What is a Certified Sex Addiction Therapist (CSAT)?
Specialized Training for Pornography Use, Sexual Behavior, and Relationship Recovery
You may have noticed the letters CSAT after my name and wondered what they mean. CSAT stands for Certified Sex Addiction Therapist, a certification through the International Institute for Trauma and Addiction Professionals (IITAP).
There are a lot of certifications available to therapists, and they don't all require the same amount of training. Becoming a CSAT was a fairly extensive process. The training includes four separate modules totaling 120 training hours, along with specialized supervision and additional requirements before certification. The curriculum covers assessment and treatment of problematic and compulsive sexual behavior, pornography use, the impact these behaviors can have on partners and relationships, disclosure, shame, trauma, sexual health, and long-term recovery.
For me, though, the value of that training isn't really the letters after my name. It's how the training influences the work I do with clients.
What Does CSAT Training Actually Cover?
One reason I pursued CSAT training was that pornography use and problematic sexual behavior can be more complicated than simply telling someone to stop doing something.
Sometimes pornography has become a way of dealing with stress, boredom, loneliness, rejection, anxiety, or other uncomfortable emotions. Sometimes there is a long-established pattern of secrecy and broken promises. In other situations, the pornography itself may not be the biggest problem, but dishonesty surrounding it has created significant damage in a relationship.
CSAT training gave me a much deeper framework for assessing those differences rather than treating every person who walks into my office the same way.
The training also spends considerable time on what happens within relationships. IITAP's curriculum includes the impact of discovery on partners, disclosure, betrayal, boundaries, empathy and relationship repair, in addition to assessment and treatment of problematic sexual behaviors.
That's particularly relevant to the work I do today because I'm rarely interested in only helping someone stop a behavior. I'm interested in understanding why the behavior keeps happening and what needs to change for something different to become sustainable.
Does Seeing a CSAT Mean I'll Be Diagnosed as a Sex Addict?
No.
This is probably one of the most important things I would want someone considering working with me to understand.
My CSAT training has been incredibly valuable to me, but that doesn't mean I believe everyone who struggles with pornography or sexual behavior should identify as an addict. In fact, one of the things I've become increasingly interested in throughout my career is looking beyond the label and understanding the actual pattern.
If you're watching pornography more than you want to, hiding things from your spouse, repeatedly breaking promises you've made to yourself or someone else, or doing something that no longer fits the kind of husband or person you want to be, we already have something worth talking about.
We don't necessarily have to settle the question of whether you're an "addict" before we can start working on it.
How My CSAT Training Influences the Way I Work
The CSAT framework gave me a lot of useful tools for understanding problematic sexual behavior, recovery, relationships, betrayal, shame, and sexual health. Over the years, I've also integrated that training with other approaches and with what I've learned from actually sitting across from clients dealing with these issues.
One of the things I've noticed is that lasting change usually requires more than becoming better at resisting an urge. We need to understand what happens before the urge.
For one person, that might be boredom late at night. For someone else, it may be stress after work, conflict with a spouse, loneliness, rejection, shame, or simply having unrestricted access to pornography during predictable vulnerable times. Once we understand the pattern, we have considerably more to work with than "I need to have more willpower."
That is one reason my approach today tends to focus heavily on patterns, emotional awareness, accountability, relationships, and developing a healthier response to the things that have historically triggered the behavior.
What About Infidelity and Betrayal?
My CSAT training also influences my work with men following infidelity or other forms of betrayal.
Stopping an affair or pornography use may be an important first step, but it doesn't automatically repair the damage that happened around it. There may still be secrecy, defensiveness, resentment, shame, questions from a partner, and a significant loss of trust.
This is where the work often shifts from simply asking, "How do I stop doing this?" to asking, "How do I become someone who can be trusted again?"
Those are related questions, but they're not the same question.
For many of the men I work with, that second question eventually becomes much more important.
Do You Have to Be a CSAT to Help With Pornography Use?
No. There are excellent therapists who work with pornography use, infidelity, and problematic sexual behavior who aren't CSATs.
What I do think matters is whether your therapist has meaningful training and experience with the specific problem you're bringing into therapy.
Pornography use can involve sexuality, relationships, shame, secrecy, compulsive patterns, attachment, emotional regulation, and sometimes significant betrayal within a relationship. Specialized training gives me a framework for understanding those pieces and determining which ones actually matter for the person sitting in front of me.
That's what I consider the real value of my CSAT certification.
Finding the Right Therapist
Credentials matter, but they're not the only thing that matters.
You should also feel like your therapist understands what you're dealing with and can talk about it without immediately reducing you to a diagnosis or a label. You should be able to ask questions about how they approach pornography use, infidelity, sexual behavior, accountability, and relationship repair.
My CSAT training is one part of what informs my approach. My years of clinical experience, the clients I've worked with, and the other therapeutic approaches I've trained in have continued shaping it as well.
Ultimately, the goal isn't to make you better at calling yourself an addict—or better at arguing that you're not one.
The goal is to understand what's happening, regain the amount of control you want to have over your behavior, repair the things that have been damaged, and help you become the man you want to be.