Sexual Issues

Counterpoise Wellness offers comprehensive services to individuals who struggle with many different sexual issues. Our therapists specialize in the evaluation and treatment of maladaptive sexual behavior including:

• Sexual Offenses
• Pornography Misuse
• Youth with Sexual Behavior Problems 
• Infidelity
• Compulsive Sexual Behavior Disorder

Sexual Offenses

Counterpoise Wellness provides psychosexual evaluations to adults and adolescents who have been charged with a sexual crime. Referrals typically come from an individual's defense attorney, but may also come from the court, a prosecuting attorney, or other agency.  Evaluations may be performed at a variety of stages including:

• Prior to charging (during the investigation stage)
• Prior to conviction or adjudication 
• Prior to sentencing or disposition
• After sentencing

The evaluation can provide important information regarding the individual's risk factors, treatment needs, and responsivity issues that may impact treatment success. We work with attorneys to address the unique characteristics of each individual and provide a written report to the attorney or court upon completion. 

Counterpoise Wellness also offers therapy to individuals who are undergoing court proceedings due to inappropriate sexual behavior. Participating in therapy prior to the conclusion of court proceedings can help begin the process of healing and recovery sooner. 

In criminal cases, the evaluator or treatment provider may be called to testify in certain situations. Our staff has significant experience providing expert witness testimony and fact witness testimony. 

Pornography Misuse

Many people struggle with pornography. Sexually explicit material has become easier to access than ever before. It is estimated that over 30% of the internet is pornography. With websites that cater to every sexual impulse, it is easy to understand how people can get carried away with pornography use. 

Counterpoise Wellness offers treatment for individuals who struggle with problematic pornography use, those who believe they have an addiction, and those whose lives have been adversely impacted by pornography use. Pornography misuse may contribute to relationship difficulties. Other behaviors such as sexualized communication with others online, sharing or trading sexually explicit material, or the consumption of Child Sexual Exploitation Material (CSEM) can also have detrimental effects on the individual and his or her family. We can help identify concerns and develop strategies to decrease problematic use. 

Youth with Sexual Behavior Problems

Adolescence is a time of constant change. It is the role of the developing youth to explore who they are, what they believe, and how they fit in to the world. As youth progress through puberty into adolescence, they may be sexually curious. Learning how to deal with emerging sexuality can be difficult, adding in social media and pornography makes it even more challenging. 

Sometimes, youth act out sexually, whether it's inappropriate touching, the taking and/or sharing of sexually explicit photos or videos, or becoming heavily involved in pornography. Occasionally, such behaviors may be illegal, and law enforcement or courts may become involved. It is important to remember that youth are still learning, still developing, and their sense of what is right and wrong is also still developing. 

The overwhelming majority of youth who act out sexually are NOT sexually deviant. Their inappropriate behavior may stem from deficits in social skills, attachment issues, or problems with impulse-control and decision-making. Youth who exhibit sexual behavior problems often benefit from therapy aimed at some of these topics:

• Sexual education
• Consent
• Boundaries
• Healthy use of technology (social media)
• Pornography use (Porn Literacy)
• Social Skills
• Interpersonal relationship skills (dating behavior)
• Appropriate outlets for sexual urges

The Association for the Treatment and Prevention of Sexual Abuse (ATSA) has developed this fact sheet for understanding and responding to adolescent sexual behavior. It provides useful information for parents, educators, court personnel, and others about normal adolescent behavior and how to promote healthy sexual development. 

If your child has displayed concerning sexual behaviors, we may be able to help. Through an initial consultation, we can discuss appropriate next steps, whether that includes a psychosexual evaluation or therapy. If your teen is involved with the legal system, we will work with his/her attorney and provide recommendations for additional services. 

Infidelity

Infidelity can take many forms and usually has a significant impact on relationships. When a partner is unfaithful emotionally or sexually, it sends a shockwave through the woven fabric the relationship is based on: honesty and trust. The after-shocks of infidelity expand outwards and can impact other aspects of the relationship (children, housing, finances). 

Many people struggle with how to cope with infidelity. The loss they have experienced leaves them hurt, angry, betrayed, and humiliated. Therapy can help a person sort through those feelings and begin to heal. 

Although some seek therapy during these times in an effort to 'save' the relationship, therapy for infidelity is more about understanding the patterns and contributing factors that led to instability in the relationship and how to best move forward. If you or your partner has been unfaithful, we may be able to help. We can provide a safe space for these issues to be discussed, with a goal of increased understanding of the dynamics and communication issues within the relationship.

Compulsive Sexual Behavior Disorder

Compulsive Sexual Behavior Disorder (CSBD) is often called "hypersexuality" or "sexual addiction." Although those terms are not listed as diagnosable disorders according to the DSM-5-TR, the latest version of the International Classification of Diseases (ICD-11) includes Compulsive Sexual Behavior Disorder as a diagnosis. 

The essential features of CSBD are a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behavior that has occurred for at least 6 months and has caused distress in important areas of functioning. The diagnostic criteria for CSBD can be found here. 

Treatment for CSBD begins with a thorough assessment of the individual's sexual history and associated behaviors. Therapy seeks to explore the pathways that led to compulsive sexual behaviors including:

• Adverse childhood experiences
• Attachments
• Relationship characteristics
• Pornography use
• Negative emotional states

Counterpoise Wellness offers treatment for Compulsive Sexual Behavior Disorder (CSBD). Our approach includes enhancing motivation for change, addressing core issues that led to the behaviors, and building a better future. Our therapeutic approach is collaborative and treatment goals are objective, clearly defined, and realistic. 

Our treatment is not 'addictions-based.' Therapy will stress the importance of 'approach' goals such as the attainment of healthy sexual scripts and is not limited to 'avoidance' strategies such as strict abstinence (unless the behavior is illegal). Treatment will focus on coping skills, emotional regulation, and feelings of shame, loneliness, and jealousy. The goal of therapy is to decrease the maladaptive behaviors and have positive, pro-social sexual experiences that are compatible with one's core beliefs. 

Sexual behaviors, particularly those that are deemed 'out-of-control' may be difficult to discuss. Individuals with CSBD often present with significant shame regarding their perceived inability to control their behavior and the consequences that have resulted. We believe that shame has no place in therapy. We will address these topics head-on, with compassion and respect.