Sex and love addiction fellowships

Domain V · Systemic, relational, group & community

What it is

What these are. These five are peer-run, non-professional mutual-aid fellowships adapted from the Alcoholics Anonymous Twelve Steps and Traditions. They are not therapies, and a clinician does not run them. SA states it "should remain forever non-professional" and does not endorse or lend its name…

Format

• The fellowships have no clinical phases or session counts. Their published structure is: arrive at meetings, choose a sobriety definition (or accept SA's), get a sponsor (often a temporary one first), work the Steps in order and repeat Steps 4 and 5 as needed, do daily practices, then do service…
• Phase A — Assessment and formulation (1–3 sessions, individual). Goals: establish what the behaviour is, whether ICD-11 CSBD criteria are met, whether distress is mainly moral incongruence, comorbidity and risk, and the client's values, orientation, relationship structure and faith. Move on when…

Who practises it, and how they are trained or regulated

• Phase D — Parallel work (ongoing, weekly to fortnightly therapy). Goals: therapy addresses formulation-driven targets (emotion regulation, trauma, shame, relationship, sexual health) while the fellowship provides peer structure. Each session briefly reviews sobriety plan, meetings, sponsor contact and slips. Move on when sobriety is stable for a period the client and you agree, functioning has improved, and shame is…

Evidence status, as the guide reports it

• Re-entry criteria to Phase A at any point: rising shame or suicidality, a sobriety definition becoming more and more restrictive, evidence the fellowship is reinforcing moral incongruence rather than reducing distress, new legal or safety issues, or a slip pattern that persists despite engagement.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• the client triangulating sponsor and therapist.
• avoidance after one bad meeting; triggering stories.
• depression or suicidality emerging as the behaviour stops.
• plan is stable, specific, and includes positive sexuality.
• partner trauma symptoms; the partner being made the client's monitor.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.