The Marylebone Centre was set up in 2001 first to provide help to men struggling with compulsive sexual behaviour and their seriously affected partners. From that, it has expanded to include general CBT for mood disorders, work with health professionals, business psychology and forensic work.
Our forensic work is led by Dr Roberta Babb with John Woods from the Portman Clinic and Kelly Watkins. We have put together a programme of work which includes psychodynamic work based on work done at the Portman Clinic. This has been expanded to include a section on CBT management of difficult and unwanted behaviours. Individuals who have offended are able to become involved more creatively in the treatment process. In fact, there has been an integration of a variety of models of treatment into one cohesive process. I believe this to be a unique and un-paralleled development.
In other types of groups, we work with men who have compulsive patterns of behaviour which do not have coercive or illegal targets to the behaviour. With these men. we try to help them to understand that internet based behaviours have the risk of straying into the illegal just out of boredom with the routine. Behaviours can move from the barely legal to the illegal. This is especially true if the internet behaviours are accompanied by alcohol. Some would argue that this process means that the original sexual template could be altered by the reinforcement of orgasm to the new set of images.
Creating a trauma programme for women
Of concern is the impact of the behaviour on partners. These women, and it is mostly women, are experiencing interpersonal trauma that creates great distress. I am in the process of considering how best to create a trauma attenuation programme for these women. We already run groups for partners which are effective.
In my experience, an addictive process lies behind most forms of illegal sexual behaviour and CBT provides effective management skills to protect men from such behaviour. If you can reduce the risk, you better protect the vulnerable. CBT has the best evidence base of any therapeutic strategy for successful work with these and adjacent problems.
Finally, we have done outcome studies and the results demonstrate the effectiveness of the work.
About the author
Thaddeus Birchard is the founder of the Marylebone Centre and the Association for the Treatment of Sexual Addiction and Compulsivity. He has an MSc in Psychosexual Therapy and a Doctorate. The dissertation was on the treatment of sexually compulsive behaviours. He is accredited by BABCP and COSRT. Routledge has published three of his books: CBT for Sexually Compulsive Behaviour – A Guide for Professionals, Overcoming Sexual Addiction – A Self Help Guide and the International Handbook of Sexual Addiction.
StopSo, looking at the issues raised by working with both sex offenders and survivors. Views expressed are those of the author not UKCP.