Sexual Addiction Treatment Choices

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.

There are four basic approaches to addictions treatment: Biological, Psychological, Socio-Cultural, and Spiritual. People can combine these various approaches to match their individual needs and circumstances as they work to develop their own individualized, custom-tailored approach to recovery.

1. Biological approaches to addictions treatment attempt to correct or modify the presumed underlying biological causes of addiction. This approach follows a logical rationale. If we know what caused something to become broken, we can fix it. Then, we can repair or restore the broken “thing” to its original purpose and function. According to biological models of addiction, a “broken” or damaged brain causes addiction. For example, perhaps someone’s brain chemistry makes sex a little bit too enjoyable. Perhaps other ordinary pleasures cannot be enjoyed because of underlying depression. The solution is to fix the faulty brain chemistry. This is accomplished via the addition of corrective chemicals; i.e., medications. The specific medications used in addiction treatment and their purposes are reviewed in our addiction topic center on Biological Approaches to Addictions Treatment.

2. Psychological approaches to sexual addiction aim to increase a person’s motivation for change. Helping people to accurately appraise the costs and benefits of their addiction increases their motivation. Once a person is motivated to change, they must actually take steps to change. It seems rather obvious, but wanting to change is not the same thing as completing said change. People in recovery must make some very difficult changes in the way they think, feel, and behave. In this way, they can make wiser, healthier choices. Psychological approaches are ideal for helping people to make these needed changes.

In addition to changing thoughts, feelings, and behaviors individuals embracing recovery may also need to restructure their social world. Our relationships with other people greatly determine whether addiction or relapse is likely. Thus, another psychological approach helps people to evaluate whether or not their social circle is supportive of the changes they wish to make. Psychotherapy may also help addicted individuals to correct for developmental immaturity.

It is difficult to change behavior. It requires a significant amount of motivation. Therefore strengthening the motivation for recovery is very helpful. One such approach is called Motivational Interviewing. There are also several effective types of psychotherapy. These are: Relapse Prevention Therapy; Contingency Management; Cognitive-Behavioral Therapy; Dialectical Behavioral Therapy; Acceptance and Commitment Therapy. These psychological approaches to addictions treatment are discussed in more detail in our addictions topic center. We also discuss what does not work such as confrontational “interventions.”

3. Socio-cultural approaches to addictions recovery emphasizes the important influence of social groups on individuals as they attempt to recover. There are several socio-cultural approaches to sexual addiction treatment. These include: 1) couples and family therapy, and 2) the social support approach to addictions treatment.

Social support groups (or simply “support groups”) refer to groups of people who meet to share their common problems and experiences. Support groups are not the same as therapy groups. Trained professional facilitate therapy groups with a specific therapeutic purpose. In contrast, support groups are led by non-professional volunteers. Social support groups include two basic types. There are self-empowering support groups and 12-step support groups such as Sex Addicts Anonymous, Sexaholics Anonymous, Sex and Love Addicts Anonymous, and Sexual Compulsives Anonymous.

Each of these socio-cultural approaches to addictions treatment is discussed in greater detail in our addictions topic center.

4. Spiritual approaches to sexual addiction recovery are based on research that has repeatedly demonstrated that spirituality can have a positive effect on recovery from many diseases and disorders. It is unknown the precise source of this effect. Recovery may indeed originate because of a “power greater than ourselves” (aka, God). Alternatively, recovery may be due to the psychological benefit of hope that such a belief instills. In any case, the fact remains that many people’s health is benefitted by their spiritual beliefs and practices. As God and related concepts do not lend themselves to scientific research, we are in no position to comment upon the reasons for this effect. What we can say is that research has indicated that a spiritual faith or practice can be beneficial in the recovery from many diseases and disorders.

The most well-known spiritual approaches to addictions recovery are the 12-step support groups modeled after Alcoholics Anonymous (AA). However, spirituality is not limited to a belief in a power greater than oneself. Spirituality might more broadly include a belief that life has a meaning and purpose. Such a belief might provide a guideline for living according to that meaning and purpose. Restoring a meaning and purpose to life is one of the four key ingredients to any successful recovery effort. For more information, see our Addictions topic center on Spiritual Approaches to Addiction Recovery.


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