2015 SASH Conference Presentations (Archives)

2015 SASH Conference Loews Philadelphia Hotel

2015 SASH CONFERENCE Presentations (Archives)

Order a CD of 2015 SASH presentations

Increasing Intimacy in Wounded Couples through the Fertile Ground of Secure Attachment 
Ann Smith, LMFT
Austin Houghtaling, Ph.D
Whether injured by serious challenges such as addiction or betrayal or just suffering from the cold distance of superficial communications, couples in therapy generally come in wishing for more emotional and sexual intimacy. This workshop offers a clear path to intimacy as a natural outcome of secure emotional connection between partners. The presenters will integrate brief exercises and techniques designed to create safe moments of intimacy that will be demonstrated throughout this day-long workshop.
Empowering Sexually and Multiply Addicted Male Survivors of Sexual Victimization
Jim Struve, LCSW
Lynne MacDonell, CADC, CHt 
This workshop focuses on therapeutic interventions to help empower sexually and multiply addicted male survivors of sexual victimization. This workshop will focus on the specific needs of male survivors, help therapists understand how to effectively assess for sexual victimization history, describe the healing process or sexual trauma, and how to integrate sex addiction and multiple co-addiction recovery while supporting healing from abuse. We will pay special attention also to ways therapists can effectively cope with their own vicarious traumatization and counter-trauma while providing these interventions.Controlling Currency: Working with Sex, Money, and Power in Relationships
Debra L. Kaplan, MA, MBA, LPC, CSAT-S

Relationships often involve power struggles and control conflicts over sex and money. As such they experience adverse outcomes in the bedroom as well as in the therapy room. The volatile coefficient of sex and money becomes ever more challenging for couples when there has been sexual and financial betrayal or exploitation. In order to navigate these potentially volatile dynamics, therapists must address the unresolved earlier life issues that fuel these precarious dynamics as disputes over sex and money are often unresolved childhood beliefs about sex and money. Join Debra L. Kaplan for an experiential, multimedia workshop and gain hands-on learning and techniques to successfully treat sex, money and power in relationships. Included in this workshop will be the role that narcissism and even psychopathy plays that may put many couples at risk for relational distress and/or dissolution. Areas of workshop focus include: 1) Attachment dynamics in at-risk and controlling relationships, 2) The role of narcissism and psychopathy in controlling relationships, 3) Concepts of relational currency, 4) Monetized and Eroticized rage, and 5) Elements of sex, money and power in relationships.Increasing Intimacy in Wounded Couples through the Fertile Ground of Secure Attachment (cont.)
Empowering Sexually and Multiply Addicted Male Survivors of Sexual Victimization (cont.)
Using Mindfulness and Self-Compassion Approaches to Working with Hypersexual Patients
Rory C. Reid, PhD, LCSW

Patients seeking help for hypersexual behavior exhibit a low tolerance for uncomfortable or unpleasant experiences. Such intolerance translates to emotional dysregulation in the wake of discomfort or stress triggering a desire for “pain relief.” Unfortunately, individuals with hypersexual behavior often avoid emotional pain and distress at the expense of impulse control. This inability to delay gratification compromises their ability to achieve long-term goals and frequently leads to numerous negative consequences. Emerging research from neuroscience, neuroimaging, and neuropsychology suggest an alternative approach to coping with unpleasant experiences that involves heightening our awareness of such moments in a mindful and nonjudgmental way. Self-compassionate aspects of mindfulness has been shown in our research to attenuate the negative impact of shame common among hypersexual patients and using self compassion approaches will also be part of this workshop. Participants will gain pragmatic and clinically relevant information. They will be exposed to the mindfulness exercises used in the UCLA Mindfulness Awareness Research and in our clinical trials with hypersexual patients.The Power of Therapeutic Collaboration in the Treatment of Problematic Sexual Behaviors
Nancy Gambescia, PhD
Cara Tripodi, MSS, LCSW, CSAT-S

This presentation emphasizes the essential importance of a collaborative network of professionals when treating sexual compulsivity. Collaboration provides the highest level of support, not only for the identified client but also for the partner and other family members. Dr. Gambescia and Ms. Tripodi will examine several cases in which a team approach has significantly contributed to successful outcomes in the long-term management of problematic sexual behaviors. Teamwork requires considerable “behind the scenes” effort, communication, and documentation. The presenters will review the advantages and complexities of collaborating, including the prerequisite for clear and articulated boundaries within the treatment team and the clients. Additionally, they will offer strategies that have proven to be successful and others that require more development.

