Sexuality and intimacy in aging: two MFT questions

Two questions, answered **separately**, at a minimum of 150 words each. The instruction is explicit and it is the first thing a marker checks, so give them two labelled sections rather than one continuous response. They are also different genres: the first asks how you would address a **colleague** — a supervisee whose assumption needs correcting without humiliating them — while the second asks how you would address a **client** couple's distress. Supervision and clinical practice call for different registers, and a submission that answers both in the same voice has missed what makes this pair of questions interesting. Note the minimum is a floor with a citation requirement attached, so 150 words of substance is the target, not 150 words including the reference. Labelling them 1) and 2) exactly as the brief numbers them is worth doing, since it makes the separation unmistakable at a glance.

Question one turns on a piece of evidence rather than on tone. The intern's remark — *I didn't think people at this age still thought about sex* — is a factual claim, and it is wrong. Substantial proportions of adults in their seventies and eighties remain sexually active, and interest and intimacy persist well beyond the point at which frequency changes. So the response should lead with what the literature actually shows, then address why the assumption matters clinically: a therapist who holds it will not ask, and a couple who are not asked will not raise it. The brief's own phrase is *a considered posting informed by the literature*, which rules out an answer built only on values. Being specific about what the evidence shows also protects the answer from sounding like a reprimand, because a number is harder to take personally than a judgement.

Do not miss the supervisory dimension, because it is what makes question one a preceptor's question rather than a knowledge question. You are precepting: the goal is to correct an assumption in a way that leaves the student able to hear it and to notice their own reactions next time. That means naming the assumption without shaming, connecting it to what it would have cost this particular couple, and then — as the brief specifically requires — **suggesting at least one peer-reviewed resource** for the student to read. That last clause is a deliverable, not a flourish, and the resource should be one you can describe: say what reading it would change for the student. Choosing a review rather than a single study is usually the better recommendation here, since the student needs the shape of the field rather than one result.

Question two has a hidden second half that is easy to answer in a clause and is graded: *include how you would collaborate with medical professionals*. Sexual difficulty after a health event is very often medical in origin or medication-related, and the therapeutic answer alone is incomplete — so the response needs a referral pathway, a reason for it, and the consent that makes it possible. Notice too that the couple's presenting fear is relational rather than physiological: the individual *is afraid that spouse may be upset*. Treating that fear as the problem, and the physical change as its occasion, is the reading that keeps this an MFT answer rather than a medical one. Ask what the person is actually afraid of losing, because it is often the relationship rather than the act, and that distinction decides which intervention fits.

Use the required readings, because both are named and both are doing specific work. The National Institute on Aging page supplies the normative physiological changes and the reassurance that sexual activity continues in later life; the second source is flagged with an instruction to *follow links to learn about physical changes and how to maintain sexuality in aging*, which means its subpages are part of the reading rather than optional. Between them they cover most of what question two needs clinically. The *at least 1 source* requirement is a minimum, and question one separately requires a peer-reviewed suggestion, so in practice you are citing more than one. Both readings are also written for a general audience, so cite them for the clinical content and bring peer-reviewed work in where the brief asks for evidence.