Sex addiction treatment utilizes the same basic strategies and techniques that work with alcoholism, drug addiction, other addictions, and eating disorders. Early treatment efforts focus on containing the problematic behavior. Safety is our primary concern. After that, we focus on breaking through the addict’s denial, managing the crisis or crises that pushed the addict into recovery, and preventing relapse. Nearly all sex addicts are trauma-based in their behavior, but dedicated trauma therapy is typically set aside in the early stages of treatment, embarked upon only after the client has established a modicum of sexual sobriety, ego strength, and social support.
Sex addiction treatment typically includes both individual and group therapy—most often a directive, behavior focused modality like cognitive behavioral therapy—paired with social learning, psycho-education, 12-step or other addiction-focused social support, and alternative methodologies like psychodrama, art and movement therapies, exercise, meditation, animal therapies, and the like. Some clients might also begin a trial-run of an antianxiety or antidepressant medication, as these can reduce not only anxiety and depression, but cravings to act out sexually.
As always, the first therapeutic task is performing a thorough bio-psycho-social assessment. This evaluation must explore every aspect of the client’s life, including the client’s sexual and relationship history. Additionally, clients should be assessed for family, social, work, and financial concerns, plus other psychological issues, including cross and co-occurring addictions.
Nearly always, individual therapy is not enough when working with sex addicts. To stay sexually sober and heal from their addiction and its underlying issues, sex addicts need external support. Group therapy focused on sexual addiction is incredibly helpful in this regard. Generally, it is best to work with 6 to 10 same-gender sex addicts. This group setting helps clients understand they are not unique, which goes a long way toward reducing the shame that drives so much of their thinking and behavior. Group therapy is also an ideal setting for confronting an addict’s denial. Additionally, clients can talk about the interventions and healthy coping mechanisms that do and don’t work. Perhaps most importantly, they can learn that helpful advice and support are available from many sources, especially other recovering addicts.
As a therapist, it is important to remember that each sex addict has a unique background and a specific set of sexual and romantic problems. As such, each sex addict requires an approach tailored to his or her highly individualized needs—always with an emphasis on client safety. Some will do better in individual therapy, while others will do better in group settings. Many will need inpatient rehab or an intensive outpatient program to temporarily separate them from the people, places, and things that trigger their addiction, and to jump start their program of healing. There may be some trial and error when working with a new sexually addicted client. It is important to understand this and to remain flexible in your treatment approach, recognizing what does and doesn’t work with each addict.