Dear Infomike,
The way I see it, your question relates more to my advice-giving role as a therapist, and less to my specific view of providers in society as a whole.
I try to do as little advising as possible and as much encouragement of the client to come to his/her own conclusions. When a client comes to me with an issue, we process it from a multitude of angles. It takes several sessions and we attempt to go very deeply into the person's psyche. There is rarely a purely physio-sexual matter which is the direct cause of a client's issues. If after much processing we were to find that to be the case, I might refer the client to a professional sex surrogate - although I must admit that I haven't had to do that yet. Of course, I practice in a major US city where people are fairly sexually savvy and their problems are more existential, rather than physio-mechanical. My client base consists of "high-functioning" individuals who have a garden variety of issues. I also haven't had any client with a diagnosed sexual aversion disorder per se, or any situation where a sex surrogate would be the most appropriate way to go.
In general, I believe that seeing a provider may not be the solution to psychotherapeutic problems for most clients. Just as I don't think going to Disneyland every day for months on end or eating tons of candy are good solutions to a child's problem. If anything, I view providers as part of 'luxury entertainment' in our society. For those who can afford it, seeing providers can provide excitement, phantasy and certainly release for the moment. And please note that I would NEVER advise anyone to see a street prostitute - that could be dangerous, unhealthy and not really help anyone, quite frankly.
Since it's so much fun, people generally find their way to providers without my help. Just like people find fine wines that cost a fortune, or they spend money on very expensive cars, watches or pricey homes. Would I advise my clients to do any of it? No, not really. I believe it is entirely possible to live a productive and interesting life without many luxuries at all. Let's remember that our society is relentlessly focused on always being on top financially, physically and emotionally. Being with providers can be part of that scenario. I am not saying it's wrong, but I am saying that it is possible to live a happy life without ever having an expensive watch, an expensive car, and yes, without seeing a provider. These are luxuries which to some people become "indispensables," for lack of a better term. And it is clearly up to my clients as to how they wish to spend their discretionary income, whether it's on providers or Porsches. If anything, I have found that people come to me because their belief in a more materialistic lifestyle has caused more problems than happiness. They seek a way to find meaning in their lives that comes from the inside, not from a service or an item that can be purchased. And yes, that includes providers as well.
Now for people who have a lack of touch and physical contact in their lives, for whatever reason, I have advised them to get therapeutic massages, or obtain pet animals and such. We also work on ways in which such people can extend their boundaries and include the possibility of meeting more people in general. Oftentimes, people who lack opportunities for physical contact have been chronically depressed and/or have character disorders which prevent them from engaging on a deeper level with other human beings. There might also be bereavement issues. In that case, no, I don't send a grieving widower to providers or sex surrogates. We work on constructing a new meaningful life that might include taking steps to meet new people in general. When someone has been bereft of their loved one, it's not so much the loss of sexual contact that is palpable, it's the entire relationship and the emotions that are missing. Sending someone to a provider in that case would not be productive.
Finally, I should say the "ideal" client [please apply term VERY loosely] who would be capable of engaging with providers, would be someone who is emotionally stable, able to observe boundaries, and perhaps just out to have some physical fun for the moment. Having paid sex, on either end, requires the capacity of letting go and seeing the encounter for what it is - and doing it in moderation. Such a person is rarely a client, at least not in my therapy room.
Hope that cleared things up somewhat 
the Love Goddess
-- Modified on 7/19/2006 9:25:09 AM