A pilot research study examined how US graduate-level creative arts therapists (CATs) engaged clients in sexuality discussions as part of treatment, a mixed-methods concurrent design of survey research and semi-structured interviews. The quantitative survey obtained comprehensive data from over 130 CATs on their comfort and willingness to address sexuality in session. Limited qualitative data was gathered from four CATs during individual semi-structured interviews, which identified therapist qualities of being open, accepting, inclusive and nonjudgmental to contribute to clients' overall well-being, and explored the impact of sex-positive and sex-negative theoretical frameworks. The findings indicated a high level of comfort, with over 80% of the CATs surveyed and all CATs interviewed addressing sexuality in various settings and across age groups.