Photo ID: A walk symbol person painted on asphalt with a leaf covering where the legs meet in the middle with pictures of Jamila Dawson and Theo Burns to either side and text overlay

Clinical Work with Sex Workers: An Interview with Jamila Dawson, LMFT and Dr. Theo Burnes, PhD

Curt and Katie interview Dr. Theo Burnes and Jamila Dawson on their new book Essential Clinical Care for Sex Workers. We talk about what therapists get wrong when thinking about sex work and sex workers, what common biases therapists hold about sex work, what sex work looks like now, and how clinicians can work effectively with sex workers.


Click here to scroll to the podcast transcript.

An Interview with Dr. Theodore R. Burnes, PhD and Jamila M. Dawson, LMFT

Photo ID: Dr. Theo BurnesTheo Burnes is a Professor of Clinical Education at the University of Southern California (USC)’s Marriage and Family Therapy program. He is a licensed clinical psychologist and a licensed professional clinical counselor in the state of California. His professional interests are in sex-positivity and sex education for mental health professionals.Photo ID: Jamila Dawson, LMFT


Jamila Dawson is a licensed marriage and family therapist in the state of California. She has professional interests in sex positivity, sexual pleasure, BDSM, kink, and relational-gestalt therapy.

In this podcast episode, we talk about sex workers seeking therapy

There are number of client populations that we just don’t talk about in grad school. Sex Workers are an important group that we find continue to face bias and ignorance in the therapy room. We reached out to Theo Burnes and Jamila Dawson to learn more about this often forgotten client population.

What are therapists getting wrong when thinking about sex work and sex workers?

“We’re not here to save people, even if they’re not sex workers, clinicians need to stop thinking we can save people. I’m going to be very blunt: I think that comes from a really white supremacist kind of dominant culture way of thinking of, ‘I have it together, you don’t, it’s my responsibility to help you get better.’” –  Jamila M. Dawson, LMFT, Author, Essential Clinical Care for Sex Workers

  • Clinicians often are focused on saving people, which is misguided
  • We lose opportunities as change agents
  • Not understanding sex work and the complexity of any job
  • There is a bias about the relationships between sex and work and what sex is

What are common biases that therapists hold related to sex work?

“Mental health has actually created a whole system and culture, around hating people in the [sex work] industry.” – Dr. Theo Burnes, PhD, Author, Essential Clinical Care for Sex Workers

  • The bias that there must be trauma if someone chooses to do sex work
  • The bias that they must hate their job and want to get out of this work
  • The lack of awareness about immigration’s intersection with sex work
  • The additional bias related to racism, sexism, and genderism
  • Anti-erotophobia
  • Anti-neurodivergence – there are more folks in sex work who are neurodivergent due to the flexibility and other characteristics of the job
  • Entertainment bias is pervasive with the rescue theme (e.g., Pretty Woman)

What does sex work look like now?

  • The “Whorearchy” or hierarchy within sex worker communities (outside vs inside, independent or employee, safety level) – for example working independently in the safest environments (i.e., inside, virtually) is seen higher up the whorearchy
  • Different types of sex work including courtesan/girlfriend experience versus other types that are less heterosexual normative
  • Understanding the pros and cons of each type of sex work is important for clinicians working with sex workers
  • The opportunities related to innovation (sex and porn often drive innovation) and creativity

How can a clinician work effectively with sex workers?

“I guarantee you; you’re going to come across somebody who has done sex work, or is currently doing sex work, or who may do sex work. And the way that clinicians speak about sex, speak about sex work, will all flag if the client is safe or not to have these kinds of conversations.” – Jamila M. Dawson, LMFT Author, Essential Clinical Care for Sex Workers

  • Getting curious to fully understand the unique situation for the client
  • Assessments availability in the book: Essential Clinical Care for Sex Workers
  • Pay attention to how you talk about sex work as clients will test whether they can talk about their sex work
  • Sex work may not be the presenting issue, but it is relevant to identify whether they are self-identifying as a sex worker to the therapist
  • Holding space for clients not disclosing everything at the beginning of therapy
  • Showing sex positivity and openness to hear about any sensitive topics (sex, drug use, etc.)
  • Understanding the fears and myths that are floating around (e.g., the myth that therapists will call law enforcement or CPS solely because someone reports being a sex worker)
  • Being an agent for social change and advocating for systemic change


Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

Essential Clinical Care for Sex Workers: A sex-positive handbook for mental health practitioners by Theodore R. Burnes, PhD and Jamila M. Dawson, LMFT

Jamila Dawson on Twitter

Theo Burnes on Instagram

Relevant Episodes of MTSG Podcast:

Sex and Shame: An interview with Eliza Boquin, LMFT

Let’s Talk about Sex: An interview with Liz Dube, LMFT

What Therapists Should Know About Sexual Health, Monkey Pox and the Echoes of the AID Epidemic: An interview with Mallory Garrett, LMFT

Therapy as a Political Act: An interview with Dr. Travis Heath

Who we are:

Picture of Curt Widhalm, LMFT, co-host of the Modern Therapist's Survival Guide podcast; a nice young man with a glorious beard.Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is the cofounder of the Therapy Reimagined conference, an Adjunct Professor at Pepperdine University and CSUN, a former Subject Matter Expert for the California Board of Behavioral Sciences, former CFO of the California Association of Marriage and Family Therapists, and a loving husband and father. He is 1/2 great person, 1/2 provocateur, and 1/2 geek, in that order. He dabbles in the dark art of making “dad jokes” and usually has a half-empty cup of coffee somewhere nearby. Learn more at:

Picture of Katie Vernoy, LMFT, co-host of the Modern Therapist's Survival Guide podcastKatie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, coach, and consultant supporting leaders, visionaries, executives, and helping professionals to create sustainable careers. Katie, with Curt, has developed workshops and a conference, Therapy Reimagined, to support therapists navigating through the modern challenges of this profession. Katie is also a former President of the California Association of Marriage and Family Therapists. In her spare time, Katie is secretly siphoning off Curt’s youthful energy, so that she can take over the world. Learn more at:

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:


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Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann

Music by Crystal Grooms Mangano

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Transcripts do not include advertisements just a reference to the advertising break (as such timing does not account for advertisements).

… 0:00
(Opening Advertisement)

Announcer 0:00
You’re listening to the Modern Therapist’s Survival, here are your hosts, Curt Widhalm, and Katie Vernoy.

Curt Widhalm 0:06
Welcome back modern therapists, this is the Modern Therapist’s Survival Guide. I’m Curt Widhalm, with Katie Vernoy. And this is the podcast for therapists about the things going on in our professions, the clients that show up in our office and how we can better serve them. And as we continue to build to our catalogue of episodes, there’s always topics that are new to the show, which surprises me for as long as we’ve been around. And we are joined today by Jamila Dawson, LMFT, and Dr. Theo Burnes, both sex therapists. Talking about working with sex workers in our practice, and the ways that this can come up in our office. And they were wonderful in sending over a copy of their book essential clinical care for sex workers. We’ll talk a little bit more about that throughout the show here. But I got a chance to get through a pretty big part of this before recording. And so if you want to be on our show, send us stuff. Thank you for joining us and sharing your expertise with us here today.

Jamila Dawson 1:18
Glad to be here.

Dr. Theo Burnes 1:19
Yeah. Glad to be here.

Katie Vernoy 1:21
We’re so excited to have you here. And just to clarify, I reached out first before you guys sent us stuff. I’m not saying we won’t take unsolicited gifts. But anyway, but the first question that we ask all of our guests is who are you? And what are you putting out into the world?

Jamila Dawson 1:40
Well, I am a sex therapist. I am what I call a pleasure-ist. I have become fascinated by pleasure, how it works, what we have ideas about, how we don’t tend to like it in this culture, or we only view it in very specific ways. And what I’m putting out into the world is how critical pleasure is, that it’s quite radical. I would say it’s when I look at all the different movements that are out there that are about world changing the core of them, they are about the pleasure of connection, the pleasure of just having a good life.

Dr. Theo Burnes 2:13
I am Theo Burnes, I use he/him/his pronouns. I’m a licensed psychologist and a Licensed Professional Clinical Counselor. I’ve been in practice for almost 20 years. And I’m also a professor at the University of Southern California. And I have a real strong value around comprehensive sex education for people across the entire lifespan. So young folks, adolescents, college students, folks in assisted living facilities who identify as elderly. I’m really a big proponent of people getting the education that they need to make value based decisions about the pleasure in their lives.

