A new framework for treating problematical sexual behaviour

This week I had the pleasure of catching up with Bill Herring, a certified sex addiction therapist (CSAT) in Atlanta. We spoke using video conferencing technology, he in Atlanta and me in London, and discussed his new framework for treating problematical sexual behaviour. Bill has been a counsellor and psychotherapist for over 25 years and is a lead trainer on The Society for the Advancement of Sexual Health (SASH) new advanced training for categorising chronic problematical sexual behaviours. Whilst being CSAT certified he does not strictly follow the CSAT model for treating problematical sexual behaviour.

The framework involves assessing five categories to determine whether a pattern of sexual behavior can be considered to be problematic. These five categories are sexual behaviour patterns that regularly:

  • Conflict with a person’s commitments, and/or
  • Conflict with a person’s values, and/or
  • Conflict with a person’s self-control, and/or
  • Result in negative consequences, and/or
  • Lack fundamental sexual responsibility (everybody consents, everybody is protected, nobody is exploited).

These five categories each yield a question to explore when assessing for any problematic components of a person’s ongoing sexual behaviour:

  • Commitments—are you keeping your promises?
  • Values—are you OK with what you are doing?
  • Control—are you in control of yourself?
  • Consequences—is everything OK?
  • Responsibility—are you protecting others?

In the interview we discuss ICD10 /DSM5 classifications, problematical sexual behaviour, sex addiction, contextual factors impacting a person’s sexual behaviour, treatment models, what constitutes ‘recovery’ in this area, and the categories of his new framework.

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