The PLISSIT Model

PLISSIT: The central sex education tool used to answer questions about sex. PLISSIT stands for Permission, Limited Information, Specific Suggestions, Intensive Therapy. (Jack Annon, 1976)

Permission: Most folks who has sexual concerns will benefit from permission. Permission includes not only permission to do or desire whatever they want, but also permission to ask, to speak freely, to request information, to discuss their concerns. This so-called “permission-giving” is best seen as an on-going process rather than a once off event. Having received such permission to be a sexual human being and to have sexual concerns without being judged, people are more likely to feel able to raise any sexual concerns on their mind or to answer questions of a sexual nature more openly and confidently. In some instances, permission giving and the provision of limited information may prevent difficulties from arising in the first place. These low intensity interventions by themselves can also mobilize a person’s inner coping resources to overcome some concerns by themselves. Gentle direct questioning communicates that such material is appropriate for discussion, without leaving a patient feeling forced to disclose information they do not wish to share

Limited Information: Many folks with sexual concerns also need information. Usually, this is fairly simple information, or it may be slightly more complicated information. Most sexual concerns are addressed successfully by the giving of limited information (e.g. STIs, risks of pregnancy, sexual side effects of treatment) or specific suggestions (use condoms & where to get them, spend more time of foreplay, try different positions).

Specific Suggestions: Providing limited information often moves onto making an assessment detailed enough to provide specific suggestions. Some people are looking for specific suggestions from a sex educator. Specific suggestions can include simple sexual solutions or even more direct advice. Most sexual concerns can be addressed at the limited information & specific suggestion level of intervention.

Intensive Therapy: A few folks will need more help than you (or any sex educator) can competently, ethically, or legally provide. These folks are needing therapy, which is outside of our job description. Only small numbers of patients require further specialist help (intensive therapy). Where specialist investigation, treatment of other form of intervention (Psychosexual Therapy, Medical Resources, etc) is required, folks should be referred to the appropriate service.

Tools to use in conjunctions with the PLISSIT Model:

Sex Positive: Promotes and embraces sexuality with few limits beyond an emphasis on safe sex and the importance of consent. Sex positivity is "an attitude towards human sexuality that regards all consensual sexual activities as fundamentally healthy and pleasurable, and encourages sexual pleasure and experimentation. The sex-positive movement is a social and philosophical movement that advocates these attitudes. The sex-positive movement advocates sex education and risk reduction as part of its campaign." The movement generally makes no moral distinctions among types of sexual activities, regarding these choices as matters of personal preference.

• Harm Reduction: A model of Public Health which encourages awareness of and decisions about risk as a continuum. Harm reduction is an alternative to largely unsuccessful attempts to prohibit certain lifestyle choices

• Consent: An agreement to engage in a specific activity, including: the ability to refuse, a clear understanding of the behavior and possible consequences. All sexual activities based in consent are “good”.

Cheerleading: Most therapists are encouraging and emphatic, and some therapy models emphasize this warm support more than others, but certainly not all therapy works this way. Therapists also challenge and educate clients. Cheerleading therapy makes for entertaining TV, but not always good therapy. Listen carefully without judging the person’s feelings or your own. It’s OK to point out and disagree with self-defeating thoughts. Do not tell the person to “cheer up” or “think positive” if they are depressed. The therapist asks the patient to look at the ponderance of evidence to reach tentative conclusions and remain skeptical about all the ways of knowing. This is emphasized to underscore the the cognitive therapist should not become a “cheerleader” for positive thinking. We should avoid the impression characterized by SNL’s Stuart Smalley and his tag line “I'm good enough, I'm smart enough, and doggone it, people like me!” Cognitive therapy is not a process of bolstering defense or proselytizing about the “power of positive thinking.” Rather, it demonstrates the power of realistic thinking - that is, to the extent that we can know reality.

“Normal”: As a sex educator, it is often not necessary for you to know the exact # of people who do a specific activity. However many people are concerned if their sex life is “normal” or falls with a “normal” range of behavior and it is important to address these comments or concerns.

• “Some”, “Many”, “Most”: Often a more general framework will work just as well. A useful way to generalize the amount of people who do a certain activity, identify a certain way, etc. Often used to help normalize sexual variation.

• Outlier: A rare case brought up to challenge an overgeneralization (“All americans are puritanical”) or to acknowledge the complexity of human behavior.

• Corner Case: Bringing up an Outlier in an attempt to invalidate the general rule

Admitting Your Own Limits: You don’t need to be comfortable talking to everyone about every subject all the time. If you find that your triggered it important to admit your limits. Even Dr. Ruth says there are limits to her toleration for kink: she won't, for example, counsel people who are into BDSM because she can't "visualize" it.

#PLISSIT #sex #pleasure #sexuality #permissionb #information #therapy