Clinical, Family, and Environmental Challenges for
Successful Re-Entry from Prison for the Sex Offender
James Prager, MSW, ACSW, LSW
This presentation contrasts Sex Offender therapy inside and outside prison. The challenges of parole as a sex offender, including housing, employment, and the registry, are discussed. Additionally, issues related to re-establishing appropriate family connections and new relationships are explored. Various treatment modalities including aversion, cognitive, relapse prevention, and group approaches will be reviewed. The final portion of the presentation will review a program in Germany, which offers an alternative approach to child sexual abuse.

Sex, Shame and Eroticized Rage
Debra Kaplan, LPC, CMAT, CSAT-S

Sexual arousal, erotic pleasure and what becomes a sexual “turn-on” are at the core of our sexual development and sexual arousal templates. Therapists who work with the spectrum of sexual health, addiction and compulsivity often assist clients in their personal exploration to understand and resolve what may be their verbalized and unwanted sexual compulsions. For many, erotic pleasure and sexual arousal can be fused with shame, anger and/or fear to be expressed as eroticized rage; sexual expression that is often shameful, aggressive or even violent. Nonetheless, clients often experience the sexual dilemma of experiencing these behaviors as gratifying yet unwanted. The implication for therapists in working with these core sexual manifestations is to help clients see what is sexually latent yet externalized as disowned eroticized rage. Join Debra for an intriguing exploration into the strata of sex, shame, entitlement and hostility. Learn what to look for when working with eroticized rage in the sexually addicted population, how to successfully identify the distinctions of shame, anger or fear, and successfully interrupt unhealthy patterns. Included in the presentation will be video clips and case examples.

The Use of Polygraphs in Treating Individuals with Sex Addiction
Lucien Thomsen, LCSW, CSAT, CSOTS
William L. Fleisher, C.F.E.

In the last several years, more and more therapists treating individuals with sex addiction have begun using polygraph exams in order to increase the accuracy of sexual histories and disclosures, and to maintain therapeutic gains made in treatment. This workshop will present useful information to therapists who are considering recommending or requiring their clients complete polygraph exams in treatment. Clinical case examples will be shared throughout and questions from the participants are encouraged.

An Ounce of Prevention: A Course in Relapse Prevention
John Leadem, LCSW, CSAT, CMAT
Shawn Leadem, LCSW, CSAT, CMA
T  [PDF]
This workshop introduces a relapse prevention model, An Ounce of Prevention: A Course in Relapse Prevention that demystifies the relapse process and challenges the dangerous notion that “relapse is a part of recovery.” The model is predicated on the core belief that relapse is preceded by a desire to change the way we feel and is a dynamic component of the addictive process that is identifiable, predictable, and unnecessary. Participants will learn the seven phases of the relapse process and the behavioral symptoms one exhibits when he or she is in a relapse process. Participants will see how this knowledge is used to develop individualized interventions designed to address the symptoms one presents while in a relapse process so that a return to active addiction can be interrupted. Presenters will also highlight strategies for using the course in a variety of treatment modalities.

Strategies of Therapeutic Care for Addictive Arousal &
Sexually Compulsive Behavior in Adolescents and Young Adults
James B. Lewis, LCSW, CSAT-S, CLC
Todd D. Spaulding, LCSW, CSAT

This presentation will describe the nature and extent of teen sexually compulsive behaviors, introduce a new model of addictive arousal for teens, and identify principles for treatment and recovery. A case study will illustrate compulsivity and arousal, and identify key areas of competency that must be developed in affective adolescent treatment. It will highlight the treatment program where the material is being used at Oxbow Academy’s two facilities in Utah. In addition, there will be experiential exercises that therapists can use with their clients and a number of tools described that can be used in the treatment of troubled youth.

Mandated Reporting of Child Pornography Disclosures: Does it Really Protect Children?
Richard Joseph Behun, PhD, NCC, ACS;
David Delmonico, PhD, NCC, ACS;
Mary Deitch, JD, PsyD

The purpose of this presentation is threefold: (1) provide the legal definition of child pornography and related terms, (2) discuss recent changes to laws in California and Pennsylvania regarding mandated reporting of clients who view child pornography, and (3) discuss the advantages and disadvantages of mandated reporting laws related to viewing child pornography. The balance between protecting client confidentiality and mandated reporting of child pornography viewers is a difficult one to navigate. Previous mandated reporting laws required the child to come before the counselor, or the identity of the perpetrator and/or victim to be known; however, these laws are being reconsidered. Although child pornography laws and mandated reporting laws have the same goal – the protection of children – proposed changes may actually provide less protection to children and more focus on prosecution of offenders. How can individuals who wish to stop their child pornography viewing behavior safely present for treatment knowing that they will be met with possible legal and social consequences? This presentation will provide a venue for participants to both learn about and discuss the implications of child pornography mandated reporting laws, including important questions such as: What role does the First Amendment play? How are obscenity laws related to child pornography? How is client confidentiality protected? Can we report a client’s illegal behavior or fantasies? Case examples and open discussion will allow participants to better understand all the issues involved with this highly charged issue.

