Counselors can also receive training and specialized certifications in sexual addictions, such as the certified sex addiction therapist program at the International Institute for Trauma and Addiction Professionals, which was founded by Carnes. The bottom line is that if you have zero experience working with this population, you should refer accordingly and seek training if you want to work in this area. Consider the following checklist: Is in active, engaged recovery and maintains a support group of friends, recovery partner(s) and sponsor Has grown more aware of his or her feelings and is able and willing to talk about them to others Has learned how to reach out to others when difficult feelings or cravings emerge, or when issues arise in close relationships Has acknowledged any co-occurring or crossover addictions and is working on them in recovery Has acknowledged any co-occurring mental illnesses that may be present and has sought help. When you do this, you decrease reactivity and begin to trust yourself again so that you can appreciate who you are and your own intuition. You develop an improved sense of confidence that allows you to attune to the reality that the addict s behaviors affect you but are in no way, shape, or form because of you. Recovery support can include support groups, like Sex Addicts Anonymous, recovery sponsors, accountability partners, in- or outpatient treatment programs, counselling, medical help and Internet filters. 2. Stopping rituals All addictions have rituals. Rituals can be anything from thoughts to behaviours that eventually lead to sexual acting out. According to Patrick Carnes, Ph.D., the pioneering sex addiction researcher, 97 percent of people with sex addiction suffered emotional abuse in childhood or adolescence, while 81 percent suffered sexual abuse. A further 72 percent suffered from physical abuse; furthermore, frequent abuse was even more strongly associated with sex addiction than occasional abuse. Other Means of Recovery If 12-step meetings prove not to be appropriate for you for whatever reason, there are other avenues. Private Psychotherapy One-on-one counseling with a psychiatrist trained in treating sexually compulsive or addicted individuals is perhaps the best alternative. Some individuals continue private therapy in addition to attending 12-step group meetings.