Internet pornography and sex-based websites continue to shift the way Americans think of sex and their sexual behaviors. More view sex as a type of recreation, such as gambling, and increasing levels of sexual imagery across television and movies are making sex more casual. For millions of adults, however, the ability to control their behaviors toward sex gets lost. They develop sexual compulsivity, especially if they can no longer manage their impulses toward sex despite the negative results of their actions. As experts collaborate on new research about sexual compulsivity and similar sexual behaviors, treatment strategies are emerging, and they often follow patterns of treatments for substance abuse. Twelve Step Support Groups Similar to obsessive compulsive disorders, many people with sexual compulsivity may revert to sexual acts to soothe stress, negative emotions or anxiety. One treatment for sexual compulsivity involves psychosocial elements, such as attending group sessions of Sexaholics Anonymous. Twelve Step groups have national chapters and are based upon similar philosophies as the 12-step program of Alcoholics Anonymous. Participants can find support and new levels of accountability among people who share in their struggle. One hallmark of participation in the groups is the willingness to admit that one's sexual compulsions or obsessions have become unmanageable and that help is needed to bring the actions back under control. Inpatient and Outpatient Treatment for Sexual Compulsion Treatment for sexual compulsion is also available on an inpatient or outpatient basis. These treatment programs typically work to help the patient locate the inner beliefs or personal triggers that lead to sexually compulsive behaviors, such as obsessive sexual thoughts, excessive use of pornography or excessive masturbation. Treatment also helps the patient develop new coping skills and a set of healthy tools to manage cravings and obsessive thoughts. Individual and Couples Counseling On an individual basis, some patients find relief from sexual compulsion through CBT, or cognitive behavioral therapy. In CBT, treatment is similar to patients with drug or alcohol addictions. The patient is guided toward discovering what spurs their sexual acts and toward new perspectives and ideas about their actions. Emphasis may be on setting up healthy life systems and habits that can help prevent a relapse into compulsive sexual activity once the person leaves treatment or life stressors return. Because sexual compulsivity and sexual addiction affect a person's spouse in profound ways, many patients are encouraged to attend couples-based therapy as well. In this setting, they can each address the shame, fear and anger that can keep the relationship from progressing in healthy ways at the same time the patient is working toward recovery with individual counseling. Medication for Sexual Compulsivity Limited research exists regarding the effectiveness of medications for treating sexual compulsivity, but some patients have been prescribed antidepressants, antipsychotics, mood stabilizing medications and anti-anxiety medications, following similar patterns as drug or alcohol addiction patients. Medications to change the way a person's sexual hormones perform, such as anti-androgens, have also been part of treatments for some patients on a short-term basis to help curb cravings for the behavior. SSRIs have also been prescribed to patients in an effort to control the preoccupying thoughts toward sex. Using research from substance abuse studies, some patients have seen positive results using naltrexone, typically in combination with individual counseling. The drug is used for other addiction-based conditions like addictive gambling, and may help curb cravings by dulling the euphoric response a patient gets from sexually compulsive activity.