Generally speaking, inpatient sexual addiction treatment involves a 30- to 60-day stay in a gender-separate facility. For the most part, sex rehab relies heavily on the structure and techniques that have proven effective in the treatment of other forms of addiction (alcoholism, drug addiction, gambling addiction, etc.) Nearly always, the early focus of sex addiction treatment is on separating the addict from his or her addiction (and the people, places and things that trigger that addiction), breaking through the addict’s denial about his or her problems, managing the crisis or crises that sent the addict into treatment in the first place and developing some basic coping skills that will help the addict maintain sobriety after his or her inpatient stay.
One common misperception about sex rehab (and also substance abuse rehab) is that addicts will leave the treatment center cured of their addiction, and that they will never again struggle with problem sexual behaviors (or any other addictions they have). This is most definitely not the case. In reality, the main goal of sex rehab is to prepare sex addicts for the necessary longer-term outpatient work to come.
Another common misperception about sex rehab is that the primary focus will be identification and resolution of the addict’s early-life trauma. Yes, childhood trauma is one facet of inpatient work, but it’s only one among many, and usually not paramount. Instead, sex rehab deals mostly with the here and now – helping sex addicts develop a basic understanding of their disease and cultivating some basic coping skills that will help the addict to maintain sexual sobriety on a day-to-day basis. Essentially, this first-things-first approach is mostly concerned with identifying and stopping the addict’s problematic sexual behaviors. Later, after the addict has established a modicum of sexual sobriety, painful childhood issues can be looked at more deeply.
The first thing that usually occurs in sex rehab is a thorough bio-psycho-social-sexual assessment that explores pretty much every aspect of the addict’s life, looking not just at sexual addiction, but at life circumstances and any other addictions, mental health issues and/or physical health issues that may need to be addressed. As part of this assessment process, a complete sexual and romantic history is taken and thoroughly reviewed. This helps both the addict and the treatment staff to fully understand the addict’s situation.
After evaluation, treatment focuses on two main issues: 1) separating the addict from his or her active addiction; and 2) breaking through the addict’s denial (the justifications and rationalizations the addict uses to make his or her addictive behavior acceptable). This work is best accomplished through use of a highly directive, accountability based treatment modality, such as Cognitive Behavioral Therapy. CBT differs significantly from traditional forms of talk therapy (which examine the ways in which the past affects the present), focusing instead on the present moment. With CBT clients are taught to recognize their desire to act out sexually and to short-circuit the process by thinking about and/or doing something different – calling a supportive friend in recovery, going to a 12-step meeting, cleaning the house, cooking a nice dinner, exercising, reading a good book, enjoying a fun hobby, etc.
In addition to once or twice weekly individual therapy sessions, addicts in sex rehab typically attend daily group therapy sessions (sometimes more than one per day). They may also attend, with fellow patients, nearby 12-step sexual recovery meetings. This “collective recovery” approach recognizes that addicts of all types nearly always require external reinforcement and support from others who are also in recovery if they wish to permanently alter their problematic behavior patterns. During inpatient treatment (and also afterward), group therapy is especially useful in this regard.
In group therapy sessions sex addicts are able to see, often for the first time, that their problem is not unique and they are not alone. This helps to reduce the shame, guilt and remorse associated with sexual acting out (any of which can be a trigger for relapse). Group therapy is also an ideal setting in which to confront the denial that is common among sex addicts. Group-level confrontations are useful not only for the individual being confronted, but for the addicts doing the confronting. Through these interactions everyone present can learn how rationalizations, minimizations and justifications sustain addiction. In group settings, addicts are also able to learn, based on their own and others’ experiences, which interventions and coping mechanisms work best.
The most important thing to know about sex addiction rehab is that inpatient treatment does not provide a cure for sexual addiction. Sex addicts do not leave treatment with their problem licked. Hopefully, however, they leave treatment having broken through their denial about their addiction, seeing and fully understanding that their behavior is problematic, and being willing to do the necessary work of healing and recovery that lies ahead.