What Is a CSAT? How a Certified Sex Addiction Therapist Is Different From a Regular Therapist

A CSAT is a Certified Sex Addiction Therapist, a licensed clinician who has completed specialized post-graduate training through the International Institute for Trauma and Addiction Professionals (IITAP) in assessing and treating sex, porn, and love addiction, along with the betrayal trauma partners experience. It's a credential added on top of a state license, not a replacement for one.

That's the short answer. Here's the longer one, because if you're reading this, you're probably trying to figure out whether the letters after a therapist's name actually matter for what you're going through.

I'm Allan J. Katz. I'm a Licensed Professional Counselor and Supervisor here in Memphis, and I've held the CSAT credential for well over a decade. I get some version of this question every week, usually from someone who has already tried therapy once and left feeling like the therapist was kind, competent, and completely out of their depth on this particular problem.

What the CSAT certification actually requires

Every CSAT starts as a licensed mental health professional. You can't get into the training without an active license, so the credential always sits on top of a master's degree, supervised post-graduate hours, and a state board exam.

From there, IITAP requires a sequence of training modules focused specifically on the neuroscience of compulsive sexual behavior, assessment tools, treatment planning, relapse prevention, and partner betrayal trauma. Those modules are taught by clinicians who built the field, and they're not weekend seminars you can absorb passively. Each one builds on the last.

After the coursework comes supervision. A candidate has to complete supervised clinical hours with a CSAT Supervisor, bringing real cases and getting real feedback on how the treatment is going. That's where the training turns into competence, because reading about disclosure preparation is very different from sitting with a couple while it happens.

The credential doesn't stay with you automatically, either. CSATs are required to keep up ongoing education in the specialty to maintain certification. I'll be honest about what that means: it doesn't make anyone a miracle worker. It means I've been trained, supervised, and held accountable in one specific area of clinical work, and I keep learning in it.

What a general therapist usually misses

I want to be careful here, because the therapists I'm about to describe are good at their jobs. Most general therapists are well trained in anxiety, depression, grief, family systems, and trauma. The issue isn't competence. The issue is scope.

Here's how it usually plays out. A man comes in because his wife found something on his phone. The therapist, reasonably, treats the porn use as a symptom of stress or a marriage problem and focuses on communication skills. Six weeks later, he's using again, he's lying about it again, and the couple is worse off than before, because now the wife feels like therapy failed and there's nothing left to try.

What got missed is that compulsive sexual behavior runs on its own cycle. There's a preoccupation phase, a ritual, the acting out, and then the shame that feeds right back into preoccupation. If you don't know that cycle exists, you can't interrupt it. You also can't tell the difference between a habit someone can drop with willpower and a compulsion that needs a structured recovery plan, and that difference changes everything about treatment.

The other thing that often gets missed is the partner. In a lot of general therapy, the betrayed partner is treated as a supporting character in the addict's recovery story. She's told to be patient, to work on her own trust issues, to stop checking his phone. Nobody tells her that what she's experiencing has a name, that it looks a lot like post-traumatic stress, and that she's entitled to her own treatment. I see this on my betrayal trauma and couples counseling page more than anywhere else: partners who've spent months in therapy without anyone naming what happened to them.

What working with a CSAT looks like in practice

It starts with assessment, and I mean real assessment. Before we build a plan, I want to understand the full picture: what the behavior looks like, how long it's been going, what it's covering up, what else is going on in your life and history. CSATs use validated screening tools designed for this exact question, so we're not guessing about whether this is an addiction or something else.

From there, we build a treatment plan that fits what we found. For someone in the grip of compulsive porn use or acting out, that usually starts with the work I describe on my individual therapy page for sex, porn, and love addiction: stopping the behavior, understanding the wound underneath it, and building accountability that holds when willpower runs out. I draw on Brainspotting, DBT skills, and experiential work depending on what someone actually needs, and I'll say plainly that I've watched people in Memphis rebuild lives they thought were over.

Then there's the partner. This is where CSAT training separates most clearly from general therapy. The partner's experience isn't a side issue we get to once the addict is stable. It's part of the work from the beginning. That means the betrayed partner gets her own space to stabilize and heal, it means disclosure is planned rather than blurted out in a fight, and it means the couple's work happens in a structure where honesty is possible instead of one more thing to survive.

None of this promises an outcome. What it offers is a process built for the problem you actually have.

How to vet a CSAT before you book

Not every therapist who lists sex addiction as a specialty has the training behind it, and a directory checkbox isn't a credential. Before you book with anyone, including me, ask these questions directly:

Are you a Certified Sex Addiction Therapist through IITAP, and is your certification current? A yes should come without hesitation.

How do you work with the betrayed partner? Listen for whether they treat her as a client with her own trauma or as an add-on to the addict's treatment.

What does your assessment process look like? You want to hear about structured tools, not just an intake conversation.

Do you have a plan for disclosure? A CSAT should be able to describe how they prepare both people for it rather than letting it happen by accident.

If you want to know more about how I answer those questions myself, my about page covers my background, my books, and how I came to this work.

Frequently Asked Questions

Is a CSAT the same as a sex therapist?

No. A sex therapist is trained to help people with sexual function, desire, and intimacy, often within an otherwise healthy relationship. A CSAT is trained to treat compulsive sexual behavior and the betrayal trauma it causes. Some clinicians hold both credentials, but they're different bodies of training aimed at different problems, and it's worth knowing which one you need.

Do I have to be an addict to see a CSAT?

No. Plenty of people come to me unsure whether what they're doing counts as an addiction, and figuring that out is part of the assessment. Betrayed partners also see CSATs for their own healing, whether or not their partner is in treatment. You don't need a label before you reach out. You need a problem that isn't getting better on its own.

Does my wife come to sessions?

Sometimes, and it depends on where you both are. Early on, I often see each of you separately so the partner gets her own support and the person who acted out can be honest without an audience. Joint sessions come when there's enough stability to make them productive. That sequence is decided together, not imposed.

How long does treatment take?

Longer than most people hope and shorter than most people fear. Establishing sobriety and stabilizing a relationship after betrayal usually takes months, not weeks, and the deeper work of understanding what drove the behavior continues after that. I'd be suspicious of anyone who gives you a fixed number before they've met you.

Are sessions confidential?

Yes. Everything shared in session is protected by professional ethics and state law, with the narrow legal exceptions every licensed therapist is bound by. For people with careers and families on the line, I take discretion seriously, and I'm happy to walk through exactly what confidentiality covers during your consultation.

A low-pressure next step

If you're in Memphis or anywhere in Tennessee or New Jersey and you've been circling this decision for a while, you don't have to be certain before you call. A short consultation is enough to figure out whether working with a certified sex addiction therapist makes sense for you. You can request an appointment here, or call 901-248-6001 and we'll talk it through.