Mindful attention and awareness may promote sexual satisfaction. However, experiencing cumulative childhood interpersonal trauma (CCT; sexual abuse, neglect, etc.) is associated with distress, which might interfere with dispositional mindfulness and lead to lower sexual satisfaction. Although the concept of mindfulness emerged as an interesting variable to understand sexual difficulties, little empirical data are available on this topic. This study tested an integrative mediation model of the relation between CCT, psychological distress, dispositional mindfulness, and sexual satisfaction within a clinical sample of 410 adult patients consulting in sex therapy. Patients completed questionnaires assessing CCT, psychological distress, dispositional mindfulness, and sexual satisfaction. Results showed that the majority of patients reported experiences of childhood interpersonal trauma. Path analyses highlighted three distinct significant paths from CCT to sexual satisfaction. First, dispositional mindfulness mediated the relationship between CCT and sexual satisfaction. Second, psychological distress also mediated the relationship between CCT and sexual satisfaction. Third, the effect of CCT on sexual satisfaction was sequentially mediated through greater levels of psychological distress and lower levels of dispositional mindfulness. The model explained 19% of the variance in sexual satisfaction. Findings suggest that dispositional mindfulness and psychological distress are key processes explaining sexual satisfaction in CCT survivors.

In this chapter, a comprehensive literature review of the theoretical underpinnings and clinical practices of cognitive-behavioral couple therapy (CBCT) will be presented. First, a description of the theory underlying CBCT and the role of the therapist will be reviewed. Different mandates and motives for couples to consult in CBCT will then be described, with attention given to specificities for diverse populations. The assessment process and main intervention techniques used by CBCT therapists will be presented, including communication training, problem and conflict resolution, cognitive restructuring, identification and expression of emotions, expression of affection and sexual problems as well as acceptance and tolerance of differences. The chapter will conclude with a critical analysis of CBCT and suggestions for future clinical developments.

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