Katie Vernoy 2:53
I love that.

Curt Widhalm 2:54
One of the things that I’ve come across a lot in my career as an educator, as a podcast host and talking with a lot of students and trying to make our fields better. One of the areas that I often hear people point to is one of the things that seems to be missing most from graduate education is talking about sex. And there’s, you know, kind of this, here’s a credit or a credit and a half class that talks about the organs of sex, but it doesn’t really get into pleasure of sex, how to improve people’s sex lives a whole lot better air quotes around this, you know, talk about the dysfunctions that happen in sex. And so I want to just start this out with like, how did you get into talking about sex more, and especially into bringing sex workers and sex work into the conversation as a part of your professions.

Dr. Theo Burnes 3:49
I always like to say that a lot of the work that I do as a therapist, and as a mental health trainer, it actually came to me because it was not available to me. And so I like to say I like to take the Swiss cheese approach to professional development, which is I often found the holes in what I wanted, and created the spaces because I couldn’t find other things. And I share stories about how, as someone who was doing their hours for licensure, and a lot of mental health facilities for sex workers would often access services as an pre-licensed person, I would look for literature that I could use to support affirming understandings about the work I was doing, and there wasn’t much and a lot of the work was focused on getting people out of the industry. It was illness based, and honestly, it was just kind of like sickening. And so I think a lot of that started a fuel for wanting to tell another side of the same story.

Jamila Dawson 4:50
For me, I used to work at different adults education based adult stores, which I wish there is an official internship program. I think that would be amazing. And so I talked a lot about sex, I listened to a lot of people, a lot of sex workers came in to either purchase toys for their work. Or if they were seeing a client, they were bringing a client in to kind of do some work with the clients like either buying stuff that was part of their experience, and I enjoyed seeing what they did. And I think what I really started to see was kind of how other people reacted to them. And I started going to grad school while I was still working at The Pleasure Chest. And I saw the difference between how we were talking about sex, sexuality and sex workers in school versus what I was seeing the joy, the creativity, as well as the complete lack of support, both legally and emotionally for sex workers. And similar to Theo that made me really angry and made me really frustrated about the field. It made me kind of doubt my interest in this field of if this is how this field looks at people who also just want and need support, then is this really the right field for me? Luckily, I was like, I don’t have to look at their way of doing it. I’m going to do it my way. And time and luck led me to collaborating with Theo.

Katie Vernoy 6:11
So, Jamila, I want to go into that a little bit more, because I think it ties very well into the question that we ask towards the beginning of most episodes is what are we getting wrong as a profession? And so you had an interesting juxtaposition there, you were working at The Pleasure Chest, you were also going to grad school, what are we getting wrong? And you guys go into this a lot in the book. So I definitely recommend, you know, kind of taking a look at that.

Jamila Dawson 6:34
Chapters one through three.

Katie Vernoy 6:36
From your perspective, what are we getting wrong as a profession when we’re thinking about sex work and sex workers?

Jamila Dawson 6:44
I mean, what I would say this, we’re not here to save people, even if they’re not sex workers, clinicians need to stop thinking we can save people. I’m gonna be very blunt, I think that comes from a really white supremacist kind of dominant culture way of thinking of, I have it together, you don’t, it’s my responsibility to help you get better. And that leads to these contradictions in our field, it leads us to, again, look at our clients as resistant or a problem. And I don’t want any part of that. My work is about how do I stay human? And how do I support my clients to stay human, find more people to be human with, be in relationship with. So I think we’re looking at it wrong. We’re also not focused on really as a field of how radical we can be, we can be change agents, like we literally have the DNA to, here’s how we can help people, here’s how we can be trauma informed. And instead, too often, what I see is clinicians who have been trained to focus more on control, to be afraid, afraid of the state, afraid of their clients, afraid of messing up and we lose all these opportunities, when we’re orienting in this fearful place this anti pleasure-place. Theo…

Dr. Theo Burnes 7:56
Yeah, no, I totally second, those comments, Jamila. I think the place that I would add would be around just an idea that, like many other jobs, being in the sex work industry is complicated. Some people like their jobs, some people hate their jobs. Some people like their jobs, some days and not like their job other days. It’s when we have jobs that are sex focused that therapists get really invested in helping people quote, unquote, leave their job. And Jamila and I have spent the good part of the last three or four years, really, not only capitalizing on our own political work, but also being really invested in learning more just about the kind of labor structures that are involved in the sex work industry. And it gets really complicated when you ask not only mental health professionals, but I’ll just go bigger and say social service providers about their biases about work where sex is involved, and people get real nervous real quick. And so when I hear the question, what are we getting wrong? I think a lot about what are the biases that we have about the relationship between sex and work?

