Skip to main navigation menu Skip to main content Skip to site footer
Quaderni di Psicoterapia Cognitiva - Open Access

La sessualità in psicoterapia cognitivo-comportamentale

No. 57 (2025)

Sexuality in Frailty: Recommendations for Good Clinical Practice

DOI
https://doi.org/10.3280/qpc57-2025oa23132
Submitted
giugno 24, 2026
Published
2026-07-16

Abstract

The paper explores the multidimensional construct of frailty, understood not merely as vulnerability but as an evolving process of selfreorganization in specific atypical life conditions, articulated in its reactive, developmental, and integrated forms. The focus lies on the intersection between frailty and sexuality, examining how this fundamental dimension of human wellbeing is redefined, supported, and at times neglected in three specific contexts: aging, disability, and oncology.

Theoretical models and evidencebased interventions (cognitivebehavioral, mindfulnessbased, and psychoeducational) aimed at promoting a “sustainable sexuality” are presented and discussed, integrating biological, psychological, and contextual dimensions. The article emphasizes the importance of ecological and systemic approaches involving the individual, the family, healthcare professionals, and the institutional context, in order to recognize sexuality as a right and as a vital space for recognition, agency, and continuity of identity even in conditions of frailty.

 

References

  1. Addlakha R. (2017). Disability and sexuality: Claiming sexual and reproductive rights. Disability & Society, 32(9): 14691489. DOI: 10.1080/09687599.2017.1351504.
  2. Almont T., Bouhnik A.D., Ben Charif A., Bendiane M.K., Berquet C., Cleirec G., Mancini
  3. J. & Villes V. (2019). Sexual health in cancer: Survey on practices, attitudes, knowledge, and communication in oncology healthcare providers. Supportive Care in Cancer, 27(11): 40634072. DOI: 10.1007/s00520019046846.
  4. Andersen B.L., DeRubeis R.J., Berman B.S., Gruman J., Champion V.L., Massie M.J., Holland J.C., Partridge A.H., Bak K., Somerfield M.R. & Rowland J.H. (2014). Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: An American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology, 32(15): 16051619. DOI: 10.1200/JCO.2013.52.461.
  5. Baile W.F., Buckman R., Lenzi R., Glober G., Beale E.A. & Kudelka A.P. (2000). SPIKES – A sixstep protocol for delivering bad news: Application to the patient with cancer. The Oncologist, 5(4): 302311. DOI: 10.1634/theoncologist.54302.
  6. Barbera L., Zwaal C., Elterman D., McPherson K., Wolfman W., Katz A. & Fitch M. (2017). Interventions to address sexual problems in people with cancer: American Society of Clinical Oncology clinical practice guideline adaptation of Cancer Care Ontario guideline. Journal of Clinical Oncology, 35(23): 26272637. DOI: 10.1200/JCO.2017.72.5961.
  7. Bauer M., Fetherstonhaugh D., Tarzia L., Nay R. & Beattie E. (2014). Supporting residents’ expression of sexuality: The initial construction of a sexuality assessment tool for residential aged care facilities. BMC Geriatrics, 14: 82. DOI: 10.1186/147123181482.
  8. Bornstein M.H. (2003). Parenting e sviluppo infantile: considerazioni interculturali e interculturali. In: Poderico C., Venturi P. & Marcone R. (a cura di), Diverse culture, bambini diversi? Modalità di parenting e studi crossculturali a confronto (pp. 3150), traduzione di S. de Falco. Milano: Unicopli.
  9. Cavallo F. (2025). Manuale di sessuologia clinica. Milano: FrancoAngeli.
  10. Lambruschi F. (2024). Psicoterapia cognitiva: L’orientamento costruttivista ed evolutivo. Roma: Carocci.
  11. Martino et al. (2025). Narrative review of frailty. Journal of Clinical Medicine, 13(3): 721. DOI: 10.3390/jcm13030721.