Sober Kink: Considering Spaces for Alternative Sexual Lifestyles in Recovery
Erica Sarr, PsyD, M.Ed., BCB

One of the challenges of treating sexual addiction is helping clients sort out behaviors that are part of their compulsive patterns and behaviors that might be part of a sexual template that they wish to keep in their sober life. Just as we strive not to stigmatize variants of sexual orientation or gender presentation, we must also consider whether other forms of consensual sexual expression can find a place in healthy recovery. This presentation aims to examine fundamental principals underlying functional BDSM relationships and to discuss how these values can align with the goals of sobriety. Practical challenges and possible solutions will be discussed in order to develop a theoretical framework by which to work with kink-identified clients in recovery.

When the Chaos Doesn’t Stop – Helping the Partner Move Forward
Barbara Steffens, PhD, LPCC, CCPS
Most of our literature on assisting partners of those with problematic sexual behaviors comes from the assumption that both are in a recovery process. All too often however, partner specialists are providing support to partners where their loved one is either not initiating a recovery program, or recovery work is not producing the depth of change hoped for by the partner. These partners are faced with difficult choices and often continue to be negatively impacted by the chaotic nature of the relationship. Helpers and partners can experience this time as being “stuck.” Specialists need information and skills to assist the partner who is caught in the chaos, who feels stuck, or who are facing painful decisions. This workshop will provide just such preparation for those providers who help walk the partner through the ongoing storm.

Processing Military Sexual Trauma Within the Couple Relationship
Heather Love, B.A., B.S;
Eric Goodcase, B.S
Eilene Ladson, M.S., B.A.

Military Sexual Trauma (MST) is sexual assault that occurs during military service. Survivors of MST suffer physical, emotional, psychological, and interpersonal difficulties, which can compound on traumas experienced in the military and traumas prior to service. This therapy model integrates transgenerational theory, attachment theory, emotionally focused therapy, and incest treatment models to help an MST survivor and her partner process the trauma. The therapist identifies projections present in the relationship, helps the couple become more sensitive to emotional needs, helps create asecure attachment within the partnership, and allows the couple to process the trauma after the termination of therapy.

Re-Considering Men & Masculinity: Sexual Health and Emotional Intimacy in Men’s Lives
Robert Heasley, PhD, LMFT

Sexual health is grounded in a capacity to have and maintain emotionally intimate relationships. The male journey is not just fraught with confusing messages and models when it comes to sexuality; there is often a critical absence of intimate, emotional connection with other males and a confusing relationship with, and dependency on, women. The emphasis in this session is on understanding the process of male development and challenges for males in forming emotionally close, indeed emotionally intimate, relationships. For many men, their childhood and teen experience sets the stage for feeling fear and disconnection around intimacy. This leads to escaping intimacy through the use of pornography, destructive sexual fantasy, and sexual acting out. This also results in gender-based anxiety – an anxiety that can take the form of hyper-performance of masculinity for some, and withdrawal from social interaction for others. Sexual health is not just the absence of sexual dysfunction; it is the presence of a range of social and sexual ways of being that embrace intimacy and allow for vulnerability, empathy and compassion. When men can experience emotional intimacy with other men and create an identity of positive difference in defining their masculinity, eliminating homophobia and misogyny, they have an opportunity for new relationships, and new types of relationships, with themselves and others. This session will draw from clinical and research experience on the role of same-sex emotionally close (intimate) friendships in men’s lives, and on men who have learned to live “outside the restrictive box” of traditional masculinity.

Healing Unwanted Sexual Fantasies
Wendy Maltz, LCSW, DST 
People in sexual recovery are often troubled by persistent sexual fantasies that fuel problematic sexual behavior. Addressing and diminishing these unwanted fantasies constitutes an essential part of successful treatment. This dynamic workshop reveals the nature of sexual fantasies—their origins, common types, psychological functions, and deeper meanings–as well as provides criteria for evaluating when particular sexual fantasies are problematic. Therapeutic techniques for healing unwanted sexual fantasies are shared and case examples provided.

KEYNOTE: In the Shadows of Giants: Facing the Future of Sex Addiction in the Land of Giants
Dr. Jes Montgomery, MD

What we do on a daily basis can be a source of criticism, questioning, and joking. However, by looking at the role of the underdog in history and the thread of the power of sexuality in cultural change, we may actually find advantages in the role of the perceived underdog. Insights gained from history will be reviewed to seek inspiration for continuing the work in the face of all the challenges in the future of the field. At the same time, an obvious horizon of people who are overlooked and never make it to the “table” of treatment and new areas of need will be brought to the forefront, highlighting the need for focus, cooperation, and persistence.