Jamila Dawson 9:02
Or work itself?

Dr. Theo Burnes 9:04
Yeah, that’s right.

Jamila Dawson 9:06
What is work supposed to be? What it should be, you know, a lot of times criticisms they have of sex workers is you’re using your body. Which I don’t understand if we all use our body to do work. And there are people who work in industries where they are absolutely physically using their body. And so again, why is there this huge pressure on sex workers of, oh, you’re using sex as part of the work that you do. And suddenly the rules kind of are different. I really don’t see anybody trying to get hedge fund managers out of their business. Just saying.

Katie Vernoy 9:42
Very fair, or construction workers if it were really going to people who use their bodies.

Dr. Theo Burnes 9:48

… 9:48
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Curt Widhalm 9:48
I do appreciate that. You’ve spent a significant portion of your book talking about you know, looking at your biases, which I think for a lot of areas in In our fields, there’s a lot of good intention of like, you know, check your biases, it’s something that comes up in a lot of conversations. When it comes to biases around sex work, give us some concrete stuff here. Because I think that this is such a new way of looking at this kind of stuff that like, I can imagine a lot of clinicians just be like, Yep, I’ve got them and then just not doing something with them.

Jamila Dawson 10:24
I would hope they would be self aware enough to say like, Oh, yes, I have them. Because oftentimes, people will act as though they don’t have any biases. And Theo and I are very clear if you’re going to have biases, we’ve all been swimming in this culture that is very sex negative, and is very anti sex work. And so you’re going to have biases. Know this. But your question is kind of what are some of the biases that we have heard of?

Curt Widhalm 10:47

Jamila Dawson 10:48
Oh, anything from they must have had trauma that they would want to do this. They must have been abused as a child that they want to do this or need to do this? Theo, others?

Dr. Theo Burnes 11:00
Well, and I guess one thing that I’ll just say is I learned that bias comes from a larger systemic frame in how we view sex work. So in the book, we talk a lot about this idea that mental health has actually created a whole system and culture, around hating people in the industry. And some of that comes from like really bad research, where we’ve done some really awful studies, it also comes with the way that we really actually just confirm the biases that we have. And a lot of it is that we don’t actually look at the intersections that many sex workers have with other parts of their identity sphere. So we talk a lot about the idea that textbook and migration are hugely intertwined. And yet it what’s interesting is, is that when we look at individuals who have migrated to the United States and are involved in other industries, right, we don’t have some of the same concerns with those industries that we do with individuals in the industry. And so some of that bias is also around what is it about, not only our xenophobia, our systemic racism, our blatant misogyny, our hatred of trans people, right. So all of those pieces, because unfortunately, sex workers have disproportionate demographic rates in certain areas. And so also looking at, if we have to actually look at sex work, not only will we have to look at our own anti erotic-phobic bias, then we’d have to look at all of our other systemic biases as well. And we don’t want to look at a erotic-phobia, we really don’t want to look at how we’re like racist, sexist, and homophobic.

Jamila Dawson 11:00
And I would also add the being neurodivergent. So many of my clients who are sex workers talk about that they have ADHD, or they may have or in the past had a TBI where they have people in their family that they’re caring for, and they need jobs that offer flexibility, that offer a higher rate of pay for the time spent doing it. And most jobs do not offer both the flexibility as well as a good rate of pay. And so one of the smartest things to ask yourself is what do I have to do in order to make enough money so that I can do what I need to do, which is care for myself and carefully people who I love who are dependent on me.

Dr. Theo Burnes 12:37
Totally. The last thing I’ll just add is that I am based in Los Angeles as is Jamila. And so we often joke about some of the entertainment bias related to the sex work industry as well. So media is really great at depicting certain types of sex work and saying that certain types of sex work are true for everybody. And usually what it is is like the damsel myth, right? So we are very great at having like, the sex worker who has no resources, has no ability to be empowered, and often needs like some sort of male identified person with a lot of resources to come in and save them.

