FAQ

Questions about fees, insurance, scheduling or getting started are answered on the New Path Family general practice FAQ. The questions below are specific to sex addiction recovery and betrayal trauma.

Understanding sex addiction

Is sex addiction a real condition?

The suffering is real. The diagnostic world is still catching up, and that gap is worth understanding.

The World Health Organization formally recognises what it calls Compulsive Sexual Behaviour Disorder in the ICD-11, the international medical classification used by health services worldwide. The American Psychiatric Association considered it for the DSM-5-TR — the manual most therapists in the United States use for clinical diagnosis — and ultimately left it out.

What that means in practice is that there is no perfect official label in the US system yet. It does not mean what you are experiencing is unreal, unserious, or untreatable. Clinicians have been treating compulsive sexual behaviour for decades. The pattern — escalation, loss of control, failed attempts to stop, damage to the people you love — is consistent and well documented. The debate is about classification. Nobody debates that people are suffering.

What is sex addiction really about?

It is not really about sex. It is about regulation.

People use sexual behaviour to cope with stress, anxiety, trauma or emotional pain — much as others use alcohol, food or spending. The behaviour offers quick, reliable relief from emotional states that feel unmanageable. Over time the brain comes to rely on it as a primary coping mechanism, which makes it harder and harder to stop even when the person genuinely wants to.

Is sex addiction only about pornography?

No. Pornography is one form, but the pattern can also involve hookups, massage parlours, webcams, emotional affairs or compulsive sexting. What defines the problem is the compulsive cycle — urge, acting out, shame, resolve to stop — rather than any particular behaviour. You can read more about the different types of sex addiction and about pornography addiction specifically.

Does this mean something is morally wrong with me?

No. People struggling with compulsive sexual behaviour often carry enormous shame, but this is not a moral failing. It is a treatable pattern with identifiable psychological and neurological drivers.

Shame is one of the forces that keeps the cycle running — it feeds the emotional pain that drives the behaviour in the first place. Effective treatment addresses shame directly rather than adding to it.

Can it co-exist with other conditions like ADHD or anxiety?

Yes, commonly. Compulsive sexual behaviour frequently appears alongside depression, anxiety, ADHD, trauma or substance use.

Co-occurring conditions need to be addressed together rather than one after the other. A thorough assessment at the start identifies the full picture, so the plan addresses all the drivers instead of only the surface behaviour. We have written separately about the overlap between neurodivergence and sex addiction.

Insurance

Does insurance cover sex addiction treatment?

Coverage is inconsistent. Because compulsive sexual behaviour is not a standalone diagnosis in the DSM-5-TR, plans differ widely in what they will and will not cover, and the answer depends on your specific plan rather than on any general rule.

Some clients receive partial coverage, some receive none, and some find coverage they did not expect. It is genuinely worth a call to your insurer before assuming either way, and we are happy to talk through what to ask them.

Full information on fees and what to expect financially is on the New Path Family general practice FAQ.

Self-discovery

Do I really have a problem? How would I know?

That is the right question to start with. A structured self-assessment gives you a clearer picture than either minimising or catastrophising on your own does.

We offer two free screeners on our self-discovery page — one for the person who may be struggling, and one for partners who have experienced betrayal. Both are free and confidential.

What is the Sexual Addiction Screening Test (SAST-R)?

The SAST-R is a validated 45-question screener developed by Dr. Patrick Carnes. It measures compulsive sexual behaviour and how far it is affecting your daily life.

It reports on four areas: preoccupation with sex, loss of control, relationship disturbance, and affect disturbance. It takes ten to fifteen minutes and gives you a structured picture rather than a guess.

I am a partner who has been betrayed. Is there a screener for me?

Yes. The Trust Disruption Scale is a free 20-question screener we developed for partners who have experienced betrayal connected to compulsive sexual behaviour.

It looks at emotional safety, honesty and transparency, sexual safety, and the pain you are still carrying. It is designed to help you see the scope of what you are dealing with — which very often looks like trauma.

I scored high on the screener. What does that mean?

It means your experience lines up with patterns associated with compulsive sexual behaviour, which is worth taking seriously.

A screener is not a diagnosis. Only a clinical assessment with a trained therapist can do that. But a high score is a clear signal that support is worth pursuing, and it gives you concrete language to bring into that first conversation — which for most people is the hardest part.

How bad does it have to be before I need help?

If it is causing you distress, affecting your relationships, or taking up mental space in a way that feels outside your control, that is enough. You do not need to have lost a marriage or reached a dramatic low point to deserve support.

Many of the people who benefit most come in early, while the pattern is established but has not yet produced serious consequences. Early work is considerably easier than crisis repair.

Treatment

What does treatment actually look like?

Our integrated model brings together individual therapy, couples work where relevant, and support resources, coordinated around your situation.

Individual work focuses on understanding what drives the behaviour, building other ways of coping, processing underlying trauma, and building a concrete relapse-prevention plan. The process is structured but responsive — it changes as you do.

What is the best treatment approach?

The approaches that work best are multifaceted: individual therapy, couples work where relevant, accountability structures, and often a support group. The centre of gravity is healing trauma, building secure attachment, and breaking the compulsive cycle.

There is no single answer, because the drivers vary a great deal from person to person. A thorough assessment at the start is what makes a plan fit the person rather than the category.

Do I have to give up sex entirely?

No. The goal is not to give up sex. It is to stop the behaviours that are causing harm and to build a healthy, connected relationship with your own sexuality.

