Sex addiction treatment has become big a topic for public discussion due to many recent sexual misconduct allegations against prominent men. But it\u2019s a term that is sometimes misunderstood or misused. Media reports that portray recovery as a summer camp for privileged men does not accurately reflect what typically happens in rehab. \u201cWhen most people come to recovery, they are frazzled, exhausted and in pain,\u201d explains Karen Brownd, Director of the Center for Relationship and Sexual Recovery and Associate Clinical Director at The Ranch. \u201cFor many people, this is the last chance.\u201d The outside world may be folding in on them, whether from public accusations, getting in trouble at work or receiving an ultimatum from a spouse. But inside the walls of any respected sex rehab center, they are treated as patients suffering from compulsions and the disease of addiction. The aim is to offer the best treatment possible to help them understand the attachment disorders, trauma and pain that may have led them onto their troubled path and to acknowledge the problems and behaviors that have hurt themselves and others. This may include many different therapies. \u201cWe will use any evidence-based therapy or approach we possibly can to help them,\u201d says Brownd. The treatment program at The Ranch may be in a homey residential setting, but it is structured and specifically tailored to each person. Agreeing to remain sober is the first rule of treatment. Inside Rehab for Sex Addiction While many media outlets have focused on creative treatments such as equine therapy and high ropes courses, Brownd explains a series of things must happen before these creative therapies can begin. 1. Evaluations. When someone enters rehab, therapists only know that person through what they have shared or family members have stated. The first step is a thorough psychological evaluation along with a biopsychosocial assessment, which is like a full history of many things from their life. 2. Getting their story. Once she has reviewed the paperwork, Brownd sits down with a client to find out in their own words what brought them to rehab. \u201cI tell them, \u2018I want you to tell me why you\u2019re here and what got you here,\u2019\u201d says Brownd. \u201cThey start to give their story of what happened or how their life has changed.\u201d Insight into the client's background and current troubles helps Brownd and her team decide on the right treatments. 3. Deciding on therapies. \u201cThen, by putting all of those other pieces together, we can start to feel what type of modality will best help the client,\u201d says Brownd. \u201cWe don\u2019t do just one thing; we do a number of things simultaneously.\u201d Once an understanding of the person\u2019s circumstance and needs are established, the therapeutic process begins. This will include talk therapy in both private and group settings, as well as explorations into childhood trauma and understanding the impact of their family of origin. 4. Establishing they are not alone. At the core of the treatment is for clients to understand that addiction is not about being a bad person and one of the ways this is best experienced is in primary process groups. In the company of others who share their stories, they realize they are not alone. \u201cThey're all talking, sharing and bonding and understanding they are not bad,\u201d says Brownd. \u201cThere are things that have happened, but people may still love them. They just hate what they\u2019ve done.\u201d 5. Observing emotions. \u201cYou\u2019re watching their emotions. Maybe there are tears, shame, remorse. Some people have a very difficult time speaking about any feeling or emotion because they were never allowed to do that.\u201d In group therapy, sometimes it is in hearing others share their stories that clients have an \u201caha\u201d moment and recognize their own experience. \u201cPeople may not say it out loud, but it touches them when they realize, \u2018Oh God, I know what that was like.\u2019\u201d 6. Honoring nonverbal approaches. People with addiction often have attachment issues and trauma from childhood that led to self-soothing with sex, and the sexual activities then turned to compulsions. Brownd points out that many were raised in homes where speaking about feelings or expressing themselves was not permitted or they were taught at an early age to keep secrets. It carries over, and when therapy begins, they cannot always get at the root of their pain with words. Part of the therapeutic process is to find nonverbal ways to express feelings until they can learn how to identify their feelings,\u201d says Brownd. \u201cAnd to also know that you can have more than one at the same time.\u201d 7. Creative therapies. After a client has been in basic therapies, there is a further assessment. \u201cWe may find out by working with a client that they would do well with EMDR (eye movement desensitization and reprocessing) or that they need equine-assisted experiential therapy or they need to be able to communicate in some way that is nonverbal.\u201d For example, if somebody is a CEO who talks all the time for their job, they may find equine therapy a good approach. \u201cIt\u2019s a challenge, because how do you get across to a horse what you want it to do or what you need them to do? They\u2019re not going to hear your words.\u201d It\u2019s a chance to develop new ways of relating. Therapies may range from high ropes courses, to trust exercises, to walking a labyrinth. They may include drawing, journaling or mindfulness training. It could be DBT (dialectical behavior therapy), EMDR or energy work. Or all of these things and more. \u201cThis diverse therapeutic approach is infused in many of our programs at The Ranch,\u201d says Brownd. \u201cAs therapists, there is an understanding that because we work with one client in one particular way, it does not mean we can do that with another person. We often have to figure out something completely different for each person because they have unique needs and challenges.\u201d The Ranch also works with the partners, spouses and families, as long as the client provides the appropriate HIPPA releases. \u201cWe try to help their loved ones understand as well,\u201d says Brownd. The goal of sex rehab is to give clients new skills, tools and a sober community in which they can learn how to create boundaries, develop ways to cope and learn to regulate emotions. The ultimate goal is to give them all the tools and support needed to help quell the urge to drink, drug or act on a sexual compulsion so they can repair their lives and families.