Katie Vernoy 13:37
Like ‘Pretty Woman’, right?

Jamila Dawson 13:39
I was just gonna say, ‘Pretty Woman’. We all love Julia Roberts. We all love Richard Gere. And yes, it was based on a opera, which also has some issues with it, Portus opera, but have some issues with the storytelling for this. I need somebody to rescue me. And I’m very pretty, and I’m very like, and isn’t the great thing is I no longer have to do sex work at the end of the story.

Katie Vernoy 14:01
Yeah. So for some folks that are like, wait, what not all sex workers are Julia Roberts? Maybe we can talk through a little bit like what does sex work look like now? And to tie something else in there that I read in the book is the “Whorearchy”. Is that your term? Because that is okay. Because I was reading that I was like, Oh my gosh, like that was kind of where I realized, oh, I have some bias within that. And so maybe we can talk about what is it and what is the “Whorearchy”?

Dr. Theo Burnes 14:29
Yeah, so actually, the “Whorearchy” is a term that has been used in activist communities for multiple decades, and is based actually in social science research. And it wasn’t called the “Whorearchy” forever. In fact, in the early 1970s, there were social science researchers who used all sorts of other kind of really negative classist understandings around kind of hierarchy within sex work communities, and it was more around activist communities and sex worker outreach communities that really claimed that term. But the term really speaks to the idea that just like in many different other communities, there are different types of sex work. And unfortunately, many of those types of sex work are differentiated from one another by the type of location that one works in, whether they work outside or inside, whether they work independently, or they may work for, let’s say, some sort of an institution or company like a brothel or a club. The other piece that’s also important is, is that many people will make some decisions about where they work based on the type of safety that they have. And so what we often hear about is, the more kind of independence that you might have, or the more likely that you are to work inside, the farther up the “Whorearchy”, you might actually go because you are safer, you may have more empowerment, you may have more connection to the actual money that you receive, versus it going to some sort of agent who may pay you what you’re worth, but may not. So that term is really interesting. But what we’ve heard from sex work communities is that the internalized “Whorearchy”, around Hey, I internalize these different structures, and this kind of understanding, and that that might have huge direct impact on things like my self esteem, my ability to see my work as valuable, my ability to set boundaries with clients. So all of those things come into play as well.

Jamila Dawson 16:24
You know, there can be people who have kind of whatever things that are kind of the courtesan style of doing sex work, and that is very much, you know, again, more similar to Pretty Woman, and people can sort of wrap their heads around that of, you’re pretty and you wear really pretty close. And it’s more of like a girlfriend experience. And that will, because it’s closer to girlfriend, which is closer to monogamous culture and normative culture, it can be read as A: not as dangerous, whether that’s true or not. And it can be read as more acceptable. And that can provide some cover for people. But it can also be really alienating, you know, they might not feel solidarity with other kinds of sex workers. And they can also sometimes like, not reach for certain kinds of support, because it feels so different than other sex workers, or I don’t need that, or who would I even turn to. So it’s if clinicians are really wanting to work with this population, getting super curious about what are the pros and cons of the kind of work that you do, and the way that you do it. And even working inside, just because somebody is working through a computer, I’ve known clients who have gotten doxed and had to leave their home. Pack up as quickly as possible and get out because they had children, and they now, their location was no longer safe.

Katie Vernoy 17:34
That’s interesting, I was gonna comment on that there was kind of the further away from sex or the further away. So you know, folks that are working at home at their computer, that kind of stuff, have some, you know, kind of that false safety, it sounds like that needs to be aware of, but it seems like it’s definitely an evolving profession. As there’s more, you know, there was kind of phone sex when I was growing up, that was as far away as you could get from the physical act. And you know, now there’s content creators, and there’s a lot of opportunity that wasn’t there before, and is part of this little bit more removed, and so potentially less understood, and maybe also feeling less capable to reach out for support because of the differences and those types of things. I think it’s very interesting.

