PATHOS Screening for Sex Addiction

by Dan Drake, LMFT, LCPP, CCPS-S, CSAT-S


Here’s another article I wrote for therapists in a local journal:


Many of us who work with alcoholics or addicts are familiar with the CAGE screening for alcoholism:

C: Have you ever felt you should CUT DOWN on your drinking?

A: Have people ANNOYED you by criticizing your drinking?

G: Have you ever felt bad or GUILTY about your drinking?

E: EYE OPENER: Have you ever had a drink first thing in the morning to steady your nerves or to get rid of a hangover?

In addition to the AUDIT and T-ACE screenings the CAGE test can be a quick way for us to find out if our clients might have a problematic dependency upon alcohol requiring further assessment.

What do we do, however, if our clients present with possible symptoms of a process addiction like sex addiction?  Patrick Carnes has developed a simple and useful screening for sex addiction.  If your clients are presenting with the following symptoms, it is likely that they require further assessment for the possilility of sexual compulsivity:

P: PREOCCUPIED – Do you find yourself preoccupied with sexual thoughts?

A: ASHAMED – Do you hide some of your sexual behavior from others?

T: TREATMENT – Have you ever sought help for sexual behavior you didn’t like?

H: HURT OTHERS – Has anyone been hurt emotionally because of your sexual behavior?

O: OUT OF CONTROL – Do you feel controlled by your sexual desire?

S: SAD – When you have sex, do you feel depressed afterwards?

If you have clients presenting with these symptoms it is important to take the symptoms seriously.  Many sex addicts will not voluntarily disclose about their addiction, even to their therapist, until they are discovered by a partner or spouse.  When this happens, the consequences can be devastating for the individual, his or her relationships, and his or her community.  My hope is that you can use this simple assessment to bring healing to your clients before they experience the devastating consequences that result from sex addiction

Sex Addiction Resources