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When Shame Runs the Room: Treatment of Male Sexual Dysfunction

Wednesday, September 9th, 2026   1:45 PM EDT -4:45 PM EDT
Michelle Fischler
$59.99 USD

When male sexual dysfunction enters the clinical room, technique alone is rarely enough. This training offers a nervous system-informed, shame-first framework that changes how clinicians enter the conversation, sequence treatment, and support lasting change across all three major presenting concerns.

In this 3-hour intensive, sex therapist Michelle Fischler walks clinicians through her shame-first framework applied to erectile dysfunction, early ejaculation, and delayed ejaculation. Participants will leave with a structured assessment approach, a sequenced treatment model, and concrete interventions for each condition, grounded in current research and applicable in the next session.

About the Presenter

Michelle Fischler, MSW, RSW, RP, is an ASTO Certified Sex Therapist and Approved Supervisor based in Ontario. She completed her Master of Social Work at the University of Toronto (2009) and has maintained a private practice in sex therapy and clinical supervision since 2013, with specialisations in early ejaculation, desire discrepancy, vaginismus, erection concerns, and shame-informed treatment. A longtime ASTO board member — serving as Secretary (2015–2020) and Registrar (2020–2023) — she has presented at professional conferences and facilitated clinical workshops on integrating sexual health conversations into practice. She is the author of Coming Soon: The Unshaming Guide to Early Ejaculation and Lasting Longer (2026) and the founder and host of the GETSOME Podcast.

Learning Objectives:

  1. Describe the clinical distinction between shame and guilt as it presents across erectile dysfunction, early ejaculation, and delayed ejaculation, and explain how this distinction guides treatment sequencing.
  2. Apply a shame-first assessment approach to male sexual dysfunction presentations using the five clinical questions outlined in the training.
  3. Identify at least three evidence-based interventions for each condition covered and name the clinical conditions under which each intervention is introduced.

Agenda:

0:00 - 0:15 | Opening: The Unifying Argument. Why technique fails when shame leads. The nervous system framework applied to male sexual dysfunction. How this lens changes clinical entry across all three conditions.

0:15 - 0:45 | Module 1: Erectile Dysfunction. The shame spiral and performance anxiety cycle. Medical vs. psychological sorting and red flag referrals. Concrete clinical interventions for psychogenic ED. Guided discussion.

0:45 - 1:40 | Module 2: Early Ejaculation. Shame-first assessment: five clinical questions. Shame vs. guilt distinction and treatment sequencing. Research-backed techniques: stop-start, sensate focus, diaphragmatic breathing, pelvic floor physio, mindfulness, SSRIs off-label. Partner and relational dynamics. Case example.

1:40 - 2:05 | Module 3: Delayed Ejaculation. Shame presentation in reverse. Masturbation retraining framework. Psychological and relational layer: applying the shame-first model to a frequently misunderstood presentation.

2:05 - 3:00 | Integration and Q&A. Cross-condition clinical patterns. Case consultation. How you know when the work is done. Open discussion.

This workshop offers 3 Live Interactive Continuing Education Credits

This presentation is open to:
  • Social Workers
  • Professional Counselors
  • Therapists
  • Psychologists
  • Licensed Mental Health Practitioners
  • Medical Doctors and Other Health Professionals
  • Other professionals interacting with populations engaged in mental health based services
Course Level: introductory
Level of Clinician: beginner
  • New practitioners who wish to gain enhanced insight surrounding the topic
  • Experienced practitioners who seek to increase and expand fundamental knowledge surrounding the subject matter
  • Advanced practitioners seeking to review concepts and reinforce practice skills and/or access additional consultation
  • Managers seeking to broaden micro and/or macro perspectives

Participants will receive their certificate electronically upon completion of the webinar and course evaluation form.

Disability Access - If you require ADA accommodations, please contact our office 30 days or more before the event. We cannot ensure accommodations without adequate prior notification. Please Note: Licensing Boards change regulations often, and while we attempt to stay abreast of their most recent changes, if you have questions or concerns about this course meeting your specific board’s approval, we recommend you contact your board directly to obtain a ruling. The grievance policy for trainings provided by NEFESH INTERNATIONAL is available here Satisfactory Completion Participants must have paid the tuition fee, logged in and out each day, attended the entire workshop, and completed an evaluation to receive a certificate (If this is a pre-recorded program, a post-test with a passing grade of 80% to receive a certificate.) Failure to log in or out will result in forfeiture of credit for the entire course. No exceptions will be made. Partial credit is not available. Certificates are available after satisfactory course completion by clicking here.
There is no conflict of interest or commercial support for this program.
  • This program meets the requirements for the American Association of Sexuality Educators, Counselors and Therapists. These CE credits may be applied toward AASECT certification and renewal of certification. AASECT Knowledge Areas: Developmental Sexuality, Health/Medical factors that influence sexuality, Intimacy Skills, Learning theory and its application, Range of sexual functioning and behavior, sexual and reproductive anatomy, Socio-cultural and familial factors. May be used for Sex Therapy Training ST1, ST2, ST3, ST4, ST5, ST6, ST7.
  • Therapist Express is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed creative arts therapists. #CAT-0122.
  • Therapist Express is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed marriage and family therapists #MFT-0129.
  • Therapist Express is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0325.
  • Therapist Express is recognized by the New York State Education Department's State Board for Psychology as an approved provider of continuing education for licensed psychologists #PSY-0275.
  • Therapist Express is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed marriage and family therapists #MFT-0129.
  • Therapist Express is recognized by the New York State Education Department's State Board for Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors. #MHC-0325.
  • Therapist Express is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0774.
Refund Policy:
Full Refund until 48 hours before scheduled date.
48 hours before: full refund less $5.00 processing fee. After event no refund will be given.
*exclusions apply for reasonable need and cause.