Jamila Dawson 18:17
Yeah, yeah. I don’t usually use the word community anymore for any particular groups. I think you build community. But this is a culture that is always on the front end of technological adaptation. It is amazing. You go back to the Gutenberg Press, like the first things that were printed, right where the Bible and then porn. Those were the two things like, like, really, if you’re interested, there’s really great, like, just gorgeous, like graphics and stuff. But this is a community that is always on the front edge. And again, I would want clinicians to really work to see their clients in multiple dimensions. Situate them in society of how do they know what to do? How are they getting support? What are some of the structural or interpersonal barriers, but also like, what is the creativity?

Dr. Theo Burnes 19:03
And I’ll just add that for folks that are listening. If you’re wondering a little bit about questions to ask related to wanting to be curious about people’s situation in the industry, there are several assessment resources in the book that really speak to specific questions that folks can ask so that we’re not making the assumptions about, oh, this person divulged or disclosed that they were in the sex industry. And I immediately started thinking about these ways that my client was in the industry, and I’m getting curious about what that might look like.

Curt Widhalm 19:35
And I want to add to this, going back to something that you said a few moments ago, Jamila is, you know, for clinicians who want to do this work, but I know Katie and I have both realized recently that we have clients who are sex workers. Who had come to us for completely different things in the proliferation of things like only fans and kind of the direct to consumer. online platforms like this allow for many more people to explore or this part of their lives. And it may not necessarily be a clinical specialty that you start with or somebody that you are actively seeking out as being competent to treat from the beginning.

Jamila Dawson 20:12
Sooner or later, I mean, this is a California 3000 hours to get license. I guarantee you, you’re going to come across somebody who has done sex work, or is currently doing sex work, or who may do sex work. And the way that clinicians speak about sex, speak about sex work, will all flag the client’s safe or not, and to have these kinds of conversations. But we really in the book, we wanted to have this reallyrelational approach meaning like just truly relationship based. We’re not here to shame anybody, but to have some containment. And to have some, you do have to have a certain mindset that you want to practice, if you’re going to do this work. We were very clear. Not everybody should be seeing folks who are sex workers.

Dr. Theo Burnes 20:55
Right. I smiled when you were talking, because I think Jamila and I have joked often that we often will hear folks that will say things like, oh, I don’t think I’ve ever had a client who’s a sex worker, and we’ll often say, Well, is it that you’ve not had a client that’s a sex worker, or maybe that person just hasn’t felt safe enough to tell you? Because the likelihood that folks are involved in the industry is a lot higher than I think we as a field care to admit.

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Katie Vernoy 21:22
Well, and I think it’s interesting, because there’s the potential that it’s also not the presenting problem.

Dr. Theo Burnes 21:27
That’s right.

Katie Vernoy 21:27
And most likely, it may not be the presenting problem. I think the bias is that they’re coming in because they’re this damsel in distress, and has this horrible trauma and wanting to get out of sex work. But in truth, it might just be their job. And there’s an acceptance and an understanding, but there are other things that are coming into play that are really more relevant. The question I have is, when we’re doing clinical work with someone whose presenting problem is not sex work, but they are a sex worker, how does that how does that interplay in the work that we’re doing as a clinician?

Dr. Theo Burnes 21:57
I think the first thing is, is to figure out if that person has actually disclosed their identity as a sex worker, regardless of what the presenting problem is, in the initial assessment.

Katie Vernoy 22:06
Disclosed, like to folks in their life? Is that what you mean? Are you talking about disclose to the therapist?

Dr. Theo Burnes 22:12
No, disclose to the therapist? Yeah.

Katie Vernoy 22:14

Dr. Theo Burnes 22:14
So yeah, so thinking about if they’ve disclosed that identity to you in the therapeutic space. And sometimes what you’ll find is, is, if it’s not the presenting problem, folks will make the decision not to disclose just because it’s easier. And so they’ll say, you know, oh, I work at home, right, I work, I work for an online company. And so you’ll get some of those pieces, and then it may come up because of safety, because maybe that’s exacerbating other things that they they’re experiencing, or there is let’s say, some sort of externalize mental health symptoms like anxiety and depression, where that work might come up later. And then that person has to make the choice of like, well, not only do I need to disclose this, but if I disclose it later, do I then have to get into a conversation with my therapist about why didn’t disclose it earlier. And so I would say, for me, what often comes up if it’s not, the presenting problem is always just being really open about the fact that folks don’t necessarily have to disclose things in the beginning, and that you’re not necessarily going to punish them for being not the best client for not disclosing certain pieces that people understand their own sense of safety. But I think it intersects with a lot of different things, and that it just comes up when it needs to. I don’t know if that makes sense, Katie.

