The Power of Working Bottom-Up in Sex Therapy: An Introduction to the PACT Approach (4 CE Hours)
$160.00
Presented by: Karen Berry, PhD and Caroline Russell Smith, LCSW
4 CE Hours
Distance Learning – Recorded workshop available via video on demand
AASECT Category: Sex Therapy, Section C.
Description
If you know what to look for, the more you slow a couple down in your office the easier it is to see why they are so stuck in the bedroom. This four-hour course is all about slowing down and learning what to look for using the Psychobiological Approach to Couple Therapy (PACT). We will use real case material to highlight how a complex couple moved from a sexual impasse towards secure erotic functioning. Along the way you will learn how the PACT model works with attachment and its relationship to arousal regulation and developmental neurobiology in an erotic context. We will highlight why working bottom-up with attachment is an effective way of helping couples grow their relationship in the bedroom and beyond.
Learning Objectives
At the conclusion of this workshop, participants will be able to:
- Identify the three domains that make up the PACT approach
- Describe 2 examples of secure erotic functioning.
- Identify differences between attachment, arousal regulation and developmental neuroscience.
- Describe how attachment style, arousal regulation strategies and developmental neuroscience look in erotic scenarios.
- Understand the value of helping couples identify a secure erotic vision.
- Discuss the value of staging a couple’s difficult sexual challenges.
Activity Schedule
Section 1: Introduction
- Speaker Introductions
- Course targets
- Introduction to the PACT paradigm
- Description of Secure Erotic Functioning
- Introduction to case material
Section 2: Attachment
- Introduction to Attachment Theory
- Signal, Response, Consequence System
- Attachment Types
- Measurable behaviors to assess attachment
- How the case couple looked through the lens of attachment
Section 3: Arousal Regulation
- How arousal regulation is wired into the body
- Window of Tolerance
- Affect rides the wave of arousal
- 4 Styles of arousal regulation
- Arousal and attachment are woven together
Section 4: Developmental Neuroscience
- Ambassadors and primitives
- How the brain “shows up” in the bedroom
Section 5: Video
- Video of real couple doing “toward and away” and hugging with therapist working bottom-up
- Description of how therapist was working bottom up using the 3 PACT domains
Section 6: Integration of 3 PACT Domains
- Island, wave and anchor sexuality
- Fractals
- Development of a Secure Erotic Vision to address fractals
Section 7: Staging
- What is staging and what is required to do it safely
- Staging sequence with case and follow-up zoom session
- Couple’s Erotic Care Manual
Section 8: Summary
- Secure Erotic Functioning Principles
- Review of course targets
- Contact information
Speaker Bio
For over 35 years Karen Berry, Ph.D. has been a clinical psychologist and differentiation-based sex therapist who has optimized clinical outcomes for clients and therapists alike. She was a member of the original Core Faculty at the PACT Institute, continues to mentor new and experienced PACT therapists, and she now leads Ripening Retreats for couples seeking erotic upgrades. For Karen the body is the gateway to transformation. She weaves yoga, ecstatic dance, and Tantric practices with relational science into a powerful alchemy for embodied transformation and sacred relationship.
Caroline Russell Smith is a clinical social worker and AASECT certified sex therapist who has dedicated her 25 year career to complex trauma recovery and erotic liberation. Her work with couples is rooted in the PACT approach. Caroline teaches and runs Ripening Retreats with her dear colleague Dr. Karen Berry, and Caroline is a proud member of SSTAR. Widening access to clinical knowledge is a guiding principle for Caroline. She has facilitated a free monthly LGBTQ+ support group for the last 16 years and regularly offers sexuality and gender workshops for colleagues, parents, teens and college students in her community. Caroline and her wife live in upstate NY where they are raising two sons neither of whom think it’s cool that one of their moms is a sex therapist or at least they aren’t admitting that publicly yet.
Class originally recorded: 12/20/2025
Social workers completing this course receive 4 clinical continuing education credits.
MSTI is an approved CE organizational provider for IBOSP, AASECT, and ASWB. Modern Sex Therapy Institutes is part of the Advanced Mental Health Training Institute. The Advanced Mental Health Training Institute has been approved by NBCC as an Approved Continuing Education Provider, ACEP No.6901. Programs that do not qualify for NBCC credit are clearly identified. The Advanced Mental Health Training Institute is solely responsible for all aspects of the programs.
MSTI is approved by the American Psychological Association to sponsor continuing education for Psychologists. The Modern Sex Therapy Institutes maintains responsibility for this program and its content.
Modern Sex Therapy Institutes (MSTI), provider #1787, is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Regulatory boards are the final authority on courses accepted for continuing education credit. ACE provider approval period: [1/7/22-1/7/26].
Attendees must attend the entire course and complete a course evaluation to be eligible for CE credit
For Live Courses: To obtain CE credits, attendees must attend the entire course and complete an evaluation to receive credit.
For asynchronous/recorded courses, Attendees must pass the multiple choice posttest with a minimum score of 80% in 3 attempts to be eligible for CE credit.
Certificates of completion can be downloaded immediately upon course completion.