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Psychosexual counselling - a room to say the unsaid.

Talking-only sessions for couples and individuals with COSRT-accredited counsellors. Desire, arousal, pain, function, identity, and adjustment after cancer, surgery or menopause. Nothing physical happens in the room.

See indicative pricing
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Indicative pricing

What private psychosexual counselling costs in the UK.

In short

A first couple appointment: £180–£300, typical course of 6–12 sessions.

Appointment Indicative range
First appointment (couple, 75 min) £180–£300
First appointment (individual, 60 min) £120–£220
Follow-up session (couple, 50–60 min) £130–£220
Follow-up session (individual, 50 min) £90–£170
Typical course (6–12 sessions) £700–£2,600 (course)
Secure video session (same tariff) £90–£220
Urology or gynaecology consult (if needed) £250–£450

Fees vary by counsellor seniority and location. London senior COSRT clinicians sit at the top of the range; regional and video work at the lower end. Concessions are sometimes available for post-cancer and post-natal referrals.

The problem

A specialist room, a specialist counsellor, and a shared vocabulary.

General couples counselling often circles around sex without landing on it. Psychosexual counselling has the training, the language and the framework to do the work properly.

  • Trained specifically in sex

    COSRT accredited counsellors complete dedicated postgraduate psychosexual training on top of a parent counselling qualification.

  • Couples or solo, with the same clinician

    You can start alone and add a partner later, or begin as a couple and take an individual session when it helps.

  • Medical review where needed

When it helps

When psychosexual counselling is the right step.

What we see most often - plus the one red flag that means safety support first, not couples work.

  • Loss of desire, or a desire gap

    One partner wants sex more than the other, or desire has slipped away completely - the single most common reason couples come.

  • Difficulty with erection or ejaculation

    Erectile difficulty, delayed or rapid ejaculation. Often needs a joint conversation and a medical check-in, not either alone.

  • Vaginismus and painful sex

    Vaginismus, vulvodynia, or pain that started after childbirth or menopause. Counselling alongside pelvic-floor physiotherapy or a gynaecology review.

  • After a diagnosis or surgery

    Reconnecting after prostate cancer, mastectomy, hysterectomy, stoma surgery, cardiac events or a chronic pain diagnosis.

  • Affair, disclosure or a broken trust

    When an affair or a secret has surfaced. A structured counselling course helps you decide whether to rebuild or to separate well.

  • Sexual identity, orientation, coming out

    A space to talk about questions of orientation, gender, non-monogamy or coming out - with a counsellor trained not to have an agenda.

  • Faith, culture and sex

    Where religious or cultural beliefs are part of the conversation.

  • Red flag: coercion, violence or abuse

    Couples counselling is not appropriate where one partner is being coerced, harmed or controlled. Call the National Domestic Abuse Helpline (0808 2000 247) - separate, safe support first.

Counselling options

One frame does not fit every couple or every life-stage.

The formats we most often arrange, and where each fits.

  • Couples psychosexual counselling

    Both partners in the room. The most common frame - around two-thirds of our work. Focuses on the shared story, communication, and the meaning sex holds for each of you.

  • Individual psychosexual counselling

    Where a partner cannot or will not attend, or the difficulty predates the relationship. Confidential to you, with disclosure to a partner never done without your consent.

  • Short-focused counselling (6 sessions)

    A brief, agenda-led course for a defined problem - a specific dysfunction, a life-stage change, adjustment after surgery - with clear goals and a written summary at the end.

  • Extended course (12 sessions and beyond)

    Where trust rebuilding, longer-standing difficulty or complex history need more time. Reviewed every six sessions.

  • LGBTQ+ affirmative counselling

    With a counsellor whose training and practice is explicitly affirmative - including non-monogamy, gender-diverse relationships and coming-out work.

  • Post-cancer and post-surgical counselling

    For couples adjusting after prostate cancer, breast cancer, stoma surgery, gynaecological surgery or head-and-neck cancer. Integrated with the surgical team.

  • Menopause and mid-life counselling

    For desire loss, painful sex, body-image shift or the couple recalibration that often accompanies the menopause transition.

  • Older-age and dementia-aware

    For couples renegotiating intimacy in later life, including where one partner has a dementia diagnosis and adjustments are needed.

Safety and expectations

What to expect - honestly.