Katie Vernoy 23:29
Oh, it totally makes sense. I guess the question is, how do we make sure the clients know that we are open and accepting and sex positive? Or those types of things like what are the recommendations you have for folks who are truly wanting to be present and available, regardless of the presenting problem to folks who are doing sex work?

Dr. Theo Burnes 23:49
Yeah, I think a big piece of it is just being able to note in the beginning, that you can bring up anything in our room. Whether that’s sex or drug use, or having conversations about a variety of different topics. And what usually happens for me is that folks might, especially if they don’t want to bring it up in the beginning, there may be a kind of look like, oh, okay, that sounds great. And they may not pick it up right away. And then 5, 6, 7 sessions later, it’s, Hey, remember when you said that we could talk about? And so part of it is just planting the seed in the beginning. I don’t know Jamila, if that rings true for you.

Jamila Dawson 24:25
Completely. That’s what I do. And when I train people, like, here’s the script you can use, if you like it great. Want to modify it fine. But of mentioning those things that people feel like they can’t talk about in therapy. So I literally will say similar to Theo: in this space, you can talk about anything that you want to. You do not have to answer all of my questions or any of them. If it makes you feel uncomfortable, I’ll skip it and we’ll move on to something else. But in this space, you can talk about sex. You can talk about money. You can talk about how you feel about your parents. I will list the things that usually are like the big stress test ones. Because so often they’ve heard, and Theo I know this is true for you. You’ve had clients are like, Oh, I couldn’t possibly bring that up to my therapist, whether it’s sex, money, sex work, drug use any of it. And so we’re doing half work. And then I’m gonna, I’m just going to call it out, we have therapists are like, I’m so bored with the client, nothing’s happening. Like, have you like 1: How is that possible, 2: have you really seeded the ground that this is space where they truly can bring who they are. And I will also be really clear that A: there’s still rumors in the sex work community that therapists can and will call the police if they find out that their client is a sex worker. That is still floating around in different communities.

Katie Vernoy 24:26

Jamila Dawson 24:43
Yeah. Or that if the clinician finds out that the client is a sex worker, they will call CPS. And there was a lot of legitimate and understandable fear of clinicians. That is not so like no clinician should be calling CPS simply because admit as a sex worker.

Katie Vernoy 26:04
Yeah, to clarify, that’s not a call.

Jamila Dawson 26:07
That is not call.

Katie Vernoy 26:08
That is not a CPS report.

Jamila Dawson 26:09
At all. Ever. And there’s still that fear, the power that we have as clinicians is profound. And this is a population that cannot take that risk into, they’re going to be scanning for a sense of safety, maybe for months, and they may never say anything, which is heartbreaking to me, understandable, and heartbreaking.

Curt Widhalm 26:33
You’ve described thinking of individual therapeutic interventions as opportunities to push the needle on social change. And how does this compare with the way that therapists are trained to interact with marginalized people?

Dr. Theo Burnes 26:45
Jamila, do you want me to start that or do you?

Jamila Dawson 26:48
Go for it. Yes, start it off.

Dr. Theo Burnes 26:50
So I think, historically, therapists have been trained in a really interesting kind of individual level about the way that they see the world and the way that they need to intervene. And it’s only been in the last, I would say, 20, 25 years where this larger systemic approach to understanding people’s worlds and contexts have really been incorporated throughout people’s experiences. So it’s not like a class, but really kind of the formula from which people learn all of their stuff about therapy. And I think the cool thing about social change agents is that when you are trained from a systemic level, it’s almost impossible to divorce the need to make larger systemic shifts from the individual work that we do as clinicians. That you can’t actually do one without the other. That if mental well being is really the goal of your life’s work, to do it in the room, and then leave the room and be like, Oh, my work stays in the room, right? If I cared about the human experience, it’s kind of almost impossible not to look around and see opportunities for our work everywhere you look.

