Facilitated & Developed by: Neva Chauppette, Psy.D.

1. PROTOTYPES Division of Training, Technical Assistance and ConsultationPresents:SEX ADDICTION ASSESSMENT & TREATMENTAn Advanced Training For Health Care & Other Service Providers Facilitated & Developed by: Neva Chauppette, Psy.D.

2. PROTOTYPES 5601 W. slauson Ave., Suite 200 Culver City, CA 90230 Telephone: 310.641.7795 Fax: 310.649.4347 Email: www.prototypes.org Neva Chauppette, Psy.D.P.O. Box 6234Woodland Hills, CA 91365-6234CA Psychologist License # PSY14524(818) 680-0234 (voicemail/pager)(818) 439-7080 (cell)(818) 703-1854 (fax)NCHAUPPETT@aol.com

3. The Addictive Cycle a) preoccupation – the trance or mood wherein the addicts’ mind is completely engrossed with thoughts of sex. This mental state creates obsessive search for sexual stimulation. b) ritualization – the addicts’ own special routines that lead up to the sexual behavior. The ritual intensifies the preoccupation, adding arousal and excitement.

4. The Addictive Cycle c) compulsivity – the actual sexual act, which is the end goal of the preoccupation and ritualization. Sex addicts are unable to control or stop this behavior. d) despair – the feeling of utter hopelessness addicts have about their behavior and their powerlessness.

5. Application of the Core Elements of Addiction to Sex Addiction Obsession • Planning daily events around obtaining the "fix" (e.g., sex - where to go, how to dress, items needed to engage in the behavior, etc.) preoccupation with.

6. Application of the Core Elements of Addiction to Sex Addiction Compulsion • Feeling that the behavior "fix" must occur to satisfy the drive; if not satisfied - the obsession will only escalate and there will be further consuming.

7. Application of the Core Elements of Addiction to Sex Addiction Denial • "Everyone needs to relax" • "With the stress I'm under, I deserve it" • " A lot of people get VD"

8. Ten Signs of Sexual Addiction • Out of control behavior • escalating frequency • escalating dangerousness

9. Ten Signs of Sexual Addiction • Consequences - escalating and compounding consequences • impaired or decreased job performance due to preoccupation, absenteeism • STD, unwanted pregnancies

10. Ten Signs of Sexual Addiction • possible arrests - lewd/lascivious conduct • marital/monogamous relationships are jeopardized/lost

11. Ten Signs of Sexual Addiction • Inability to stop - self perpetuation of behavior once guilt and shame are fused • Self-destructive or high risk - as frequency of "using" goes up, so too does the need for drama; danger to add to the "rush"

12. Ten Signs of Sexual Addiction • Effort/desire to limit the sexual behavior - limit sexual behavior to only certain types, with certain partners, etc.

13. Ten Signs of Sexual Addiction • Sexual obsession/fantasy - when things are uncomfortable or problematic, this is the mental place sex addicts go to

14. Ten Signs of Sexual Addiction • Increased amounts - it is equivalent to physiological need (tolerance) and the desire to achieve the same effect can only be reached with increasing frequency, intensity, etc. of acts

15. Ten Signs of Sexual Addiction • Mood swings - sex is used as a fix to alter "bad" mood states but ultimately is bad itself due to the guilt/shame

16. Ten Signs of Sexual Addiction • Increased time - preoccupation with obtaining, using and recovering from sexual fix

17. Ten Signs of Sexual Addiction • Neglect - as disease progresses, so does the pervasiveness of the neglect

18. Differences Between Healthy Sex and Addictive Sex • Healthy sex: is about respect for the partner, honesty with the partner • this type of sex does not require a “double life” • fosters respect and affection for self and the partner

19. Differences Between Healthy Sex and Addictive Sex • Addictive / Unhealthy sex - is illicit, stolen and explosive, dishonest and requires a “double life” • disconnects one from self and others, brings shame/guilt and wreckage

20. Unhealthy Sex Is Comprised Of And Supported By: • obsession- disconnects one from oneself • compulsion - becomes routine, is grim and joyless • denial- creates a world of unreality • guilt- compromises values • shame - feels shameful

21. Identifying Clients With Sexual Addiction • Do you or others who know you find that you are overly preoccupied or obsessed with sexual activity? • Do you ever find yourself compelled to engage in sexual activity in response to stress, anxiety, or depression?