KEYNOTE: Helping Couples Heal from an Attachment Rupture Related to Hypersexual Behavior
Dr. Sue Johnson 

The discovery or disclosure of hypersexual behavior by a partner in a couple dyad can be devastating. These “secondary” attachments to a variety of sexual outlets such as pornography consumption, multiple affair partners, commercial sex workers, and so forth compete with (and undermine) the safety and security that should be limited to the primary attachment relationship. While arresting hypersexual behavior is an important step in the process of change, an equally difficult and daunting task in working with couples is helping the relationship heal from the betrayal and deep hurt caused by the deception associated with hypersexual behavior. In this presentation, Dr. Sue Johnson will share her perspectives on how therapists can work clinically to help heal attachment ruptures related to hypersexuality with couples.

Sexual Compulsivity, Addiction and Trauma In The LGBT Community
Jeff Zacharias, LCSW, CSAT, CAADC

Estimates are 30% of the LGBTQI community struggle with some form of addictions, whether to substances or behaviors, compared to approximately 10% of the heterosexual community. Keeping in mind that 30% represents those “out” in regards to their sexuality and perhaps multiple addictions, the total estimate is likely to be significantly higher. The addiction interaction disorder of traditional addictions like alcohol and substances combined with process addictions of sexual compulsivity/anorexia as an intimacy disorder, is leading to an increased need to understand the complexity of the LGBTQI community and it’s subsequent cultural understanding of sexual expression/identity. Fueling higher rates of addiction is trauma whether singular events or chronic daily traumas – including homophobia, violence, rejection by loved ones, intimate partner violence and toxic compulsive attachments, and various forms of sexual trauma. This presentation will look at the interplay between multiple addictions, sexual compulsivity versus sex addiction versus sexual anorexia and trauma as well as examine evidence based practices clinicians can utilize to ensure best possible outcomes for the LGBTQI community impacted by these complex issues.

The 5-Step Boundary Solution: How to Help Partners of Sex Addicts
Identify, Create, and Maintain Effective Boundaries
Vicki Tidwell Palmer, LCSW, CSAT, SEP
Spouses and partners of addicts experience significant consequences as a result of being in relationship with an addicted person. Partners of sex addicts are at much greater risk of personal harm than individuals in relationships with other addicts, such as alcoholics, drug addicts, or gambling addicts. They are not only impacted by the emotional, financial, and relational consequences of addiction, but also by deep, personal betrayal and potential exposure to dangerous sexually transmitted diseases. Partners must be armed with information and tools for self-care and self-protection as they navigate through the difficult and painful process of discovery, disclosure, and beyond. In other words, they need boundaries. Although boundaries are frequently discussed as a key component of recovery and relational repair in relationships affected by sex addiction, boundary work is an elusive and often misunderstood concept.This session will explore the common mistakes, pitfalls, and misconceptions about how boundaries work, along with why effective boundary work is crucial for partners’ healing and growth. How do we, as clinicians, help partners identify and establish boundaries? How can partners be empowered to take action without using ineffective means such as manipulation, demands, and control? How does a partner’s boundary work impact the sex addict and his recovery?

The Assessment and Treatment of Sexual Disorders
Nancy Gambescia, PhD
The recent publication of the DSM-5 has promoted a new appreciation of both sexual function and disorders. Using the Intersystem approach, sexual issues will be discussed as they manifest in couples recovering from problematic sexual behaviors, infidelity, and other relational problems. This approach recognizes that the couple struggles together and also works together to mend their relationship; thus, the couple, rather than the individual, is the identified client. The Intersystem approach encompasses five integrative domains: physical issues of each partner, psychological strengths and challenges within the individual, the couple’s relationship dynamics, internalized patterns from families of origin, and other environmental stressors such as culture, race, finances, and so on. Common sexual disorders will be discussed, along with assessment using a sexual genogram, and current treatment protocols. Additionally, special focus will be given to the unique problems of couples trying to reconstruct a healthy sexual/intimate relationship after the discovery of problematic sexual behaviors.

Treating Autonomic Nervous System (ANS) Dysregulation: The Link
Between Sex Addiction, Eating Disorders and Sexual Trauma
Christopher J. Charleton, LCSW

In their seminal work on Addiction Interaction Disorder (2005), Carnes et. al. attest to the comorbidities of eating-disordered behaviors as prevalent among recovering sex addicts. Recovery literature rarely incorporates the management of eating-disordered behaviors as a dyadic concern when treating couples struggling with sex addiction. Furthermore, sexual trauma- experienced either premaritally or post-maritally by the sex addict or sex addict’s spouse is frequently not integrated into there solution of ANS distress among recovering couples. This seminar will examine treating ANS dysregulation as a vital objective in the resolution of -comorbidities associated with sex addiction, eating disorders, and sexual trauma from an individual as well as dyadic perspective. Correspondingly, ANS-dysregulatory complications associated with structural dissociation and personality disorder formation as well as ensorimotor/neurobiological disruption will be addressed. Attendees will be encouraged to transcend treatments focusing solely on the management of compulsive sex addiction symptoms by differentiating the autonomic arousal patterns that impede the resolution of complex trauma with associated interactive addictive dynamic.