  12. Mols F., Korfage I.J., Vingerhoets A.J.J.M., Kil P.J.M., Coebergh J.W.W., Essink Bot M.L. & van de PollFranse L.V. (2009). Bowel, urinary, and sexual problems among longterm prostate cancer survivors: A populationbased study. International Journal of Radiation Oncology Biology Physics, 73(1): 3038. DOI: 10.1016/j.ijrobp.2008.04.004.
  13. MustaniemiLaakso M., Peroni L. & Venkatapuram S. (2023). Vulnerability, disability, and agency: Exploring structures and possibilities for agency in the disability and vulnerability literature. Law and Philosophy, 42: 631650. DOI: 10.1007/s10982 023094902.
  14. Rizzuto I., Stavraka C., Chatterjee J., Borsi J., Mondani A., Bhogal R., Flood T., Froghi S. & Banerjee S. (2021). Ovarian cancer symptoms and quality of life: A review of the literature. Critical Reviews in Oncology/Hematology, 162: Article 103354. DOI: 10.1016/j. critrevonc.2021.103354.
  15. Rodrigues T.S., Pereira J.D.S., Lopes A.C.S., Oliveira C.S.D., Pereira L.S.D., Neves S.B.D. & Fernandes A.F.C. (2023). Approaching sexuality in LGBTQIAP+ patients with cancer: A scoping review. BMC Public Health, 23(1): Article 1910. DOI: 10.1186/s1288902316728y.
  16. Rossi A., Bianciardi F., Damiani G., Daniele A., De Padova S., Irtelli L., Lorusso D., Mennitto
  17. A. & Sgambato A. (2025). Sexual health in cancer care: A narrative review and position statement from the Italian Association of Medical Oncology (AIOM). ESMO Open, 10(1): Article 103862. DOI: 10.1016/j.esmoop.2025.103862.
  18. Rovatti F. (2016). Sessualità e disabilità intellettiva. Guida per caregiver, educatori e genitori. Trento: Erickson.
  19. Royal College of Nursing (2022). Older people in care homes: Sex, sexuality and intimate relationships (Revised edition). RCN. www.rcn.org.uk/Professional Development/publications/olderpeopleincarehomesukpub010111.
  20. Sciacchitano S., Carola V., Nicolais G., Sciacchitano S., Napoli C., Mancini R., Rocco M. & Coluzzi F. (2024). To be frail or not to be frail: This is the question – A critical narrative review of frailty. Journal of Clinical Medicine, 13(3): 721. DOI: 10.3390/jcm13030721.
  21. Thomas H.N., Brotto L.A., de Abril Cameron F. & Yabes J. (2025). Qualitative findings from a pilot trial of mindfulness for low sexual desire in midlife and older women. Archives of Sexual Behavior, 54(1): 301313. DOI: 10.1007/s10508024029756.
  22. Thurston R.C., Chu J., Chang J.C., Zhu X., Leung R. & Bromberger J.T. (2023). A virtual, groupbased mindfulness intervention for midlife and older women with low libido lowers sexual distress in a randomized controlled pilot study. The Journal of Sexual Medicine, 20(8): 10601068. DOI: 10.1093/jsxmed/qdad082.
  23. United Nations (2006). Convention on the rights of persons with disabilities. www.un.org/ development/desa/disabilities/conventionontherightsofpersonswith disabilities.html. Veglia F. (2005). Manuale di educazione sessuale, vol. 2: Interventi e percorsi secondo il me todo narrativo. Trento: Erickson.
  24. von Humboldt S., Low G. & Leal I. (2024). Sexual wellbeing in old age: Effectiveness of an intervention program to promote sexual wellbeing in older communitydwelling adults. Social Sciences, 13(12): Article 650. DOI: 10.3390/socsci13120650.
  25. Whittle C., Butler C. & Williamson G.R. (2018). Sexuality in the lives of people with intellectual disabilities: A metaethnographic synthesis of qualitative studies. Research in Developmental Disabilities, 80: 5264. DOI: 10.1016/j.ridd.2018.06.009.
  26. Xu Y., Chen Y., Wang Y., Han Y. & Zhuang G. (2022). Sexual dysfunction after breast cancer: A metaanalysis and systematic review. Supportive Care in Cancer, 30(4): 3883 3894. DOI: 10.1007/s00520021067531.