Do I Need to See a Sex Addiction Counselor?

That is a question that comes up from time to time when working with men who come to us for help with their unwanted sexual behaviors. And usually, when someone asks that, my answer is, “Not necessarily.”

I know that may sound strange to some people, but it’s true. The reason I say that is because one’s compulsive sexual behaviors, while a problem in and of themselves, are generally an expression of a much larger problem such as trauma, depression, and/or feelings of low self-worth. This is not to say that sex addiction-focused counseling can’t be helpful.

But it may not be as effective as generalized clinical counseling, depending on the individual and situation.

Realize that both general clinical counseling and sex addiction counseling seek to support individuals struggling with psychological distress. However, these fields differ in focus, techniques, and therapeutic frameworks due to the unique complexities of sex addiction and the specific tools required to address it. That said, the following are some similarities and differences between both forms of therapy.

Both general and sex addiction-focused counseling are similar in that they both:

Stress the importance of the therapeutic alliance and confidentiality.

One of the cornerstones of both general counseling and sex addiction counseling is the therapeutic alliance (i.e., the quality of the relationship between the patient and clinician). In both settings, establishing trust and a non-judgmental environment is essential, allowing clients to explore personal issues openly. Regardless of the focus, a counselor’s empathy, listening skills, and consistent support form the bedrock of an effective therapeutic relationship.

Additionally, confidentiality is another shared principle that is central to the counseling profession. Whether a client is working on general mental health concerns or seeking help with sex addiction, maintaining privacy is crucial for the counselor. This is because the knowledge that your information is safe and private is essential for building trust and rapport with your therapist.

Use evidence-based approaches

General clinical counseling and sex addiction counseling both often employ evidence-based approaches, meaning that the techniques and interventions are supported by empirical research. Cognitive Behavioral Therapy (CBT), for example, is widely used in both fields, though with some adaptations for sex addiction counseling. In general counseling, CBT may be used to help a client manage anxiety by restructuring negative thought patterns, while in sex addiction counseling, CBT can be directed toward identifying triggers and rethinking impulsive behaviors.

In general, professional counselors rely on theories and techniques that have been shown to be effective. This is not just a matter of good practice, but also something that is ethically mandated.

However, sex addiction-focused counseling does differ from general counseling in that:

The nature of the issues addressed is specific to sex addiction matters.

The primary distinction between general counseling and sex addiction counseling is the nature of the issues being addressed. General counseling may cover a wide array of issues, including depression, anxiety, trauma, family dynamics, and relationship concerns. Its approach is broad, often tailored to the diverse needs of individuals, couples, or families.

In contrast, sex addiction counseling specifically addresses compulsive sexual behaviors that are disruptive to one’s life. These behaviors can range from compulsive pornography use and serial infidelity to excessive use of dating apps or even illegal activities. The goal of sex addiction counseling is to reduce or eliminate these behaviors and help clients regain control over their actions and impulses. This limited scope of focus can serve both a strength or a weakness depending on the person and/or situation.

It is more concerned with stigma and shame management.

Realize that there is a stigma surrounding the area of mental health as a whole (which is unfortunate). However, sex addiction counseling involves a level of shame management that isn’t always as prominent in general counseling. While clients dealing with depression or anxiety may experience stigma, the shame surrounding sex addiction is often particularly intense, tied to cultural taboos around sex and morality.

This level of shame can create additional barriers to openness and trust within therapy. As such, counselors specializing in sex addiction often undergo training to handle this specific stigma, offering clients a space where they can discuss their struggles without fear of judgment.

There is more focus placed on “relapse” prevention and accountability.

In general counseling, relapse is less of an explicit concept, as clients typically work toward managing symptoms or achieving personal growth. If a client struggling with depression or anxiety faces a setback, it may not be labeled as a “relapse.” Instead, general counseling focuses on continuous improvement and resilience in the face of life’s challenges.

Sex addiction counseling, on the other hand, frequently includes relapse prevention as a major component of treatment.

Here, a relapse would refer to a return to compulsive sexual behaviors after a period of abstinence or control. Counselors in this field are trained to help clients build accountability systems, develop tools for handling urges, and create “trigger management” strategies. Relapse prevention planning becomes part of the therapeutic process, often incorporating peer support, self-monitoring, and close attention to daily routines and risk factors.

It incorporates specialized techniques.

While both types of counseling share certain techniques and intervention methods, sex addiction counseling incorporates highly specialized therapeutic tools. For instance, counselors working with sex addiction clients might use strategies from 12-step programs adapted for sex addiction, which aren’t as common in general counseling. Such programs focus on surrendering control, building accountability, and supporting others with similar experiences.

There is great emphasis placed on identity reconstruction.

For many sex addiction clients, part of recovery involves reconstructing one’s identity, separate from the addiction. This is less of a focus in general counseling unless the client is dealing with issues related to identity development, such as during adolescence or following a major life change. Sex addiction counseling, however, often requires clients to rebuild self-worth, self-concept, and values. This can include helping clients to redefine their relationships, develop new coping strategies, and build a sense of identity that supports healthier, addiction-free living.

Ultimately, both general clinical counseling and sex addiction counseling are valuable resources for mental health support, each with distinct areas of expertise. While they share a commitment to the therapeutic alliance, confidentiality, and evidence-based approaches, their goals, techniques, and challenges differ somewhat.

Understanding these differences and similarities can help you choose the type of support that best aligns with your needs. And if you’d rather work on the broader and deeper issues you may be coping with through your sexual behavior, choosing a general counselor who also has undergone specialized training in addiction can be a real benefit.

By the way, if you enjoyed this post, sign up for our newsletter to get content like this sent directly to your inbox once per week with no strings attached.

We love feedback! Let us know if this article was helpful.

Thanks for the feedback