Evaluating and treating sexual addiction.

www.aafp.org/afp Volume 86, Number 1 ◆ July 1, 2012 Case Scenario A 46-year-old man with no previous medical problems presents with depressed mood and difficulty initiating sleep. After further review, I discover that the patient recently separated from his wife and fears losing his job. He reluctantly mentions that the problems started when his wife became aware of several years of escalating use of Internet pornography and explicit online chat rooms. He also was caught viewing pornography on work computers, in spite of being previously warned to stop. Measures to control his use, including Internet monitoring programs, failed to limit his behavior. He denies problems with alcohol and any other sexual compulsivity, except masturbation when he views pornography. He is embarrassed, but feels desperate to do whatever it takes to repair his marriage and keep his job. He seems motivated to change, and I want to help him before his problems escalate further. What is the best way to treat his addiction?