Proposed Treatment of Problematic Pornography Use: A Cognitive-Behavioral Approach

As pornography use increases across the general population, mental health professionals are encountering more patients who present symptoms of sexual addictions and sexual compulsivity (Cooper et al., 2001). Never before have pornographic materials been so accessible to consumers. Viewing pornography is related to many negative consequences for the individual, including impairment of academic and professional functioning, subjective distress, and sexual compulsivity (Cooper et al., 1999a; Manning, 2006). Studies found pornography use by an individual typically leads to a decline in relationship and sexual satisfaction (Bridges, 2008a). Despite the growth in research related to problematic pornography use, to date there have been very few research studies assessing the efficacy of interventions. The current study evaluated a 12-session cognitive-behavioral treatment protocol developed by Bridges and Minarcik (2012) for the reduction of problematic pornography use and related impairments in men who present with “pornography addiction”. Participants (n=12) were randomly assigned to a 1, 2, or 3-week baseline prior to the initiation of treatment. Primary measures assessed daily minutes of pornography use, self-reported addiction to pornography, sexual cognitions, sexual compulsivity, hypersexual behavior, and pornography craving. Secondary measures were sexual cognitions, mood, relationship satisfaction, and OCD symptoms. There were consistent reductions in weekly pornography use, as measured by self-report daily monitoring forms, which supported the first hypothesis. Self-reported reductions in sexual cognitions, hypersexual behavior, sexual compulsivity, and pornography craving from pre- to post-treatment tended to be reliable and clinically significant, supporting the second hypothesis. One exploratory question revealed the cognitive content of the treatment protocol did not add incremental efficacy above and beyond the behavioral treatment content. Another exploratory question demonstrated the treatment show specificity, such that treatment gains were specific to sexual behaviors and not evidence in other measures of psychiatric distress. The last exploratory question supported that baseline pornography use did not relate to treatment outcomes, suggesting this treatment protocol was equally effective for low- and high-frequency pornography users. Overall, this protocol was found to be effective at reducing problematic pornography use. Future directions include conducting long-term follow ups of the treatment efficacy and conducting dismantling studies to enhance understanding of the relative impact of different treatment components