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Treatment Options

by Mark Laaser

Treatment Options

Rarely does a week go by when we don’t get a call from an addict, wife, pastor, or counselor about what kind of sex addiction treatment would be appropriate and effective. Usually, these questioners also state, “I for sure want a Christian emphasis.” In this brief article I would like to address some general responses to these questions.

I have always looked at treatment options as a continuum. As I try to describe this continuum remember that the main goal of treatment is for the addict to achieve sobriety or freedom from sinful sexual acting out (sexual purity). At the beginning end of the spectrum is treatment that would include getting involved in an organized support group specific to those struggling with sex addiction. There are many such groups both secular (e.g. Sexaholics Anonymous) and Christian (e.g. L.I.F.E. groups). A very popular program in that last number of years has been Celebrate Recovery. While I believe that is a very solid Christian recovery ministry, we have also found that the materials used, even when people are divided into specific addiction groups, are not concretely helpful to sex addicts. So, while Celebrate Recovery can be a helpful adjunct to a program, it really doesn’t work well as the only group an addict attends.

These days it has become more popular through the Internet to conduct groups by phone or computer including Internet based webinars and video conferencing. While such experiences may be good stop gap measures or adjuncts they can never take the place of face to face fellowship.

Next in line on the continuum is Christian individual counseling. That means working with a counselor one on one. Counselors come in a variety of shapes or sizes. There are lay counselors who don’t have formal education. Then there are those pastors who have training as pastoral counselors. Realize that most pastors, even though they may do some counseling, don’t have specific training to do so. There are a variety of master’s level counselors who may have various state licenses to do counseling. Finally, there would be doctoral level counselors, either Ph.d or Psy.d psychologists or M.D. psychiatrists. Of course one of the main questions to ask about any counselor is have they been trained in knowing how to work with sexual addiction. These days there are certification processes to go through. For example, we work with the American Association of Christian Counselors to provide training and certification for Christians counselors that desire really specific expertise.

A common combination would be for an addict to attend support groups and receive individual counseling. We are firm believers, also, in the power of group therapy for addiction. Some counseling centers, like ours, conduct weekly counseling groups for men, women, and couples. These groups can be extremely powerful, if led by a qualified therapist, because of the tranformational dynamic of fellowship. Someone in our field once said, “We usually come to addiction because we have been wounded in our famlies and, therefore, to get well we must heal in families.” Groups become our healthy family.

You will notice that at counseling centers like ours, we have three equal componenets of therapy. There is individual counseling for men and women, group counseling for men and women, and couples counseling (both as individual couples and in group).

These various components if worked agressively begin to comprise the next point on the continuum, something that is referred to as intensive outpatient treatment (sometimes called IOP). There are also counseling centers that specialize in IOP. These programs may go so far as to have the addict and/or the spouse comes to the center for up to 8 or more hours every day of the week. It is more common for an IOP program to require the participants to come several evenings a week for several hours each evening. In whatever configuration of time requirements, workbook materials are usually used to advance the healing journey. In some programs, psychiatrists are included in the process to evaluate mental health issues like depression or anxiety that are part of the profile of the addict. I would say that such programs are few and far between particularly in the Christian community.

Next we come to my personal favorite type of treatment, the Intensive Workshop. Workshops are normally 3-5 day experiences. The men, women, or couples who come for these usually stay in hotels and come to the location for the workshop during the day. A treatment day at a workshop can be from 9 in the morning to 9 in the evening. Workshops include teaching and group process.

At our 3 day workshops, we divide the time between teaching components and small group process. We may have as many as 30 men at a workshop that will be together for teaching and “large group” experience. We also divide such a large group into smaller groups of 5-6 men for more individually directed process. Each group is led by a qualified leader. The power of such workshops comes from a variety of factors, mainly the power and truth of the teaching and the power of the fellowship of the people who come. We find that those who come to our workshops for men, wives, and couples get more out of the experience than they otherwise would in a year’s worth of individual counseling. This is a bold claim but we have hundreds of testimonials from both participants and counselors that this is true.

Since I am often asked about these workshops and since I know there are others out there in the Christian world, please allow me to be very confident about ours. Over the last 22 years I have traveled the country and been involved in helping various centers set up programs. I was involved in the early days of the Every Man’s Battle program, and I also was very involved for a number of years in the Bethesda Workshops in Nashville. To put it in a positive light, our teaching has come a long way from those days and we, therefore, feel that our workshops are the most effective. We are still colleagues and friends with many of the people involved with other workshop ministries, but ours are the only ones we competely endorse. This all may sound competitive and I don’t mean it to be, but I am passionate about how effective we are and the healing journey is too important to not know that.

Finally, on our continuum, we come to in-patient treatment. Such programs involve being admitted to a hospital based setting 24/7 and are overseen by medical people, nurses and doctors. Certified and licensed counselors usually conduct the teaching and counseling work. In-patient programs are usually 4-6 weeks in length.

Over the years I have been involed with several of these programs. In my early years I worked with Dr. Pat Carnes at the original treatment center for sex addiction, Golden Valley Health Center which no longer exists. After that, I consulted with other hospitals on setting up sex addiction treatment programs. What has happened in the world of health care is that such programs have become very expensive particularly since insurance companies are less likely to pay for them.

I myself went to such a program when I first was intervened on in 1987. This was the Pat Carnes program I eventually went to work with. I am eternally grateful for that experience. I would tell you, however, that today I wouldn’t have “qualified” to go, i.e. my insurance company probably wouldn’t have paid for it. The reason for this is because of the main criteria for admission to such programs. Remember, I believe any addict would benefit from going to such a program and working on themselves 24/7. What a great “jump start” that can be. These days we think of in-patient for two main reasons.

First, has the addict tried everyting on the continuum first? In other words, has he or she gone to groups, counseling, and workshops? If over a period of months, this person can’t achieve sobriety then we will think about referring to in-patient. Second, is the person suicidal or suffering from significant depression? The only safe place for them might be in a hospital setting. These days, it is not uncommon for such an addict to be hospitalized in a local psychiatric ward and then referred to out-patient programs when they are emotionally stable.

One of my most frequently asked questions is: “Is there a good in-patient program that is Christ centered? Sadly, my answer to that question is “No.” I have traveled the country and visited many places, but there is no program that compares in effectiveness to the secular treatment centers. There are some ministries that advertise having camps and residential settings, even up to 6 months in duration. Unfortunately, while well intentioned, my experience with them is that they can even be dangerous. For example, once such program took away a person’s medication who was suffering from bi-polar disorder. This program felt it wasn’t biblical to take the medication. This person attempted suicide and fortunately was rescued in time to save his life.

The truth is, in my opinion, the situation is that the only treatment programs that I trust are those that have been, at least at some point, associated with Dr. Pat Carnes. That list would include: Keystone Treatment Center in Philadelphia; Del Amo Hospital in Torrance, CA; The Meadows in Wickensburg, AZ; and Pine Grove Hospital in Hattiesburg, MS. I often find that there are many fine people, including Christians, working at these programs.

I work with hundreds of addicts every year and in any given year I have only needed to refer a handful of men to in-patient treatment. While occasionally necessary, there are so many other effective out-patient options these days going to in-patient is just not that affordable or logistically possible.

Hopefully, this rather lengthy explanation will help you to sort out the maze of treatment options.

Mark Laaser, Ph.d

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