CARNES KEYNOTE:  Let’s Talk About Sex: Sexual Nature, Harm, and Healing
Wendy Maltz, LCSW, DST
Sex therapist Wendy Maltz has spent more than three decades helping individuals heal from all kinds of sex and intimacy concerns. In this dynamic presentation she takes us on a visual and story-telling journey to better understand what human sexuality is and how problems, such as sexual addiction, sexual dysfunction, and the experience of sexual abuse, interrelate and can reinforce one another. Maltz identifies key features of healthy sexual development and illuminates the power behind healthy sex principles and healing strategies.

Assessing and Treating Sexually Addicted Sex Offenders in Outpatient and Inpatient Settings
Lucien Thomsen, LCSW, CSAT, CSOTS
Mary Deitch, JD., PsyD

Working with clients with sexually offending behaviors who also have problematic sexual behaviors, including sex addiction, can be a daunting task. This presentation will help differentiate sexual addiction from paraphilias and offending behaviors in order to conduct effective treatment planning. The presentation will show a review of the relevant literature with a focus on treatment tasks and the similarities and differences between outpatient and inpatient treatment. This presentation will review the commonalities and differences between sex addiction treatment and sex offender treatment. By the end of this presentation, participants will understand when to incorporate sexual offending work into their case formulations and treatment plans when working with sex addicts who have sex offending behaviors. The workshop will use case examples throughout and questions from the participants are encouraged.

Sex, Lies, and Survival: Repairing Primary Attachment Trauma by Any Means Necessary
Jessica Levith, LMFT  [PDF
The presenter will address some common myths of both Sex and Love (Attachment) Addictions (SLA), briefly exploring its historical context, and defining SLA for the attendees. Attendees will then take a critical look at SLA through the Modern Attachment Theory lens, using neuropsychological research from Allan Schore and Bessel Van der Kolk (among others) supporting the theory of primary attachment trauma as a potential neuropsychological “set-up” for SLA later on in life. The presenter will explain the role of neuroplasticity in recovery from SLA and present various case studies on the link between early attachment trauma and SLA. Attendees are encouraged to engage in discussion and ask questions at the end of the presentation.

Cognitive-Neural Restructuring Therapy (CNRT): A Brain Based Approach
to Tools of Recovery and Integration with Dr. Carnes 30 Task Model
Alton Todd Freestone, PsyD, LCSW, CSAT

This presentation will focus on the explanation and use of tools that have been used in the field of sexual addiction treatment, and specific tools developed in our program for the purpose of helping clients move forward in their healing, break through denial, and track their progress. These tools have been developed from a cognitive or brain based perspective, and integrates well into Dr. Pat Carnes’ research based 30 task model of treatment.

Relational Circles: Building on the Three Circles of Recovery
Dan Drake, MFT, CSAT, CCPS [PDF]

he three circles are a foundational tool for every individual entering the recovery process for problematic sexual behaviors. They serve as a benchmark for problematic behaviors, for healthy coping, and for the work of mindful recognition and healing from vulnerabilities and triggers. This tool is utilized by 12-step programs and therapists as an essential roadmap to the recovery process. While essential for individual recovery, the three circles do not incorporate relationally as a core component to the recovery plan. Yet sex addiction is an intimacy disorder. Hence, it follows that relationality and intimacy should be a core component of the recovery plan from problematic sexual behaviors. This presentation will incorporate a new model of relating: the Relational Circles. From this model, practitioners and clients will begin the recovery process focused not only on their own recovery from problematic sexual behaviors, but also other deficits and dysfunctional ways of relating to significant others, family members, and others in their life. An updated circle plan will be provided that incorporates these components of relations, and participants will learn to utilize this plan with their clients through all phases of the recovery process.

Measuring Spiritual Recovery: The Spiritual Recovery Scale
Michael E. Bohan, MD,
Patty A. Smith, LMFT, CAC, CSAT, &
St. George Lee, MA, MD 
This scale, developed by one of the presenters, is used as a spiritual check in during group process to describe clients’ spiritual state. The scale was organized based on personal meditations on powerlessness, “The Promises” of Alcoholics Anonymous, and “The Spirituality of Imperfection” by Kurtz and Ketcham. The scale is fluid, and contains items of Control to Surrender, Self-Blame to Self-Acceptance, and Self-Pity to Gratitude that represent spiritual goals that carry meaning for anyone following a 12-step program. The presentation will discuss this scale, and invite participants to share their thoughts and reactions to the language used. Implications of using this scale in treating sex addicts and co-dependents will be discussed.

