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Table 1 Summary of intervention modules

From: A randomized controlled trial of an Internet-based emotion regulation intervention for sexual health: study protocol

  Module Content
Week 1 Psycho-education on sexual function Covers information about sexuality, sexual response cycle (desire, excitement, plateau, orgasm, resolution), and main difficulties that men and women may face in their sexual health, such as erectile dysfunction, premature ejaculation, desire disorders, pain disorders, and anorgasmia. It also differentiates the psychological characteristics of functional sexual response from a dysfunctional sexual response as well as the difference between sexual function and sexual satisfaction.
Week 2 Psycho-education on emotions and emotion regulation Covers the definition of what emotions are, evolutionary aspects of emotions, emotion functions, emotion response cycles, emotion components (physical sensations, thoughts and behaviors), and long-term consequences of maintaining an emotional state for a longer period of time.
It also defines pleasant and unpleasant emotions, the relationship between unpleasant emotion and avoidance behaviors, and avoidance strategies (emotional suppression, distraction and behavioral avoidance).
Week 3 Relaxation strategies: breathing and muscle relaxation Informs about the common physiological response to anxiety and stress (e.g., increases in heart rate, respiration and muscle tension) and teaches two relaxation strategies: breathing relaxation and progressive muscle relaxation.
Week 4 Cognitive flexibility Refers to the rational component of emotion regulation. Aims to conceptualize and enhance cognitive flexibility, the triad situation-thought-emotion is explained and detailed through the concepts of what distinguishes thoughts and interpretations, what automatic thoughts and cognitive distortions are, and the identification of negative thought patterns and most common cognitive distortions related to sexuality are described.
Week 5 Non-judgmental awareness Aims at teaching participants to experience their emotions in the present moment in a nonjudgmental way. The module also differentiates between experiencing an unpleasant emotion from experiencing an unpleasant emotion resulting from negative beliefs and reactions to experiencing it (snowball effect).
Week 6 Self-acceptance and compassion Focuses on two psychological concepts necessary for a better emotion management: acceptance and self-compassion. These are important in order not to avoid emotional experiences and to diminish self-criticism associated with sexual difficulties.
Week 7 Emotion analysis Presents a step-by-step flow-chart of how to identify emotions when experiencing them. By identifying emotions properly, we facilitate effective emotion regulation. The flow chart is composed of 6 items to pay attention when identifying an emotion: (1) emotion, (2) event-trigger situation, (3) evaluation/interpretation, (4) physical sensations, (5) previous similar experiences, and (6) behavior.
Week 8 Sexual emotional exposures Makes a summary of all previous modules and suggests a series of sexual experiences paying attention to the emotions experienced during the activities (exposures). Such gradual approach diminishes the risk of intense emotions and avoidant behaviors. By succeeding on the exposures, obtaining pleasure on the activities, assessments of danger/discomfort diminish and more adaptive evaluations arise, facilitating the identification and modification of emotional behaviors.