Treatment usually begins with a period of abstinence from the problematic behaviours, which gives the brain time to recover from the intensity the pattern has built up. As treatment progresses, people generally develop a more balanced and intentional approach to sex — oriented towards intimacy and connection rather than escape.

How long does treatment take?

It varies with the severity of the pattern and with the person. Sustained recovery usually involves months to years of ongoing support, and the useful frame is long-term remission rather than a finish line.

Many people experience real relief and behavioural change within the first few months. The longer work is addressing the emotional patterns that drove the behaviour in the first place. We have also written about relapse, which is part of many recoveries rather than the end of one.

Do you offer therapy intensives?

Yes. Where the situation is acute, where weekly sessions feel too slow, or where you want concentrated work to build momentum, we offer intensive formats — for the person struggling, for betrayed partners, and for couples together. Ask about it when you get in touch.

For the person struggling

I am ashamed and terrified of being judged. Will I be?

No. Our therapists have worked with people across every type and pattern of compulsive sexual behaviour. There is nothing you can describe that will change the quality of care you receive.

Shame is one of the strongest drivers of the behaviour and one of the biggest barriers to getting help. You will be treated with respect and competence from the first conversation.

I have tried to stop on my own many times and cannot. Why?

Because this is not a willpower problem. It is a learned pattern in which the brain has come to rely on sexual behaviour as its main way of managing stress, anxiety, loneliness or pain.

Stopping by willpower alone targets the surface behaviour without touching what drives it, which is why the same cycle keeps returning. With the right support, lasting change is genuinely possible — and individual therapy is usually where it starts.

What is a Full Therapeutic Disclosure, and do I need one?

A Full Therapeutic Disclosure is a structured, therapist-guided process in which you give your partner a complete account of your behaviour, in writing, in a controlled therapeutic setting.

It is almost always recommended. Without a full and honest picture, your partner is left managing uncertainty and filling the gaps with imagination, which is almost always worse than the truth. The disclosure creates the foundation of honesty that genuine repair needs.

For partners

My partner has a sex addiction. Is this my fault?

No. This is never about something you did or did not do. Compulsive sexual behaviour is driven by internal patterns that existed long before you, not by dissatisfaction with you.

That is often hard to feel even when it is intellectually clear. Therapy for partners helps move it from something you know to something you believe, and treats your healing as its own process rather than an accompaniment to someone else's.

I have just found out. What do I do right now?

First: you do not have to decide anything right now. Not whether to stay or go, not whether to forgive. This is a crisis, and crisis comes first.

Betrayed partners often experience something that looks very like post-traumatic stress — intrusive thoughts, hypervigilance, difficulty trusting your own perceptions. That is a real response to a real injury, not an overreaction. We have written about intrusive thoughts after discovery and about the stages of partner recovery.

Reach out when you are able to. You deserve your own support, not just support while someone else recovers.

I think my partner has a sex addiction. What should I do?

Raise your concerns gently and encourage them to get help. Coming at it with understanding rather than accusation tends to work better — not because what has happened is acceptable, but because defensiveness closes the conversation down.

At the same time, look after yourself. You do not have to wait for your partner to seek help before getting support of your own, and the Trust Disruption Scale can help you make sense of what you are experiencing.

How will I ever trust my partner again?

Rebuilding trust takes time and real effort from both people. It is possible, but it requires honest repair, genuine accountability, and a structured process that does not rush what cannot be rushed.

Many couples do report significant improvement after specialised therapy. The path is not short, but it is real — and the Trust Disruption Scale is a way to see where you currently stand and to check again later.

Couples and relationships

Should we do couples counselling or individual counselling?

Both, and the order matters. Individual therapy usually comes first for both people, because each needs their own space to process what has happened without managing the effect on the other.

Couples work typically begins once there has been some individual stabilisation. It addresses communication, the relational impact, and what repair actually looks like from here.

Should my partner and I see different therapists?

Yes, and we recommend it strongly. Each of you needs a space that is entirely yours, where you can be completely honest without weighing how it affects the other person's treatment.

You would also do couples work, usually with a third therapist. That structure means both people get their own care while the shared work still happens.

Can our marriage actually be saved?

Many marriages survive this, and some deepen. It is long-term work and it requires genuine commitment from both people.

We also offer discernment counselling for couples who are not yet sure whether they want to try, so that the decision can be made from clarity rather than from the middle of a crisis. Whichever way it goes, we will support you through it.

Family

What do I tell my children?

Be honest at a level that fits their age. Reassure them that they are safe and loved, and that the family is going through a hard time and is working on it together.

Children do not need details. They need stability, reassurance, and to know that what is happening between adults is not their fault and does not change how much they are loved. A therapist can help you find the words for your particular children.

Are my children safe?

If you have any concern at all about your children's safety, raise it directly and immediately with your therapist, or with the relevant authorities. That comes before everything else on this page.

It is also worth saying clearly that compulsive sexual behaviour and sexual offending are not the same thing, and conflating them causes real harm. Where children have not been involved or endangered, the work is addressing the pattern through therapy and keeping the home stable and supportive while that happens.

Getting started

How do we get started?

Complete our contact form and we will send therapist recommendations, fee information and next steps within 24 hours. From there you can book a complimentary consultation or go straight into sessions.

If you have questions first, reach out to Cassie Clayton, our Client Care Coordinator, at clientcare@newpathfamily.com or (408) 475-2746. You can also read more about how treatment works, browse our resources, or take one of the free screeners on our self-discovery page first.