Cognitive-Behavioural & Mindfulness-Based Online Programs for Female Sexual Dysfunction

Pilot RCT for Cognitive-Behavioural & Mindfulness-Based Online Programs for Female Sexual Dysfunction

Female sexual dysfunction (FSD) affects approximately one-third of women worldwide and is linked to negative physical, psychological, and interpersonal outcomes. Although both cognitive-behavioral therapy and mindfulness-based therapy are effective treatments for FSD, face-to-face treatments can be costly and are inaccessible to many people in remote areas. The goal of the current study is to pilot a randomized controlled trial to examine the effectiveness of and satisfaction with two online interventions for FSD. Women will be randomized to an online cognitive-behavioral program, an online mindfulness-based program, or a wait-list control group. Treatment will be administered entirely online and last 8-12 weeks. Women will meet weekly via Zoom with a navigator who will provide individualized support.

HYPOTHESES:

1. Compared to women in the wait-list control arm, women in the CBT and MBT arms will have significant post-treatment and follow-up improvements in self-report measures of the primary outcomes: (a) sexual distress and (b) sexual desire.
2. Compared to women in the wait-list control arm, women in the CBT and MBT arms will have significant post-treatment and follow-up improvements in self-report measures of the secondary outcomes: (a) overall sexual function, (b) sexual satisfaction, (c) relational sexual concern, (d) satisfaction with life, and (e) relationship satisfaction.
3. Improvements in depression, sexual avoidance, and sexual consequences will significantly mediate improvements in primary outcomes at all post-treatment assessment points.
4. Higher levels of baseline relationship satisfaction, higher levels of partner involvement, more positive baseline expectations about treatment efficacy, higher levels of treatment compliance, and perceiving higher levels of empathy and effectiveness from navigators will predict greater improvements in primary outcomes at post-treatment and follow-up.
5. Baseline personality will moderate intervention effects at post-treatment and follow-up.
6. Women in both the CBT and MBT arms will report being satisfied with treatment.

Inclusion Criteria:

• Cis and trans women of any sexual orientation.
• Must be fluent in English (online materials delivered in English).
• Must have consistent access to the internet, basic competency in using online platforms (self-report).
• Must be in a committed, stable romantic relationship of at least 6 months (because aspects of the interventions require partner participation). Partners may be of any gender.
• Must meet telephone screening diagnostic criteria for sexual interest/arousal disorder.
• Must be sexually active with a partner over the preceding 4 weeks (due to the sexual function outcome measure), and willing to engage in sexual activity with their partner during the study.
• Must be able to participate in an 8-12-week online treatment.

Exclusion Criteria:

• Have sexual dysfunction that is, in their estimation, fully attributable to another psychiatric diagnosis, the effect of a substance, a general medical condition (e.g., Multiple Sclerosis), or non-sexual conflict in the relationship, none of which are meant to be addressed by the proposed interventions.
• Poorly managed Anxiety or Mood Disorder (as per degree of life interference assessed at screening).
• Report visual impairments that would make it difficult to read online materials.
• Are regularly using prescription narcotics illegal recreational drug (not including cannabis).
• Plan to change their medications known to impact sexual function over the course of the study.
• On assessment report plans to end their romantic relationship in the next 6 months.
• Engage in any other treatment for their sexual difficulties during the study.