22. Identifying Clients With Sexual Addiction • Have you had serious problems develop as a result of your sexual behavior (e.g., loss of a job or relationship, sexually transmitted diseases, injuries or illnesses, sexual offenses)? • Do you feel guilty and shameful about some of your sexual behaviors?

23. Identifying Clients With Sexual Addiction • Do you fantasize or engage in any unusual or what some would consider "deviant" sexual behavior? • Do you find yourself constantly searching or "scanning" the environment for a potential sexual partner?

24. Identifying Clients With Sexual Addiction • Do you ever find yourself sexually obsessed with someone who is not interested in you or doesn't even know you? • Do you think your pattern of masturbation is excessive, driven, or dangerous?

25. Identifying Clients With Sexual Addiction • Have you had numerous love relationships that are short-lived, intense, and unfulfilling? • Do you feel a constant need for sex or expressions of love in your sexual relationship?

26. The Sexual Addiction Screening Test (SAST) • Designed to assist in the assessment of sexually compulsive or "addictive" behavior • Provides a profile of responses that help to discriminate between addictive and non-addictive behaviors.

27. The Sexual Addiction Screening Test To complete the test, answer each question “Yes” or “No”: 1. Were you sexually abused as a child or adolescent? 2. Have you subscribed to or regularly purchased sexually explicit magazines such as Playboy or Penthouse? 3. Did your parents have trouble with sexual behavior? 4. Do you often find yourself preoccupied with sexual thoughts? 5. Do you feel that your sexual behavior is not normal?

28. The Sexual Addiction Screening Test 6. Does your spouse (or significant other) ever worry or complain about your sexual behavior? 7. Do you have trouble stopping your sexual behavior when you know it is not appropriate? 8. Do you ever feel badly about your sexual behavior? 9. Has your sexual behavior ever created problems for you or your family? 10. Have you ever sought help for sexual behavior you did not like?

29. The Sexual Addiction Screening Test 11. Have you ever worried about people finding out about your sexual activities? 12. Has anyone been hurt emotionally because of your sexual behavior? 13. Are any of your sexual activities against the law? 14. Have you made promises to yourself to quit some aspect of your sexual behavior? 15. Have you made efforts to quit a type of sexual activity and failed? 16. Do you have to hide some of your sexual behavior from others? 17. Have you attempted to stop some parts of your sexual activity?

30. The Sexual Addiction Screening Test 18. Have you ever felt degraded by your sexual behavior? 19. Has sex been a way for you to escape your problems? 20. When you have sex, do you feel depressed afterwards? 21. Have you felt the need to discontinue a certain form of sexual activity? 22. Has your sexual activity interfered with your family life? 23. Have you been sexual with minors? 24. Do you feel controlled by your sexual desire? 25. Do you ever think your sexual desire is stronger than you are?

31. The Sexual Addiction Screening Test SCORING Relative Distributions of Addict and Non-Addict SAST Scores Percent in This Score Range Who Are SAST Score Range ("yes" answers) Non-AddictAddict 0 – 4 89.3% 10.7% 5 - 8 89.6% 10.4% 9 - 12 77.2% 22.8% 13+ 3.5% 96.5%

32. Criteria of Problematic OnlineSexual Behavior • Preoccupation with sex on the Internet (obsession) • Engaging in sex on Internet more often or for longer periods of time than intended (compulsion)

33. Criteria of Problematic OnlineSexual Behavior • Repeated unsuccessful efforts to control, cut back on, or stop engaging in sex on the Internet (compulsion) • Restlessness or irritability when attempting to limit or stop engaging in sex on the Internet

34. Criteria of Problematic OnlineSexual Behavior • Using sex on the Internet as a way of escaping from problems or relieving feelings such as helplessness, guilt, anxiety, or depression (denial) • Returning to sex on the Internet day after day in search of a more intense or higher-risk sexual experience (compulsion)

35. Criteria of Problematic OnlineSexual Behavior • Lying to family members, therapists, or others to conceal involvement with sex on the Internet (denial, shame, guilt) • Committing illegal sexual acts online (for example, sending or downloading child pornography or soliciting illegal sex acts online) (compulsion, guilt)

