Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Barbara Brents

Second Committee Member

Kate Korgan

Third Committee Member

David Dickens

Fourth Committee Member

Carissa D'Aniello

Fifth Committee Member

Danielle Roth-Johnson

Number of Pages



This study qualitatively investigates therapists’ attitudes toward their clients who work in the sex industry and assesses sex workers’ perception of these attitudes in therapy. Two separate surveys are used to assess attitudes. One is distributed to mental health professionals, and it uses clinical vignettes to evaluate the approaches used in therapy where the variable of “profession” is manipulated. The second survey is distributed to sex workers to evaluate their experiences in therapy. Then, indicators of persistent attitudes in the narrative responses are identified, organized into groups, and surveys are compared. Results suggest that participants in the survey distributed to therapists generated some patterned unsupportive approaches used with the hypothetical sex worker client. In general, most sex workers who participated confirmed these perceived negative attitudes in their experiences of therapy. When the two surveys were compared, seven final categories were identified delineating the attitudes/approaches/issues commonly present in the clinical setting with clients who work in the sex industry. These categories are: 1) Trauma and Pathology Narratives; 2) Differential Diagnostic Decisions 3) Differential Treatment; 4) Job Focus 5) Stigma 6) Therapists Lack of Competence 7) Lack of Affordability and Availability of Services. After examining the current literature and the results of this study, a list of 16 sex work informed guidelines for mental health practice is presented.


best practices; psychotherapy; sex work bias; sex workers; stigma; therapy guidelines


Feminist, Gender, and Sexuality Studies | Gender and Sexuality | Psychology | Sociology

File Format


File Size

2200 KB

Degree Grantor

University of Nevada, Las Vegas




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