Healthy Sexuality: What is It and How Is It Cultivated?
Helen Friedman, PhD
Healthy sexuality is an important part of being human and a goal for recovery from dysregulated sexual behavior. But what is healthy sexuality? How is it cultivated—both in the individual and in the couple relationship? This presentation will explore these questions through lecture and discussion. Healthy sexuality involves safety, sensitivity, respect for self and other, reverence, presence, choicefulness, connection, integration, love. It is process-oriented. Achieving these qualities requires personal growth. This involves becoming aware of and examining attitudes toward sex (derived from family-of-origin and life experiences), obtaining sex education, and resolving past issues. Mindfulness can aide in learning to be present. In the couple relationship, the sexual arena is often the stage on which other relationship issues are enacted. Therefore, healthy sexuality requires nurturing all aspects of the relationship as a foundation. Anxiety and resentment are the two major killers of healthy sexual desire. Foreplay happens (or doesn’t happen) all day long by the quality of the relationship. Couples can make a date for sex and create the mood, rather than leave it to chance. Mindfulness in the couple relationship includes meditating prior to sex to be more present, practicing sensate focus, and operating out of intention (e.g., knowing the kind of relationship wanted and creating it). Doing novel things together helps fuel desire in long-term relationships. Participants are encouraged to bring their own ideas about healthy sexuality for discussion.

More Descriptions, Less Labels: Enhancing Interpretative
Diversity of Problematic Sexual Behavior
Bill Herring, LCSW, CSAT

Terms such as sex addiction, compulsive sexual behavior and hypersexuality represent ways of understanding particular patterns of problematic sexual behavior. These and other labels construct an identity by reducing complex interactions of variables to categorical formulations. However, a common criticism of such labels is that they inevitably influence the interpretation of data in a manner that privileges some theoretical, philosophical, or ideological perspectives more than others. This workshop highlights some of the risks of using labels when assessing sexual health. As an example, some models for treating problematic sexual behavior require the assignment of a label in order to institute codified treatment plans. This provides a powerful incentive to privilege certain interpretations of information while overlooking or underestimating other perspectives, a process known as confirmation bias. This workshop shows how to avoid the inevitable limitations of labels by using descriptions that encourage the generation of multiple hypotheses that are capable of explaining patterns of problematic sexual behavior from a variety of perspectives. This descriptive model is a highly useful method for enhancing constructive dialogue between professionals from different academic disciplines, theoretical backgrounds, and practice settings.

Partner Portraits: The Treatment Mosaic of Therapy, Coaching
and the Multidimensional Partner Trauma Model
Barbara Steffens, PhD, LPCC, CCPS
Jennifer L. Cole, RN, BScN, DOHN
Dorit Reichental, MFTi, CPC, CSATc; &
Crystal Morrissey CPLC, CCRC, CDRC

Partners of sexual addicts present for treatment in myriad ways. Some are very resilient and respond well to psycho-education and coaching. Others may appear resistant to treatment or show symptoms of trauma and require therapeutic interventions. This presentation will use case studies to identify these and other partner presentations. Five experienced counselors and coaches will provide insight into multiple treatment options and share the differences between psychotherapy and Life Coaching. Attendee participation and Q&A are encouraged.

Mapping the Components of Recovery Following Initial Abstinence from Sexual Acting Out
Mark F Schwartz, D.Sc 
Once abstinence is initially established, the process of recovery begins for sexual addicts. There is little anticipatory guidance, however, provided to clients regarding the components and stages of recovery. This is due to the dynamic and complex nature and process of treatment, which involves relapse prevention in conjunction with learning new skills, practicing new ways of processing information, emotional coping, understanding the function of their symptoms and dealing with blocks to healthy intimacy. This workshop will discuss interventions mapped out during the first year following abstinence. Examples of common interventions and resistance will be presented via videotaped segments.

Clinical Profiles of Sexually Addicted Offenders Referred for Pre-Trial Treatment
Jennifer Weeks PhD, CAACD, CSAT-S
Arrests for possession of child pornography and other cybersex crimes have been on the rise in recent years. Increasingly, clinicians treating sexual addiction and compulsivity are being referred clients who are termed offenders based on their legal status. Many clinicians do not feel comfortable working with clients whose behavior has crossed legal boundaries. This presentation will detail the clinical profiles of sexually addicted sex offenders who were referred to treatment by their attorneys for the purposes of sentence mitigation. Data presented are based on retrospective case analysis that includes data from: clinical interviews, MMPI, ABEL Screening, SAST-R, HBI-19 and SASSI-III measures. The goal of the presentation is to provide attendees with a working knowledge of the clinical profiles of sexually addicted offenders. These profiles will be compared to clinical profiles of non-offending sex addicts from published research. Finally, treatment considerations based on clinical profiles and offending behaviors will be discussed.