36. Criteria of Problematic OnlineSexual Behavior • Jeopardizing or losing a significant relationship, job, or educational or career opportunity because of online sexual behavior • Incurring significant financial consequences as a result of engaging in online sexual behavior

37. Internet Sex Screening Test

38. Internet Sex Screening Test Read each statement carefully and answer honestly. If the statement is true or mostly true for you, mark the blank with a T. If it is false, mark the blank with an F. ___ 1. I have some sexual sites bookmarked. ___ 2. I spend more than 5 hours per week using my computer for sexual pursuits. ___ 3. I have joined sexual sites to gain access to online sexual material. ___ 4. I have purchased sexual products online. ___ 5. I have searched for sexual material through an internet search tool. ___ 6. I have spent more money for online sexual material than I planned. ___ 7. Internet sex has sometimes interfered with certain aspects of my life. ___ 8. I have participated in sexually related chats. ___ 9. I have a sexualized user name or nickname that I use on the Internet. ___10. I have masturbated while on the Internet.

39. Internet Sex Screening Test ___ 11. I have accessed sexual sites from other computers besides my own. ___ 12. No one knows I use my computer for sexual purposes. ___ 13. I have tried to hide what is on my computer or monitor so others cannot see it. ___ 14. I have stayed up after midnight to access sexual material online. ___ 15. I use the Internet to experiment with different aspects of sexuality such as bondage, and anal sex. ___ 16. I have my own website that contains sexually explicit material. ___ 17. I have made promises to myself to stop using the Internet for sexual purposes. ___ 18. I sometimes use cybersex as a reward for accomplishing something like finishing a project or enduring a stressful day. ___ 19. When I am unable to access sexual information online, I feel anxious, angry, or disappointed.

40. Internet Sex Screening Test ___ 20. I have increased the risks I take online (i.e., giving out my real name and phone number, or meeting people offline). ___ 21. I have punished myself for using the Internet for sexual purposes (for example, I’ve arranged time-out from the computer or canceled Internet subscriptions). ___ 22. I have met face-to-face with someone I met online for romantic purposes. ___ 23. I use sexual humor and innuendo with others while online. ___ 24. I have run across illegal sexual material while on the Internet. ___ 25. I believe I am an Internet sex addict. Total number of statements marked “True” ___________ Total number of statements marked “False ___________

41. The Lure of the Internet • Accessibility – home/office computers • Affordability – usually unlimited access available for less than $20/month • Anonymity – user can be her/himself or pretend to be anyone

42. The Lure of the Internet • Secrecy – computer use leaves less obvious traces versus physical evidence from for example, a porn magazine or video – can turn off the computer if an unwanted visitor enters the room

43. The Lure of the Internet • Safety - no risk of STDs, illegal financial exchange (prostitute or in a massage parlor), or getting arrested (for public or anonymous sex)

44. The Lure of the Internet • Normalization - can find others online who engage in a variety of different sexual behaviors -- many have created “virtual communities” for sexual activities and support of sexual lifestyles

45. National Sex AddictionRecovery Fellowships • Sex Addicts Anonymous - SAA • Sex and Love Addicts Anonymous – SLAA • Sexaholics Anonymous – SA • Sexual Compulsive Anonymous - SCA

50. Where to Find Help The following national organizations can refer callers to self-help groups in their area: Del Amo Hospital Sex Addicts Anonymous Sexual Dependency Unit P.O. Box 70749 23700 Camino Del Sol Houston, TX 77270 Torrance, CA 90505 (713) 869-4902 or (800) 533-5266 (213) 896-2964 loc www.delamohospital.comwww.sexaa.org National Council on Sexaholics Anonymous Sexual Addiction & P.O. Box 300 Compulsivity Simi Valley, CA 93062 770-989-9754 (805) 581-3343 or www.ncsac.org (213) 480-1096 Recovering CouplesSex & Love Addicts Anonymous Anonymous P.O. Box 338, New Town Branch c/o General Services Norwood, MA 02062 P.O. Box 11872 (323) 957-4881 St. Louis, MO 63105 www.slaafws.org (314) 830-2600 (toll-free: 877-742-7349 ext.1234) www.sexhelp.com Culver City: 310-322-7857 (Dr. Patrick Carnes) www.recovering-couples.org