Generally, sex addiction treatment utilizes the same basic strategies and techniques that work with drug and alcohol addiction. For the most part, early treatment focuses on breaking though denial, managing the crisis or crises that drove the addict into recovery, and relapse prevention. Techniques typically include individual and group therapy – most often a highly directive, behaviorally focused form of psychotherapy like cognitive behavioral therapy (CBT) – coupled with education, social learning, 12-step and/or other addiction-focused social support, and various alternative therapeutic modalities like art and movement therapies, psychodrama, exercise, meditation, eye movement desensitization and reprocessing (EMDR), etc. Following professional evaluation, some clients may also begin a trial-run of an antidepressant or antianxiety medication, as these medications sometimes help to reduce not only depression and anxiety, but cravings to act out sexually.
The first step in treatment is a thorough bio-psycho-social assessment. This careful evaluation explores nearly every aspect of the addict’s life, including his or her sex and relationship history. Individuals are assessed not just for sexual addiction, but for other psychological issues (including other addictions), along with relationship, family, legal, work, social, recreational, and financial concerns that may need to be dealt with.
After assessment, the work tends to be reality based, focusing on the sex addict’s behaviors and wellbeing in the here and now instead of looking at and seeking to resolve past traumas. As such, the process is task-oriented, with assignments (reading, writing, attending support groups, etc.) to be completed between sessions and discussed during sessions.
With most sex addicts, individual one-on-one therapy is not enough. They also need external reinforcement and support if they want to change their deeply rooted patterns of behavior. Sex addiction focused group therapy can be extremely helpful in this regard. Generally, a treatment specialist works with between six and ten same-gender sex addicts. (Co-ed sex addiction therapy groups are, for obvious reasons, a bad idea.)
Group therapy helps sex addicts learn that their problems are not unique, which goes a long way toward reducing the shame associated with their behaviors. It is also the ideal place to confront the denial that is so integral to sexual addiction. Such confrontations are powerful not only for the addict being confronted, but for the addicts doing the confronting. In this fashion, everyone present learns how justification, minimization, and rationalization sustain sexual addiction. Addicts are also able to learn which interventions and coping mechanisms work best based on other members’ experiences. Most importantly, sex addicts learn that helpful support and direction are available from many caring people, not just a primary therapist or a lone accountability partner.
In addition to individual and group therapy, sex addicts who are willing to push beyond their fear of “being seen” in a more public (though anonymous) setting nearly always benefit from 12-step sexual recovery meetings. Sex Addicts Anonymous (SAA), Sexual Compulsives Anonymous (SCA), Sex and Love Addicts Anonymous (SLAA), Sexaholics Anonymous (SA), and Sexual Recovery Anonymous (SRA) are nationwide programs for sex addicts.
Needless to say, every sex addict’s treatment arc is different. Each addict arrives with specific problematic sexual behaviors and a unique background, so each addict needs an approach tailored to his or her needs. Some will respond best to individual therapy supplemented by group and 12-step work. Others will do best in group settings, making little progress one-on-one. Still others will struggle utterly until they are physically separated from the people, places, and things that drive their addiction by the protective walls of inpatient treatment. The most important thing when dealing with sex addicts is to recognize their individuality in this respect, and to respond accordingly rather than by attempting to force-feed any specific approach, no matter how much success you’ve had with that approach in the past.