Hard economic times produce stress, and stress contributes to sex and relationship problems. It also reduces the number of people who can afford professional sex therapy. The good news is that if you have sexual issues but  feel financially pinched, there’s an excellent chance that self-help resources might resolve things.

As much as I endorse sex therapy when necessary, sadly, many sex therapists have a blind spot when it comes to self-help resources. I’ve heard more than one distinguished sex therapist say, “Self-help doesn’t work. All of my clients have tried it and got no benefit, which was why they came to me.” Uh, excuse me, but that’s myopic. All of those helped by self-help didn’t need any other assistance, and never consulted a sex therapist.

When people suffer persistent sex problems, they work to resolve them using a step-by-step process. First comes informal help. Not everyone takes this step, but many folks—women more than men—talk to trusted friends. If knowledgeable friends are unavailable or their suggestions don’t help, most people try self-help: the Internet, books, or videos. And if that doesn’t work, they consult a sex therapist. Studies show that 88 percent of people with sex problems try some form of self-help before consulting a therapist, which means that almost nine out of ten new clients try self-help before consulting a therapist.

Dozens of sexual self-help books and videos have been produced. Do they really help? Before answering that question, I must disclose that I am the author of a sexual self-help book, Great Sex: A Man’s Guide to the Secrets of Total-Body Lovemaking. Now, do self-help resources work? According to several studies, yes, but professional sex therapy works a little better.

Most of the research comparing sexual self-help with professional sex therapy has been conducted in the Netherlands by Jacques J. van Lankveld, a professor of psychology at Maastricht University. In one study, he and his colleagues worked with 117 women suffering vaginismus, vaginal muscle spasms that cause pain on intercourse or prevent intercourse altogether. The women were randomized to a waiting list, a self-help book (with six brief phone consults with a therapist), or professional group therapy (10 two-hour sessions). After one year, none of the wait-list group reported improvement. In the self-help group, 15 percent said they could have intercourse comfortably. And in group therapy, 21 percent. So self-help with minimal professional support produced almost the same benefit as 20 hours of group therapy.

In another study, van Lankveld’s team assigned 50 men with erectile dysfunction (ED) and 40 men with premature ejaculation (PE) to either a waiting list or a Web site that outlined standard sex therapy for these problems. After six months, the men in the wait list reported scant improvement. But among those who used the Web site, half reported significant benefit.

Van Lankveld also offered 12 weeks of email-based sex therapy to 39 men with ED or PE. Half couldn’t deal with it and dropped out. But among those who stayed, two-thirds reported improvement.

Finally, at Concordia University in Illinois, researchers analyzed 70 studies of self-help approaches to various psychological problems. Among the most effective was self-help for sex problems.

It’s no surprise that professional therapy works better than self-help. Therapy can be tailored to individual needs, and many studies show that a face-to-face rapport with a therapist is, in itself, beneficial. But if you have a sex problem and your 2010 budget doesn’t allow for professional therapy, self-help can probably help.