of-network mental health services covered under my plan?
If so, what percentage or amount of each session is covered?
Is there a deductible that needs to be met before coverage begins?
Is there a limit on the number of sessions that can be reimbursed per year?
Do I need pre-authorization for out-of-network services?
What specific information is required for reimbursement (e.g., diagnosis codes, provider information, etc.)?
Understanding Your Benefits
By contacting your insurance company and clarifying your out-of-network benefits, you'll have a clearer understanding of the potential for reimbursement and any associated costs. This will help you make informed decisions about your therapy journey.
If you have any further questions regarding insurance and fees, please feel free to reach out to me directly
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Sexuality & Sexual Health / Functioning
Exploring self-esteem in relation to sexual experiences and effectively communicating personal needs within your relationships is essential for fostering deeper connections.Male Sexuality and Intimacy Issues can often create barriers to emotional closeness and sexual satisfaction, making it crucial to address these challenges openly.
Additionally, navigating Mixed-Orientation Marriages presents unique dynamics that require careful consideration and understanding.
Finally, it is important to discuss Issues related to desire and libido, as these aspects can significantly impact both individual well-being and relationship satisfaction.
Polyamory, ethical non-monogamy (ENM), non-monogamous arrangements, and open relationship dynamics present unique challenges and opportunities for individuals and couples.
Additionally, navigating the complexities of kink, BDSM practices, and serving as an LGBTQAI ally are all significant aspects of contemporary relationships that are welcome to explore in our work together.
In this space, we also address the nuances of sexual narcissism and the intricate sexual power dynamics that can arise in various interactions.
Furthermore, I provide assistance in integrating past experiences with psychedelics and other peak life moments that individuals may struggle to process on their own, fostering deeper self-understanding and emotional healing.
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Absolutely. It's common for one partner to be experiencing a particular challenge, but couples therapy offers a space to explore how both partners are impacted. We work collaboratively to create understanding and compassion on both sides, so that healing can happen relationally, not through blame or pressure, but through connection and shared growth.
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No. My role isn’t to make that decision for you, but to help you gain clarity, insight, and emotional honesty so that you can make informed choices about your relationship. Whether you’re looking to repair, redefine, or part ways consciously, therapy offers a supportive space to move forward with care and intention.
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Desire discrepancy is one of the most common reasons couples seek sex therapy. It doesn’t mean something is “wrong,” it means there’s something important to explore. Together, we’ll unpack what’s happening beneath the surface, understand each partner’s experiences and needs, and build tools for communication, flexibility, and connection that honor both of you.
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Sex therapy is a specialized form of talk therapy that focuses on concerns related to sexual functioning, desire, identity, and intimacy. But it’s not just about sex, it’s about connection, self-worth, communication, and healing. Whether you're experiencing low libido, shame, performance anxiety, or simply want to better understand your erotic self, sex therapy provides a safe and nonjudgmental space to explore those experiences with curiosity and compassion.
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Yes. I am an inclusive, affirming space for individuals and couples of all identities, orientations, and relationship structures. Whether you're curious about non-monogamy, actively practicing polyamory, or navigating an open relationship, you'll find affirming, knowledgeable support here. I understand that non-monogamous relationships come with their own set of joys and challenges, complex communication needs, boundary negotiations, scheduling logistics, jealousy, compersion, and creating agreements that honor everyone's needs. This is a judgment-free space where your relationship structure is respected and understood.
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Couples intensives are ideal when you want to dive deeper than what weekly sessions allow—whether you're in crisis, recovering from betrayal, or simply want to reconnect more intentionally. Intensives offer a focused, immersive container for meaningful breakthroughs and lasting change. If you're feeling stuck, overwhelmed, or just ready for transformation, an intensive may be the reset you need.
desire discrepancy
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Couples Therapy
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Individual Therapy
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Sex Therapy
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Couples Intensives
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desire discrepancy 〰️ Couples Therapy 〰️ Individual Therapy 〰️ Sex Therapy 〰️ Couples Intensives 〰️
Adrian Scharfetter, PhD, LMFT, CST-S is a San Francisco couples therapist with 15 years of experience helping partners navigate conflict, disconnection, and intimacy challenges at Athenian Counseling. He specializes in attachment-based approaches for couples across all relationship structures, including LGBTQ+ and ethically non-monogamous partnerships. Adrian brings both clinical depth and genuine warmth to helping couples build lasting, honest connection.
AASECT Certified Sex Therapist
Licensed Marriage & Family Therapist
Certified Sex Therapy Supervisor
Specialized in intimacy, desire, erotic conflict, and relationship repair
Online therapy throughout California
Why Work with an AASECT-Certified Sex Therapist?
When it comes to sexual health and intimate concerns, the credentials of your therapist matter…significantly.
AASECT (American Association of Sexuality Educators, Counselors and Therapists) certification represents the gold standard in sex therapy training. It's not simply an additional degree or a weekend workshop. It's a rigorous, multi-year process that requires extensive specialized education, supervised clinical hours specifically focused on sexual health, and demonstrated competency in addressing the full spectrum of sexual concerns.
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Specialized expertise beyond general therapy training. While many therapists are willing to discuss sexual issues, most receive minimal training in human sexuality during their graduate programs—often just a single course or even less. As an AASECT-certified sex therapist, I've completed hundreds of hours of advanced training specifically in sexual health, sexual function, desire, pleasure, intimacy, and the complex interplay between psychological, relational, and physiological factors that influence sexuality.
Clinical experience with diverse sexual concerns. My certification required extensive supervised work addressing a wide range of sexual issues: desire discrepancy, erectile concerns, pain during sex, performance anxiety, compulsive sexual behavior, sexual trauma recovery, orientation and identity questions, kink and alternative sexualities, and much more. This breadth of experience means I'm not learning on your time—I've successfully helped numerous clients navigate challenges similar to yours.
A sex-positive, non-judgmental approach. AASECT certification emphasizes understanding sexuality across the full spectrum of human experience. I work with clients across all gender identities, sexual orientations, relationship structures (monogamous, polyamorous, and everything in between), and expressions of sexuality. There's no shame in my practice, only genuine curiosity about what brings you pleasure, fulfillment, and authentic connection.
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Integration of medical and psychological knowledge. Sexual concerns often exist at the intersection of physical and emotional health. I understand the medical aspects of sexual function, can help you determine when consulting with a physician is appropriate, and know how to collaborate with other healthcare providers to ensure you're receiving comprehensive care.
Ethical standards and ongoing education. AASECT certification requires adherence to strict ethical guidelines and ongoing continuing education. I stay current with the latest research, treatment approaches, and best practices in sexual health to provide you with evidence-based, effective therapy.
Many relationship therapists feel comfortable addressing "communication about sex," but struggle when clients need deeper work around sexual function, desire, arousal, or pleasure. If your concerns include:
Significant differences in sexual desire between partners
Performance anxiety or erectile difficulties
Pain during sex or difficulty with arousal
Recovery from sexual trauma or shame
Exploring sexual identity, orientation, or desires
Navigating ethical non-monogamy or open relationships
Rebuilding sexual connection after infidelity
Integrating kink or alternative sexual practices
You deserve a therapist with specialized training to address these issues effectively and compassionately.
Sexual health is fundamental to your well-being and relationship satisfaction. Working with an AASECT-certified sex therapist means you're receiving care from someone who has dedicated years to understanding the complexities of human sexuality and who brings both clinical expertise and genuine respect for your unique sexual expression.
You don't have to settle for surface-level conversations about intimacy. You deserve a therapist who can go as deep as you need to go.