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Meeting Room

Sex-Positive Therapy Consultation

 A 6-month Virtual Group for Clinicians 

Black, queer, sex therapist

Led by Rafaella Smith-Fiallo, MSW, LCSW

In graduate school I began researching barriers that clinician's face in providing sex-positive, accurate, trauma-informed, and social justice oriented sexual health care and services. From cultural to educational, the barriers are many. But that's what training and support is for! So, I'm excited to present "Sex-Positive Therapy" as the first of my clinical consultation offerings.

As a trained sex educator and therapist, working through certain concerns with clients is part of what I do. And when those client’s come to me, they let me know all about the difficulty they’ve had talking to past therapists about their sexual concerns.

Common reasons clients said talking about sex in therapy was difficult:

But, your clients want to bring 'sex stuff' up with you!

Sexuality is part of everyone’s life and will likely show up during therapy in one form or another. However, many clinicians have little to no training or education in the full range of human sexual behavior. As people are becoming more open to talking about sexuality and come to therapy for help with sexual questions and problems, the need for sexually informed and sex-positive therapy is rapidly growing.

So, this group was created to support clinical mental health professionals who are interested and invested in providing sex-positive and trauma-informed therapeutic services.

sexual healing and pleaure

What clinicians have to say...


Rafaella is truly a dynamic clinician and I appreciate her expertise in trauma, gender, and sexuality. I have consulted with her regarding couples that I have treated in the past. She respected my time by being on time to our consultation session. She was patient, an active listener, and answered all of my questions. She also made sure I left our first consultation session with follow up questions and goals to carry out in my next session with the couple.

Cherese Alcorn, MSW, LCSW - St. Louis, MO

Sex positive books at healing exchange

Group overview

The purpose of this group is to inform, expand, and support your therapy approach when client’s undoubtedly bring sex and sexuality into the session. This is a space that fosters healthy and respectful discourse and is intended to be for collaboration, innovation, and case consultation.

We will be focusing on one another’s strengths and competencies as we explore what is problematic and difficult as well as what we feel we are doing well and enjoying as therapists. Being so, this is also a space of vulnerability as we will all have our opportunities for growth and improvement pointed out and discussed.

Each meeting is centered around a specific topic for which I will provide education, tools, and resources. We will then use the remainder of the time for case discussion and support (the cases do not have to align with the month's topic).

Here are the topics:

  1. LGBTQIA+ Affirming Therapy

  2. Sexual Trauma & Healing

  3. Addressing Sexual Concerns in Couples Therapy

  4. Working with Non-Monogamous Couples

  5. BDSM & Kink Fundamentals

  6. Working with Clients Who Consume Sexual Content & Services


  • This is a peer consultation group, not a supervision group for licensure. Therefore, we provide support and are not responsible for the actions of group members.

  • This is not a sex education/sex therapy certification program of any sort.

  • In accordance with NASW's ethical code 1.07 Privacy and Confidentiality, APA's ethics code 4.06 Consultations: 1. social workers and psychologists do not disclose identifying information that reasonably could lead to client identification when discussing clients with consultants; and 2. when consulting only disclose information to the extent necessary to achieve the purposes of the consultation.

Sign me up!

What you need to know

  • 12 CEs approved through the MO State Committee for Social Workers

  • Meetings: 2023 schedule TBD

  • Location: Virtual via Zoom

  • Space availability: 8 group members

  • Cost: $600

    • ​​Flexible payment plans can be set up at check out through PayPal.

Living Room

LCSW Supervision
for Missouri clinicians only

Areas of Practice
  • Individual therapy (relationship, sex, and trauma)

  • Group therapy

  • Psycho-education

  • Sexuality education and coaching

  • Suicide pre-post-intervention

  • Crisis Intervention

  • Curriculum development

  • EMDR, Gottman, Sensate Focus, Somatic/Embodiment, IFS, Prepare/Enrich, CPT

  • Business and private practice management


Individual - $75 per hour

Group - $50 per meeting (2 hours)


Supervisees are required to meet for a minimum of 4 hours of supervision each month. Up to 2 hours can be in a group setting. 

Consider completing 2 hours of individual supervision and 2 hours of group supervision per month for more diverse supervision and training experience.

Upcoming Trainings


Erotic Self Expansion for Trauma Survivors
Use code: healingxchg for 20% off

February 17, 2023

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