Galizia R., NIMBI F.M., Rossi R., Simonelli C. (2021). Sexual fantasies and their use in clinical practice: a systematic review. Mediterranean Journal of Clinical Psychology 9(S2):52. https://doi.org/10.13129/2282-1619/mjcp-3224

Introduction: Research about sexual fantasy has mainly focused on content and frequency of deviant sexual fantasy rather than on the use of sexual fantasy as a therapeutic tool for couples with sexual difficulties. The purpose of this systematic review was to evaluate the existing literature regarding the use of sexual fantasies in clinical practice focusing on their implications for sexual deviations and for couples with sexual difficulties to provide an overview of relevant research. Method: A comprehensive search of four electronic databases (Cochrane Library, Google Scholar, Scopus, and EBSCO) was carried out to identify literature regarding the use of sexual fantasies in clinical practice. References lists of articles were reviewed to identify additional papers. A total of 156 papers and relevant books were included in the present review. Results: From the results of the current review emerged two main different theoretical traditions informing the use of sexual fantasies in clinical practice: behaviorism and psychoanalysis. Behavioral therapists usually would seem to deal only with conscious fantasy material; the psychoanalysts, instead, with all the topographic levels of fantasy production. Behavioral strategies would appear to be the predominant approach to treating sexual deviations. Furthermore, the results would suggest that sexual fantasies are also used for the treatment of couples with sexual difficulties to improve couple intimacy and sexual functioning. Conclusions: This review would suggest the limited presence of research confirming the efficacy of behavioral strategies in the treatment of deviant sexual fantasies. Studies on the use of sexual fantasy in couple interactions also seem scarce. In light of the above, the use of sexual fantasy as a means in clinical practice deserves further studies considering alternative approaches to better understand how to improve treatments for deviant sexual behavior and sexual difficulties in couples.