Ex-PLISSIT Model

The Extended PLISSIT Model, or Ex-PLISSIT, as created to address several of the issues that exist with the PLISSIT model. Instead of the linear PLISSIT model, where each stage leads to the next, the Ex-PLISSIT incorporates the permission-giving element into each stage of the process.

Permission-giving: Bringing awareness to the client that it is okay to discuss sexual concerns. During the initial evaluation, the clinician should give explicit permission to the client to discuss matters related to sexual health. This model suggests that the OT should be clear that sex is an area that occupational therapy can address sexual concerns. Even if the client does not bring up concerns immediately during therapy, the therapist should continue to provide permission for the client to discuss any concerns as they arise.

Limited information: Providing clients with brochures, pamplets, or other general information concerning sex. Therapists should follow up with clients to ask them if they have any questions regarding the materials provided. If therapists are concerned about clients becoming uncomfortable, they can simply ask, "Would you like to discuss this further?" Asking directly if a client wants to discuss these matters removes any possibility of ambiguity or misinterpretation on the part of the therapist. It is important to continue giving permission for the client to discuss matters of concern and continue to follow-up as long as the client does not become uncomfortable.

Specific suggestions: At this stage, the therapist uses a problem-solving approach to address specific conerns the client has brought up. For instance, if the client has a new physical limitation, the therapist may suggest different methods of positioning that would be effective for the individual and their partner.

Intensive therapy: Intensive therapy is typically beyond the scope of occupational therapy, unless there is a specialization. If the client needs intensive therapy, it may be most appropriate to refer them to another provider, such as psychologist, sex therapist, pelvic floor therapist, etc.

References

Taylor, B., & Davis, S. (2006). Using the Extended PLISSIT model to address sexual healthcare needs. Nursing Standard, 21(11), 35-40. Retrieved from https://go.gale.com/ps/i.do?p=HRCA&u=txshracd2618&id=GALE%7CA155663689&v=2.1&it=r