Below is a “Hierarchy: Masturbation Training” by Lisa Mitchell, LCSW-R at Penn State. Her plan for what she calls, “private touching”, was specifically developed for individuals with Autism Spectrum Disorders, but I think it is a good general framework. The hierarchy goes from lowest level of support to highest level of support. Across the board, masturbation is a topic people want more information about. I think this is a nice way to think about what kind of education or training is available as well as what you might want to try before moving on to something more intensive. I have also included a link to her entire powerpoint. She covers other topics/tips you may find interesting (relationship checklist, key concepts for topic areas, teaching techniques, problem behaviors).
- When appropriate, work with families and/or residence to establish a visual “private time schedule.”
- When appropriate, supply individual with lubricant, explaining that it is for use during “private time.”
- Meet with individual. Present illustrations of same sex persons masturbating, in conjunction with verbal explanation regarding technique.
- Meet with individual. Use illustrations and anatomical model in conjunction with verbal explanation of technique.
- Meet with individual. Use anatomically correct dolls to demonstrate appropriate masturbatory technique, in conjunction with verbal explanation.
- When appropriate, supply masturbatory aids such as body pillows, magazines, collages of stimulating pictures, vibrating pillows, masturbation sleeves, masturbation pumps, or vibrators. Explain safe usage of such aids.
- Meet with individual. Arrange for multiple viewings (when necessary) of instructional masturbation movies “Handmade Love” for males, or “Fingertips” for females
. Viewings should occur in the individual’s bedroom or the private location where masturbation will be allowed to occur. Trainer may need to supply a verbal explanation while simultaneously viewing the tape to reinforce principles. (I would have the person watch on their own before feeling the need to view with another present. In general I think the videos are very good but very explicit. You could use the video in place of the verbal instructions indicated in the hierarchy).
- For individuals with more significant challenges, consider use of ABA type
approach (preferably done with relatively unfamiliar trainer) to teach more
successful masturbatory technique. Shape up steps one at a time (e.g. “Pull pants
and underwear down”, “Lay on belly”, “Put pillow between legs”, “Rock from side to
side”. Or “Pull pants down”, “Sit on bed”. “Put fingers around penis”, “Rub up and
down, up and down.”) – I have heard of this method, but I do not know anyone personally who has ever instructed on masturbation at this level. I would want to have a very comprehensive plan on how this would be implemented, full team support, and special attention paid to protecting the individual being instructed and the person doing the instruction.