Jamila Dawson 28:03
Right. And the very implications of if I want wellness for my client, and I know that there are systemic issues that impact directly their well being then I do, like written into all of our code of ethics, and also just the ethics of being a human being that the implications are, I need to look around the other places I can intervene, the other places where I can say something, the other kinds of conversations that I can have, or even in again, not participating in certain kinds of conversations that are more normative. Doesn’t mean that we have to be cussing everybody out, you know, a cocktail party. But it can mean of, oh, I’m not going to go along with that particular kind of joke. Or I’m not going I’m going to poke a little bit at that language that’s being used in this moment. All the way up to what you read what you teach. Who are you presenting? I never came across liberation psychology in school. I am very upset by that.

Katie Vernoy 28:59

Jamila Dawson 29:00
Because that would have changed so much. I didn’t hear about other black psychologists and black therapists at all. And I know that like trans folks and LGBT like, well, the whole I just want to say like non non sis het, folks, we don’t see ourselves reflected that much across programs as a paradigm. This industry is what 100 plus years old, and the last 30 years have been incredible. And that’s not making its way into our classrooms. And even just noticing that and talking about that in class is pushing the needle. And I think it’s critical that we do that.

Katie Vernoy 29:39
What changes do you want to see in the field in the next 5 years or the next 10 years?

Jamila Dawson 29:45
I mean, some of what I’ve already said. I would love for trauma informed care to be literally the paradigm that is taught. I would love it to be centered in kind of a pan humanity kind of way of thinking of it. Of we literally have day data on what works for humans, what creates trauma and what reduces trauma. That should be woven through all of our classes, like hands down, what is relationship we’ve all heard, right? The metadata study of like, it’s the relationship that the client feels they have with the therapist, that’s the biggest predictor. I want that as the baseline.

Dr. Theo Burnes 30:20
Yeah, I would echo that the decriminalization movement for sex work is a growing one worldwide. And I have a fantasy that mental health plays a pivotal part in that, that we’re able to help lawmakers understand that the legal structures that are not only in the United States, but throughout the world that oppress sex workers have real severe impacts on their mental health. And so in the world that I dream of, we as mental health practitioners have a huge role in the decriminalization movement.

Curt Widhalm 30:52
Can you tell us a little bit more about your book here.

Jamila Dawson 30:56
We’re just so proud.

Dr. Theo Burnes 31:00
It is our little baby. It is.

Jamila Dawson 31:01
It really is, it’s our thought baby. What I love about it is this did come out of conversations, this came out of what I call righteous anger of again, instead of just having conversations that don’t really go anywhere, but that you know, are just kind of individual, really, we should write something, something that becomes that resource that we were needing. Something that keeps us kind of accountable to where we want to go. And then something that again, can kind of seed you know, I think of mycelium a lot. Even if it can become part of mycelium that changes, again, what’s possible. So the book has kind of the intellectual academic grounding, in the first part of what sex work is. And then it really, again, kind of situates things historically, and then moves on to your more practical ways to understand this. We have vignettes, which I love.

Dr. Theo Burnes 31:52
Yeah, and I’ll just add that, Jamila and I have been able to consult with a variety of different folks in the industry who were a pivotal part of not only creating the infrastructure, but also gave us feedback, as well as did some interviews that are also kind of peppered throughout the book for amazing folks that have worked in the industry who have given us a lot of feedback, and that that last half of the book is really focused on assessment, conceptualization and treatment.

Jamila Dawson 32:19
I want people to be able to dip in and out of it kind of a it’s not official supervision, but it can be an additional support.

Curt Widhalm 32:27
And so the book is the ‘Essential Clinical Care for Sex Workers: A sex-positive handbook for mental health practitioners’. And we will put a link for that in our show notes over at And where can people find more about you so we can include links to those as well.

Jamila Dawson 32:43
They can find me at And I’m on Twitter, soon probably to be at Spoutable. It’ll be @JamilaDawson

Dr. Theo Burnes 32:55
And my website is And folks can find me on Instagram at TheoBurnes one word.

Curt Widhalm 33:02
And follow us on our social media. Join our Facebook group, the Modern Therapists Group to continue this conversation. And if you liked the work that we’re doing, please consider supporting us on Patreon or Buy Me a Coffee and until next time, I’m Curt Widhalm with Katie Vernoy, Jamila Dawson and Dr. Theo Burnes.

… 33:19
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