A Cognitive-Behavioral Approach to Sex Addiction
Many cognitive-behavioral therapists rely heavily
on imagery as a means of achieving therapeutic goals for sex addiction.
The use of imagery for treatment purposes clearly acknowledges
the potentially crucial role of private events.
There is growing evidence that performance-based
therapies, in which individuals actually deal with problematic
situations, can be very effective. However, cognitive
processes, such as insight, may play an important
role in helping people develop more adaptive performance
orientations to their problems of living. As more
therapists attend to the relative roles of cognition, emotion,
and behavior, steps toward greater integration of
therapeutic approaches are becoming noticeable.
Usually, there is evidence that such an enthusiasm effect
operates in a variety of situations, including hospitals,
schools, and private consulting rooms.
Most studies of therapy techniques compare a
group of people who receive treatment with one or two
groups of people who do not. But such comparisons do
not show how individuals within the groups are affected
by specific aspects of the treatment. Clinicians also need
to know how changes in the client's behavior are related
to what the clinician does or says. Some behavior therapists
see single-subject research, which is described later in another of my articles.
There are disagreements about the relative effectiveness
of the different psychological therapies for sex addiction. In evaluating
psychotherapy a common procedure has been to compare
two groups, one that is treated clinically and one
that is not. Researchers with different criteria and expectations
have obtained different results in such comparisons.
For example, after reviewing the literature,
Eysenck concluded that psychotherapy
was an ineffective clinical method. He argued that many
apparent successes could be explained by spontaneous
remission which the client's symptoms would have
disappeared in time with or without treatment. Bergin
and Lambert (2006) found that psychotherapy had an
effect but that the effect was not necessarily positive.
Some patients actually seemed to deteriorate because of
psychotherapy.
The most important questions in outcome
studies is what the criteria for improvement should be.
Which are more important,
changes in how the client feels and behaves, or changes
in what he or she thinks about? Would the opinions of
the client's family or co-workers be helpful in evaluating
improvement? How important is the therapist's evaluation
of the outcome? Sometimes the therapist and the
client don't agree. Anthony Storr, a British psychoanalyst,
gives this example of what he had considered an
"unsuccessful" case:
Some time ago I had a letter from a man whom I
had treated some twenty-five years previously asking
whether I would see or at any rate advise treatment
of his daughter. He assumed wrongly that I would
not remember him and in the course of his letter
wrote as follows: can quite truthfully say that six
months of your patient listening to my woes made a
most important contribution to my life style.
"Although my sex addiction was not cured my
approach to life and to other people was re-oriented
and for that I am most grateful. It is part of my life
that I have never forgotten."
Many advances since this time have lead to a much higher success rate for sex addicts.
on imagery as a means of achieving therapeutic goals for sex addiction.
The use of imagery for treatment purposes clearly acknowledges
the potentially crucial role of private events.
There is growing evidence that performance-based
therapies, in which individuals actually deal with problematic
situations, can be very effective. However, cognitive
processes, such as insight, may play an important
role in helping people develop more adaptive performance
orientations to their problems of living. As more
therapists attend to the relative roles of cognition, emotion,
and behavior, steps toward greater integration of
therapeutic approaches are becoming noticeable.
Usually, there is evidence that such an enthusiasm effect
operates in a variety of situations, including hospitals,
schools, and private consulting rooms.
Most studies of therapy techniques compare a
group of people who receive treatment with one or two
groups of people who do not. But such comparisons do
not show how individuals within the groups are affected
by specific aspects of the treatment. Clinicians also need
to know how changes in the client's behavior are related
to what the clinician does or says. Some behavior therapists
see single-subject research, which is described later in another of my articles.
There are disagreements about the relative effectiveness
of the different psychological therapies for sex addiction. In evaluating
psychotherapy a common procedure has been to compare
two groups, one that is treated clinically and one
that is not. Researchers with different criteria and expectations
have obtained different results in such comparisons.
For example, after reviewing the literature,
Eysenck concluded that psychotherapy
was an ineffective clinical method. He argued that many
apparent successes could be explained by spontaneous
remission which the client's symptoms would have
disappeared in time with or without treatment. Bergin
and Lambert (2006) found that psychotherapy had an
effect but that the effect was not necessarily positive.
Some patients actually seemed to deteriorate because of
psychotherapy.
The most important questions in outcome
studies is what the criteria for improvement should be.
Which are more important,
changes in how the client feels and behaves, or changes
in what he or she thinks about? Would the opinions of
the client's family or co-workers be helpful in evaluating
improvement? How important is the therapist's evaluation
of the outcome? Sometimes the therapist and the
client don't agree. Anthony Storr, a British psychoanalyst,
gives this example of what he had considered an
"unsuccessful" case:
Some time ago I had a letter from a man whom I
had treated some twenty-five years previously asking
whether I would see or at any rate advise treatment
of his daughter. He assumed wrongly that I would
not remember him and in the course of his letter
wrote as follows: can quite truthfully say that six
months of your patient listening to my woes made a
most important contribution to my life style.
"Although my sex addiction was not cured my
approach to life and to other people was re-oriented
and for that I am most grateful. It is part of my life
that I have never forgotten."
Many advances since this time have lead to a much higher success rate for sex addicts.