Many people think of counselling as giving advice or offering solutions to the problem. However, counseling is neither of these. When the client comes for help with a problem, he has to change something in himself to solve it. This may be a change of attitude, perception of self, or of others, of habit or a change of behavior. Counselling is teaching the client ‘life –coping skills.


- To help reduce the level of anxiety when confronted with a stressful situation.
- To help bring about a meaningful change in the client and function more successfully.
- To facilitate client’s decision-making process.
- To help client to plan his solution for his problem using his value system


- Listen actively, and question effectively.
- Accept the client; respect him, his ideas and feelings.
- Show empathy and warmth.
- Be honest and non-judgmental.
- Counter the myths and misconceptions.
- Maintain confidentiality.
- Counselling can never be hurried.
 - Hold the counselling session in a private place.
- Be comfortable with your own sexuality.
- Feel comfortable with the use of language of sexuality

Treatment Level I     P: Permission: 

          The counsellor asks questions about client’s sexuality e.g. sexual thoughts, fantasies, dreams, feelings, sexual arousal, masturbation, nocturnal emission etc. The counselor assures the client that he is o.k. and to continue doing what he has been doing.

Level II:  Limited information :

          At this level the counsellor explains why the client is o.k.

The counsellor counters myths and misconceptions related to 

His sexual problem and problem and provides scientific information on the concerned topics e.g. masturbation, oral sex, breast and genital size, sex during menstruation/Pregnancy etc.

Level III: SS: Specific Suggestion:

          At this level the counsellor provides alternative explanation for the problem and offers specific suggestion to the client to manage the sexual situation e.g. specific coital position during pregnancy, sensate focus, kegel’s exercise.

Level IV: IT: Intensive Therapy:

          At this level analysis and treatment of attitudinal, reinforcing and discriminative functions of stimuli that elicit inappropriate emotional responses are required. Paraphilia, marital discord, substance abuse required this level of therapeutic intervention.

Additional instructions to the client:

1. Tobacco: to stop smoking or any other use of tobacco. Nicotine in tobacco causes vasoconstriction and enhances atherosclerosis.

2. Balanced diet: To avoid excessive consumption of fats, sugars and salt and to take plenty of proteins ( egg white, pulses, fish, skimmed milk), green vegetables and fruits. Udid contains natural testosterone and soyabean contains natural estrogen. Idli made from udid and rice is a nutritious food item. Vegetarian and non vegetarian diets are equally good provided extra milk is consumed by vegetarians. Balanced diet provides enough energy for sexual activity.

3. Exercise: the aim is to achieve physical fitness and not the body building. Exercise should be done on empty stomach. It should be gradual. If pain occurs in chest during exercise, it should be discontinued immediately and seek physician’s advice.

4. Body weight: Excessive body weight may cause difficulties in sexual activities. Optimum body weight is calculated by the formula of body mass index (BMI).

BMI= Body weight in kg. / (Height in meters)2

The resultant should be 25.

Both, dieting and exercise are necessary for the weight reduction.            

Posted by Dr. Ramesh Maheshwari, WNHO Clinic, 2014 Sadashiv Peth, Tilak road, Pune.
Free to call for further information.