The debate among clinicians, when sex therapy or couples therapy is more appropriate, has raged since the 1980s. However, this question reflects an iatrogenic problem, rather than a diagnostic conundrum. It is caused by the common state of the art of sex therapy and marital therapy, rather than characteristics of clients. Attempting sex therapy or couples therapy without the other encourage clinicians to conceptualize and practice archaically, weakens treatment of both sex and relationship problems, promotes ineffective amalgams approaches, and limits development of more effective therapies. The Crucible Approach avoids these problems with a core integration of sex, relationship, and individual therapies, differing from conventional treatment in each of these disciplines.