The things worth knowing before you begin - about the format, the frame, and where counselling is not the right fit.

  • It is talking, not touching

    Nothing physical happens in the room. Any suggestion of physical touch or sexual contact by a counsellor is a serious breach of UK practice standards.

  • Homework is agreed, never imposed

    Between-session tasks - communication exercises first, and only later anything more intimate - are only set with the informed consent of both partners.

  • Individual confidentiality inside couples work

    If you attend as a couple, information shared in a rare individual session is confidential to you. The counsellor will name the "no-secrets" or "limited-confidentiality" policy at the start.

  • Rule out the physical first

    Erectile difficulty, painful sex and sudden desire loss often have a physical component. The counsellor will ask about your last GP review and may pause work while a urology or gynaecology opinion is sought.

  • Not appropriate in active abuse

    Couples counselling is contraindicated where one partner is being coerced, harmed or controlled. Individual safety-planning support comes first, always.

  • Endings and breaks are planned

    Holidays, pauses and endings are discussed openly rather than left to fade - because separations in this work tend to mirror separations in the relationship.

  • It can get harder before it gets easier

    Difficult conversations delayed for years often surface in the first six sessions. Most couples find the middle harder than the beginning, and the end quieter than either.

  • Evidence base is real

    COSRT-standard psychosexual counselling has good evidence for most female sexual dysfunctions and for adjustment after cancer and childbirth. Combined with medical treatment for organic causes, results are better than either alone.

  • A poor fit is a legitimate reason to change

    If after two or three sessions the fit feels wrong for either partner, we will help you move to a different counsellor. Fit predicts outcome as much as any other single factor.

Reading your counselling record

Your counselling record in four parts. Read the last one first.

Every COSRT counsellor keeps a record to the same structure - from first appointment through to a written end-of-course summary.

A UK psychosexual counsellor reviewing session notes

A quiet reminder

Nothing is written that has not been discussed with you first.

If you would like us to walk you through the formulation or the end-of-course summary before you meet your GP, just ask.

  1. 01 Consultation

    What is happening, and for how long

    Presenting concern, timeline, medical background, previous counselling, and whether this is a first attempt at psychosexual work.

  2. 02 Formulation

    A shared understanding

    A short written formulation shared with the couple - what the counsellor understood, where the difficulty seems to sit, and what would help.

  3. 03 Review

    Six-session review

    A structured pause: what has shifted, what has not, and whether to continue, close or refer to a urologist, gynaecologist or pelvic-floor physiotherapist.

  4. 04 Ending

    End-of-course summary

    Read this first at ending: a plain-English summary of the work done, what changed, and a plan for maintaining that change together.

Recognised by major UK insurers

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Psychosexual counselling is sometimes funded by UK insurers, often as part of a post-cancer, post-surgical or menopause pathway.

Frequently asked

Everything we get asked about psychosexual counselling.

Quick answers on format, cost, insurance and how it differs from ordinary couples counselling.

  • What is psychosexual counselling?

    A specialist form of counselling for sexual and relationship difficulties, delivered by a COSRT-accredited counsellor. It is a talking treatment - no physical examination and no physical contact take place. The focus is on communication, desire, meaning, and the story a couple or an individual carries about sex.

  • Do I have to bring my partner?

    No. About a third of our clients come alone, either because the partner cannot or will not attend, or because the difficulty is longstanding and predates the relationship. Bringing a partner is a common route but never a requirement.

  • How is it different from ordinary couples counselling?

    General couples counselling addresses the relationship broadly. Psychosexual counselling is specifically trained in sexual difficulty - desire, arousal, pain, function, identity, and the impact of medical events - with a specialist framework and specific between-session tasks.

  • How many sessions will I need?

    Most short-focused problems settle in six to eight sessions. Longer courses of ten to twelve sessions are common where trust rebuilding is part of the work. Very few courses run beyond twenty sessions, and we review every six.

  • How much does psychosexual counselling cost in the UK?

    A first couple appointment runs £180–£300, and individual first appointments £120–£220. Follow-up sessions are £130–£220 for couples and £90–£170 for individuals. A full course of six to twelve sessions comes to £700–£2,600. Video sessions are on the same tariff.

  • Is it covered by insurance?

    Sexual health counselling is covered by some UK insurers when medically indicated - often as part of a post-cancer, post-surgical or menopause pathway, and less often as a stand-alone.

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