Psychological, Relational, and Sexual History Format
2013 Revision
Barry McCarthy, Ph.D.
American University
1.
Done individually, not together
2.
Start by saying, "I want to understand your psychological, relational, and sexual history both
before and during this relationship. I want to hear both strengths and vulnerabilities, and I
appreciate your being as forthcoming and blunt as possible. At the end, I'll ask if there is
anything sensitive or secret that you do not want shared with your partner. I will not share it
without your permission, I need to know as much as possible so I can be of the most help to
you in understanding and resolving these problems."
3.
Guidelines: Structure chronologically, move from less anxious to more anxiety- provoking
questions, be non-judgmental about variant or non-socially acceptable behavior, ask openended questions, probe for trauma and dysfunctional attitudes, and emotions.
4.
Initial open-ended questions- "What did you value about your growing up and what caused
you problems and regret?"
a.
b.
c.
d.
5.
Social and sexual experiences as a child
a.
b.
c.
6.
Formal education - Good and bad experiences
Religious background- Good and bad experiences
Parents as marital and sexual model (Attitudes towards touching and privacy)
Informal sexual experiences with siblings and children (how have siblings done as
sexual adults)
Social and sexual experiences with others (siblings or peers)
Comfort with body and gender
As a child, were you happy or troubled?
Puberty and Adolescence
a.
b.
c.
d.
e.
f.
First orgasmic experience- age, situation, feelings.
Masturbation-learned, what technique, orgasmic experience, use of fantasies and/or
material (has that changed or stayed the same?). Don't ask a yes-no question. Openended with expectation of yes "How and when did you begin self-exploration and
masturbation."
For females - menstruation: age at onset, preparation for, cognitive, and emotional
response of self and others.
Socially and sexually, what was high-school like? Did you feel good about your body
image? Was dating a positive experience or a source of anxiety or guilt?
How old were you at first orgasm with a partner? How old were you at first
intercourse? Was this a positive or negative experience? How long did the
relationship last and how did it end?
Same sex question- Many men (women) have sexual thoughts, feelings, fantasies,
and experiences with men (women). What were your experiences and feeling about
being sexual with other men (women)?
g.
h.
i.
7.
Adult sexuality
a.
b.
8.
(If attended college) What was college like socially and sexually? (If work or service)
What were your adult experiences like? What were your best sexual and
relationship experiences? What were your most difficult or negative experiences?
(After determining when the present couple met) - As you review your dating and
sexual history, what were your positive and negative learnings? What was
happening in your life 6 months before you met your partner?
Present Relationship
a.
b.
c.
d.
e.
f.
g.
h.
9.
Many people experience unwanted pregnancies or sexually transmitted infections What were your experiences? How did you handle this and feel about it? In
retrospect?
As you revisit your childhood and adolescence, what were your most important
positive learnings and experiences?
As you review your childhood and adolescence, what was the most negative,
confusing, guilt-inducing, or traumatic sexual experience?
How did you meet? What was the initial attraction? What were first sexual
experiences like?
When was sex best in this relationship? What made it good for you? How do you
communicate sexually (verbally and non-verbally)?
Are you attracted to your partner? Do you have loving feelings? When did sexual
problems begin? What caused it and how has it played out? Do you view the sexual
dysfunction as an individual or couple problem? How much anger, guilt, resentment,
blaming is involved?
What are your strengths and vulnerabilities as a couple? What three changes would
you request of your partner?
Are financial issues a relational strength or vulnerability? What doesn't your partner
understand about how you deal with work and financial issues?
(If parents) What are your strengths and vulnerabilities as a parent? Do you enjoy
parenting?
Many people have thoughts, feelings, fantasies, and experiences with extra-marital
(relational) sex. What have been your experiences? How did you feel about the
extra-marital involvement and how did it end? Is it secret? What's your guess about
your partner?
What is the role of alcohol or drugs in your life and relationship?
Wrap-up questions
a.
b.
c.
d.
e.
What else should I know about you psychologically, relationally, or sexually?
What is the most negative, confusing or traumatic sexual experience in your life?
Is there anything you do not want shared with your partner? Why?
Is there anything we haven't talked about that is important to discuss?
Is there anything you want to ask me?
Resource: McCarthy, Barry & Threstrup, Maria (2008). Couple Therapy and the Treatment of Sexual
Dysfunction in A. Gurman (ed.) Clinical Handbook of Couple Therapy (4th Edition). Pp. 591-617.
Guilford.