• When assessing and diagnosing clients, it is important to consider factors surrounding the presenting problem. Please address any two of the following factors and explain your thought process: medical factors, individual factors, relationship factors, and cultural and/or religious factors.
• List the 2-3 diagnoses you considering at this point (use proper codes). Provide your reasoning.
• As therapists, it's necessary to be aware of our own biases. Reflect on any one of the following: your comfort level with talking about sexual dysfunctions, what role you think sex plays in a partnership, and thoughts/feelings toward treatment planning for sexual issues.

How do these two fit in the scenario?

F52.31 Female Orgasmic Disorder, Acquired, Never experienced orgasm under any situation, Severe

F52.22 Female Sexual Interest/Arousal Disorder, Acquired, Severe

Vignette for TD#1 Susan and John have been married for 3 years. They seek couples therapy because they have "problems in the bedroom." John shared that Susan is "never into sex." He complains that she has never had an orgasm with him and that their sex life has gotten even worse recently, as she displays less desire to have sex as well. When the therapist asked Susan about her difficulty with orgasm she replied, I don't see the problem. I don't mind not having orgasms and I don't understand why he cares so much." She also stated, "John constantly talks about how I haven't 'climaxed' and now I feel the pressure to have an orgasm." Susan reported that this resulted in her feeling less hopeful. "I've given up." Susan comes from a conservative Catholic family. John was raised in a more liberal home. Susan does not practice her religion, and has become more agnostic since meeting John. John also expressed that before marriage, when they had sex, Susan seemed to experience more pleasure. Susan agreed with John in this regard. John complained in the first meeting in your office, "To be honest, I don't know what happened. She was always very passionate when we were dating, and now we've lost that passion."