Sexual Orientation Conflict vs. Sex Addiction: How
Misdiagnosis Could Expose Your Patient to the Dangers of Reparative Therapy
Monica Meyer, PhD, CSAT-S
This talk will describe tools for accurate differential diagnosis when presented with a male client who seeks therapy in order to stop ego-dystonic sexual contact with other men. Similarities and differences between presenting symptoms of sex addiction and sexual orientation conflict will be explored, along with other alternative explanations for sexual behavior outside of the client’s stated sexual orientation. The potential harmful outcomes of reparative therapy will be presented and more ethical and affirming approaches to addressing sexual orientation conflict in therapy will be discussed.

KEYNOTE: Hypersexual Disorder vs. Gambling Disorder: Insights and Clinical Perspectives
Dr. Jon Grant, MD, JD

In this presentation, Dr. Grant will highlight commonalities between the DSM-5 criteria proposed for Hypersexual Disorder and the DSM-5 criteria for Gambling Disorders. While differences exist, many patients with gambling disorders exhibit similar underlying issues as patients with hypersexual behavior. This presentation will draw on the neuroscience / behavioral research and clinical interventions used with gambling disorders to suggest ways clinicians might consider working with hypersexual patients.

Awakening to Your Soul Mate: A Decision to Be In Love
John Leadem, LCSW, CSAT, CMAT &
Elaine Leadem, LCSW, CSAT, CMAT
Elaine and John Leadem will introduce a model they have been using for the past thirty years in their work with couples that is intended to promote romantic health. The model, while designed for work with the general population of romantic partners, can serve as the foundation of deeper healing work with clients recovering from the hardship associated with addictive disorders. The presentation will introduce methods for establishing mutual consent between the partners, as well as strategies for creating a foundation of therapeutic safety, individual plans for self-care, and three dynamic tools for promoting emotional bonding.

Is Internet Porn Addiction Always Sex Addiction, or Can It Be Something Else?
Todd L. Love, PsyD, JD, LPC

This seminar will explore the emerging area of behavioral addictions, with particular focus on the Internet-related addictions. Via a review of the current literature, the concept of behavioral addictions will be reviewed, their similarities with chemical addictions, and the fundamental neurobiology behind all addictions. The workshop will then focus on the specific problem of Internet-related behavioral addictions. The proposed Internet-addiction subtypes of pornography, gaming, and social networking will be reviewed academically, clinically, and phenomenologically. The DSM-5 controversy surrounding Internet addiction also will be briefly discussed. This workshop will explore the unique problems reported by “digital natives” who are increasingly experiencing their first exposure to sexuality via Internet pornography. The topic of supernormal stimulus will be presented, as will the desensitization path to addiction, and attendees will understand the risk of classical conditioning to chronic viewers. Attendees will also understand the ease with which one can escalate to more extreme material via the acquired need for constant novelty. Specific sociological (role and behavioral confusion) and potential physiological problems will be discussed. Attendees will hear briefly the firsthand phenomenological experience of a young adult recovering from impacts of Internet pornography and gaming disorder. The session will end with a discussion comparing/contrasting the above phenomenon and the traditional model of sex addiction. Potential differences in etiology, presentation, consequences, and treatment will be explored, and the possibility of new approaches will be discussed.

Reading a Research Article Without a Rosetta Stone
Rory C. Reid, PhD, LCSW

Many clinicians rely on others to tell them if a new study is methodically well designed and in some cases, what the results actually mean. Not all research is equal! This session will provide some guidelines to apply when looking at the merits of a study published in a peer-reviewed journal. If research or statistics was that class you barely survived in graduate school, then this session is for you! The presenter will simplify the process of dissecting a study in a way his graduate students have found helpful over the years. Examples from the social science literature will be used to illustrate the process of reading a journal article and translating it to something pragmatic for patients in clinical practice.

Global Sexual Health and Sexually Transmitted Infections
University of Southern California

The current state in the prevalence of STIs among special age groups and in selected geographical locations and the promotion of sexual health is presented in this session. STI prevalence among teenagers, college students, and the elderly is presented, the effects of cultural factors are considered, and educational interventions for the reduction of STIs are discussed. The session also includes presentations about the prevalence of STIs in selected geographical locations and educational efforts undertaken for its management. The session concludes with a survey of key epidemic models in predicting STI proliferation.

