Kink & ENM


Eroticism & sexuality are central to self and relational life. The Sexual Crucible, my original practice model, led me to integrate sexuality into relational therapy. In 2000, that differentiation-based approach supported my focus on kinky clients, alternative sexualities and relationship structures.

Kinky clients deserve therapists with a comprehensive understanding of kink experience: psychological, emotional, physical/medical, social and legal. They also deserve a therapist with seasoned clinical skills. This means creating client safety and establishing a strong alliance. 

Many clients do not present with kink-related or ENM problems. Yet I maintain a detailed understanding of kink-related injuriesMost kinky clients also experience minority stress. For some, it’s built on top of anxiety already experienced due to racial,  gender and orientation inequality.

The Kink Clinical Practice Guidelines is the current reference standard for kink-affirmative healthcare. There’s also a detailed scale that establishes therapist competence and proficiency.

To clients who identify as kinky, I offer an addendum to my standard disclosure statement.

International Kink Health Study (IKHS) & TASHRA

In December 2019,  I was invited to join The Alternative Sexualities Health Research Alliance (TASHRA) based at California State University-East Bay.

As a Research Associate in a multidisciplinary team of clinicians and researchers, I helped develop the mental health sections of the International Kink Health Study, a multi-year longitudinal cohort study launched in 2021.

I’m currently working with TASHRA to build a new research-based, kink & alternative sex education service.


ENM re-configures commitment and desire – the “twin drive wheels” of relational life. This sparks peoples’ developmental change, especially those who grew up in a monogamy-dominant culture (practically speaking, that’s everybody.) 

It can take years to master ENM partnering skills like transparency and jealousy management. They help make ENM sustainable and rely on personal integrity and self-awareness. ENM can help shape people into having clear boundaries and high self-awareness. 

Similar to kink populations, ENM faces social stigma and minority stress at work, in families and under the law. Race, gender and sexuality inequalities add to this stress.

To address a growing minority’s healthcare needs, ENM practice standards are emerging, via the APA Committee on Consensual Non-Monogamy, and elsewhere. There is supportive professional literature here, here and elsewhere.