ELPIDA Course - English

The PLISSIT- model (1) gives an overview of what kind of support parents (two first levels) or professionals (top levels) can provide PWID, when they need help with sexual choices, information or treatment.  The model shows when there is a need for special competences in order to provide treatment e.g. in case of serious sexual problems. Watch the video and learn more about the PLISSIT-model.

Film: The PLISSIT-model (1):

The design of the model is a pyramid, with different levels of support. The bottom of the pyramid indicate the lowest level of need for support. At these two bottom levels, the therapist (or parent) needs the least amount of competence to be able to support the person in solving their sexual problems.

An explanation of the levels in the model, from bottom to top, is the following (1):

P (Permission) means to allow. This level of support implies that the person is experiences acceptance for bringing up and discussing sensitive and intimate sexual subjects. In this way, it might be possible to find out if there is a need  for intervention. Acceptance also gives the person a sign that sexuality is a normal part of human life, in every life situation. ‘The P-level’ encompass every topic related to sexuality; anatomy, physiology, health, family, identity, contraceptives, hygiene, friends, girlfriend/ boyfriend, emotions, masturbation, sexual turn-ons, intercourse, menopause, lust… etc. At this level, most people are able to talk about sexuality together with PWID. It is important that the person feels free to talk about every part of sexual health e.g. homosexuality.

LI (Limited Information) means that the level of information offered is adequate and given through general information about questions about disease, diagnosis and symptoms, so that the person receives answers to his/ her worries and challenges to a largest possible degree. Such an approach is only relevant to some part of the population, for instance children old enough to undertake sexual education at school. In most countries, teachers and public health-nurses educate children in primary and secondary school but most PWID need several repetitions and facilitated education. Parents as well as disability nurses and social workers who mainly work with PWID are especially responsible for providing limited information or refer PWID to others.

SS (Specific Suggestions) stands for specific advice and implies that a therapist needs to adjust information and means of treatment to suit the person. It includes the possibility to offer treatment in the shape of cognitive therapy, medical treatments, aids etc. A therapist or a person with the proper competences in sexuality offer consultations at this level (SS).

IT (Intensive Therapy) implies the treatment of serious sexual problems, for instance abuse, gender confusion, serious harm in relations, paedophiles, etc. In order to treat sexual problems with an intensive therapy (IT), you need to be an expert in sexology: a psychiatrist, a psychologist or a GP with specialisation in sexuality. 

Measures at SS- and IP-levels of the PLISSIT-model represent treatment that demands the competence of a specialist and ought to be anchored to health services. One option is cognitive methods, like those described by Lemmon and Mizes (2), who utilize exposure-therapy in their treatment of abuse victims. This well-known method in clinical practice is considered effective.

ACTIVITIES:

• Think of your child/sibling/client or another PWID you know well: at what level of the PLISSIT-model do you think their needs of sexual support are?
• Discuss with your child/client/sibling about how you can help them best to feel accepted for bringing up and discussing sensitive and intimate sexual subjects.
• Discuss with your child/client/sibling about possibilities available in your country to receive help/treatments for sexual problems: How they should ask for help and how the support/treatment is supposed to be offered.