The Couples Relational Trauma Dance: Moving from Trauma to Sexual Health
Richard Blankenship, LPC, CCPS, CCSAS
Janice Caudill, Ph.D., CSAT

Couples in recovery from sexual addiction encounter triggers that lead to a trauma dance. Couples must learn to dance differently to enhance intimacy development and sexual reintegration. This presentation will identify relational triggers and talk about overcoming the trauma dance and into a dance of sexual and relational health.

Presenting the Rapid Expressive Drawing Projective Technique
in the Treatment of a Traumatized Partner
Mary Ellen Goetz, PsyD

This presentation will highlight the Rapid Expressive Drawing projective technique in the treatment of a traumatized partner. This technique utilizes both art as therapy and art psychotherapy in reducing negativity and symptoms of trauma. In this case study, Rapid Expressive Drawings completed over the course of a year illustrate a partner’s path to recovery.

Managing Secrets in Couples Therapy Concerning Sexual Health Issues
Chris Fariello, PhD, MA, LMFT

When working with couples regarding sexual health, special considerations must be given to confidentiality. Can a therapist hold a secret? This workshop will discuss the potential benefits and consequences, as well as ethical considerations of holding secrets when considering sexual health and sexual compulsivity. Partners are likely to talk more freely without the other partner present making the information gathering phase much more efficient and effective. When working with clients surrounding sexual issues, however, it is not uncommon that during an individual session a client may reveal something that they would like to be held in confidence. Does the therapist hold the secret or must it be revealed to the partner? The question about therapists holding secrets has long been debated, but what are the real benefits and consequences of maintaining secrets and what are the true ethical concerns? After offering several thought provoking scenarios, the workshop leader will review the historical practices of confidentiality in mental health settings. The presenter will share his experience and the current understandings of the benefits and consequences of maintaining secrets in couple’s sex therapy as well as elicit audience participation and experience. The group will be asked to deliberate on a few ethical dilemmas around confidentiality.

Traumatic Bereavement and the Impact on Human Sexuality
Daniel A. Glaser, MSW, LCSW

This presentation will define complex traumatic bereavement with the potential impact on human sexuality. Complex traumatic bereavement can potentially lead to hypoarousal or hyperarousal behaviors, erotophobia or erotophillia. The multiple lenses of grief from recognition to reinvention will be presented from a strength-based focus. The various categories of dysregulation (emotional, somatic, attentional, behavioral, relational, and self) will be explicated. The collaborative change model will be explored with the goal of treatment moving from a survival mindstate to an engaged mindstate. Ethical attunement, compassion fatigue and practitioner reactivity (including withdrawal, enmeshment, disequilibrium and repression) will be addressed related to the interference vs. accomplishment of therapeutic goals. The core qualities of behavioral addictions and specific behavioral interventions will be presented to increase adaptive coping strategies that promote sexual vitality throughout the life cycle. Healing involves nurturing the body, mind, emotions and spirit. Specific tools to address self-nurturing will be utilized. The importance of relaxation, evidence-based thinking, the emotional healing power of writing and existentialism will be highlighted. Clinical case examples will be discussed to cement therapeutic concepts into real life situations. Working with resistance through exploration, empathy, education, and encouragement will help to continue therapeutic movement. The ingredients of a crisis safety plan to promote relapse prevention will underline expanding realities and consolidation using complex trauma informed therapy.

Treatment of Sexual Addiction: What Do Recovery Coaches Bring To The Table
Melissa Killeen, MSOD, MPhil
Steven J. Devlin, CRS, EdM, PhD
Treatment for sexual and concurrent addictions begins with the person seeking to change her or his life. Surrounding that person in the journey are friends, family, and a community of health professionals. A new addition to the treatment teams are recovery coaches a profession first defined in 1998 by William White when he wrote the Recovery Management Model. Recovery Coaching is guided by strict ethical standards, and coaches are certified in a set of skills which complement and enrich existing treatment teams. This presentation will provide a summary of the strengths-based model of coaching, the training of coaches, and their roles (e.g., mentor, peer, sober companion, etc.) which differentiate them from therapists and sponsors. This presentation will address the tools used by sexual addiction coaches, including assessments such as personality surveys, recovery capital interviews, and personal recovery plans. Finally, this presentation will provide an overview of recovery plans for chronic relapsers, individuals leaving treatment for the first time and those headed to or returning from prison.

Group Exercises to Increase Spouse Empathy in Recovering Sex Addicts
Roger Northway MS

Addicts in early recovery often carry shame as a result of an awareness of the damage to others especially in their primary relationship. A group exercise to increase empathy among addicts in recovery will be demonstrated by involving members of the audience in a mock group setting. This exercise complements the work done in 8th and 9th steps. Clients who have participated in this exercise have reported being better able to address the shame which is an integral part of the addiction. Clients have stated that the exercise helped them reach a “finer point” to their understanding of their partner’s trauma of discovery of the sex addiction.