Guidelines for Choosing Sexual Addiction Treatment Options

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D. , edited by C. E. Zupanick, Psy.D.

Sexual addiction is a specific type of addiction called an activity addiction. The range of treatment options for recovery from addictions, such as sexual addiction, is very broad. Therefore, treatment decisions for addiction recovery can become quite confusing. We hope to reduce some of this confusion by suggesting some guidelines. These guidelines can help you make wise choices for your own recovery.

1. First, determine if you need help with "just" sex addiction. Perhaps you need help with other problems as well. Most people seeking addiction treatment have previously attempted to recover on their own without success. If you've made a sincere effort to recover without success, perhaps you need additional help. It may be that you need help with other issues besides sexual addiction. These other types of problems can make recovery more difficult. It is quite possible that people who seek addictions treatment do so because they are weighted down by these additional problems. Perhaps the people who succeed with natural recovery are people who "only" have to confront addiction itself. They may not have additional obstacles to overcome. Therefore, consider what additional issues you face. The common co-occurring problems are:

  • anxiety
  • depression
  • trauma
  • bipolar disorder
  • attention problems
  • relationship issues
  • personality disorders
  • difficult life situations

If these other sorts of problems complicate your life, be sure to choose a treatment option that specifically addresses these additional concerns.

2. Second, consider your goals. How will you know if your efforts were successful? What does recovery look like to you? What do you hope to gain by receiving treatment for your addiction? How will recovery benefit you? What does recovery mean to you? How will you define "abstinence"? Are you willing to put up with some problems for the sake of continuing to have some of the pleasures of your addiction(s)? If so, which problems are acceptable? Which problems are not? For example, "It's okay if I miss a day of work once in a while. My boss is pretty easygoing. It's not okay to upset my wife, or to miss my son's football games."

Most treatment programs for alcoholism and drug addiction emphasize complete abstinence. Abstinence is simple, straightforward goal. It is clear whether you reached that goal or not. Although complete sexual abstinence is certainly possible, it's not a very practical or realistic recovery goal. Recovery from sexual addiction is more similar to moderation. Moderation is a little trickier because people can keep changing their recovery goals. These changing recovery goals may simply represent legitimate adjustments. Alternatively, it may represent an avoidance of the problem or ambivalence about the need to make significant changes. Usually people in recovery from sexual addiction identify certain behaviors or activities that they must refrain from completely. This forms an abstinence goal. Some people in recovery also decide to be completely abstinent from all sexual activities for a certain period of time. This is commonly a year.

3. Investigate effective treatment options. Determine which options appeal to you. Are these options available in your locale? Let's say you've come to the place where you've realized that natural recovery isn't working for you. You've taken a hard look at the other problems in your life. You've become clear about your recovery goals- now what? This brings us back to our original question: How does someone find the most effective treatment?

Treatments with demonstrated effectiveness are called evidence-based practices (EBP). EBP simply means a large body of research supports the effectiveness of that approach. One of the most well-known sources of EBP is maintained by the federal government of the United States. It is called The National Registry of Evidence-based Programs and Practices (NREPP). The NREPP is intended to improve access to the most recent information about effective mental health treatments, including addictions treatment. Each of the treatments listed in the NREPP have met the basic criteria to be included as an evidenced-based treatment. Your task is to choose from among these treatments. Determine which ones match your unique needs, circumstances, and preferences.


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