Does sex addiction treatment work?

It’s completely natural to want to know if something works before you invest money into it. Whether that is a new gadget for the home, a piece of sports equipment or starting a new diet or any other kind of self-improvement regime.

We’ve been measuring the effectiveness of our recovery courses for a period of years and I’m delighted to announce that the results are now in and have just been published in our peer reviewed journal.  If you’d like to read the full paper then please follow this link, but if you’re happy with the edited highlights, read on.

We followed 119 clients who had attended our 6-day residential recovery course over a period of 18 months.  On day 1 of the course they were asked to complete an evaluation form called CORE OM, a tool widely used in therapy services, which measured their general psychological health.  They also completed an evaluation form that measured their compulsive sexual behaviours.  There are 34 questions on the CORE form which ask questions relating to emotional wellbeing and ability to cope with life.  There are also 3 questions relating to the sex addiction which include how often a person has acted out, how often they have been troubled by intrusive thoughts and feelings and how often they have fantasised.  For all of the questions there are 5 possible answers ranging from ‘most or all the time’ to ‘not at all’.  These same evaluation forms are then completed again 3 months after completing the course and then again at 6 monthly intervals for the next two years. 

Before you get excited thinking that means we have data that covers 2 years post course, regrettably most people don’t reply beyond the first 6-month mark (36) and even less at the 12 month mark (15) and by 24 months it’s just 5!  I can tell you that what little data we have demonstrates that the vast majority of people maintain their recovery and continue to enjoy improvements in their general mental health, but at that level of response it wouldn’t be deemed ‘statistically reliable’.  So, what I will share with you is what we have learned about people 3 months after the course is completed and 6 months later, i.e. 9 months after the course. 

The first thing we learned was that 85% of people struggling with sex addiction and/or porn addiction experience ‘clinical distress’ and 1 in 6 are at serious risk of self-harming when they first reach out for help.  Regrettably that didn’t come as a surprise to those of us working at the Laurel Centre who work with clients, but it was good to see our experience validated and it’s important evidence for those who continue to believe that sex and porn addiction are not a ‘real problem’.  At 3-month follow up, 58% reported either a ‘significant’ or ‘reliable’ change in distress.  Change is deemed ‘significant’ if someone has moved from a score that’s classified as clinically distressed to the healthy range and ‘reliable’ means a score has changed more than would be expected without intervention.

In terms of compulsive behaviours, on day 1 of the recovery course 82% of respondents described themselves as acting out ‘most of the time’, but at 3 months that had reduced to just 4%.  76% of respondents fantasised ‘most of the time’, but at 3-months this had reduced to 7.5% and intrusive thoughts and feelings were experienced ‘most of the time’ by 80% of people, reducing to 17% at 3 month follow up.  Overall, acting out behaviours improved by 97% and 58% never acted out again, and 24% ‘only occasionally’. 

On the whole we were delighted with the results, but the research highlighted a fact that we have known for some time and that is that when you get into recovery, life sometimes gets worse before it gets better.  Whilst compulsive behaviours improved by an impressive 97%, 23% had negligible improvement in their psychological health and 19% felt worse.  If you believe, as we do, that addictive behaviours are an anaesthetic, then perhaps it’s inevitable that life will be more painful as the anaesthetic wears off and the difficulties that have hitherto been numbed, come back into sharp relief.  Furthermore, for many struggling with sexually compulsive behaviours there may be immediate harmful consequences that need to be faced, such as the impact the behaviour has had on a partner and family life, and/or work and social life.

What this research also underlines is that recovery and sobriety are not the same.  Sobriety means achieving abstinence, whilst recovery means creating a meaningful and fulfilling lifestyle, without the dependency.  Hence to achieve recovery rather than just sobriety, it is important to continue the therapeutic journey.  Whilst we can now evidence the efficacy of our recovery courses, they are not an alternative to ongoing individual therapy to address trauma and attachment wounds and develop positive self-soothing strategies, nor couple therapy to repair trust and rebuild intimacy.  Indeed, without these additional therapeutic interventions, the common phenomenology of intense remorse, regret, guilt and a sense of hopelessness may not be navigable and relapse may be more likely.

In conclusion, whilst our recovery courses can be a life-changing experience, as many of our testimonials bear witness, for most it marks the beginning of the recovery journey, not the end.  I look forward to sharing more of our efficacy studies as time goes on and as we adapt to the current pandemic and move all of our courses online, it will be interesting to see if the results are maintained. 

Remember if you’d like to read the whole paper you can find it here