Written by:

Last Updated:
4 February 2026

AI Overview

What CSBD is and why help matters
CSBD involves persistent, distressing sexual behaviours that disrupt wellbeing, relationships, and daily life, often accompanied by shame and secrecy.
Why it develops and how it’s assessed
It arises from a mix of trauma, neurobiology, and mental health factors, and is assessed through careful, compassionate clinical evaluation and screening.
Structured, evidence-based treatment
Recovery is supported through personalised residential care using CBT, DBT, psychosexual and trauma-informed therapies in an inclusive setting.
Sustained recovery and support
Long-term change is reinforced through relapse prevention, peer and alumni support, and ongoing mental health care beyond treatment.

Understanding Compulsive Sexual Behaviour and When to Seek Help

Compulsive Sexual Behaviour Disorder (CSBD) in the ICD-11 is marked by persistent, distressing sexual urges, thoughts, or behaviours that feel out of your control. While sexual desire itself is a normal part of life, these patterns can become disruptive, affecting your daily routine, relationships, self-esteem, and emotional health.

Many people dealing with CSBD carry a sense of shame or secrecy, which can make it even harder to reach out for support. For families, watching a loved one struggle in silence can feel just as painful. Recognising when it’s time to seek help often begins with noticing how these behaviours are impacting your life.

These behaviours may lead to:

Ongoing distress or emotional discomfort

Strained personal or professional relationships

A sense of isolation or lowered self-worth

Disruption to work, focus, or daily responsibilities

When these consequences are present, it’s not a sign of weakness; it’s a signal that support could make a real difference.

Common Signs and Emotional Patterns

Recognising the signs of compulsive sexual behaviour can feel overwhelming, and admitting them to yourself is often the hardest part. You might find your thoughts frequently returning to sex in ways that disrupt your concentration, relationships, or responsibilities. Perhaps you’ve tried to cut back but keep returning to the same behaviours, even when they’ve led to conflict, secrecy, or pain.

Some people notice they’re using sex to manage stress or difficult emotions, or taking greater risks just to feel something. Emotionally, this pattern often includes waves of guilt, shame, anxiety, or emptiness following sexual activity, along with a growing sense of being stuck.

What Causes Compulsive Sexual Behaviour?

There’s no single cause of compulsive sexual behaviour. It often stems from a complex mix of psychological, neurological, and social influences that unfold over time. Early traumatic experiences, such as emotional neglect, attachment disruptions, or chronic stress, can deeply shape how a person copes, connects, and seeks comfort.

Neurobiological factors like dopamine system dysregulation or co-occurring mental health problems, such as ADHD or depression, may also contribute. These underlying patterns aren’t signs of weakness; they’re often rooted in pain or unmet emotional needs.

How Sex Addiction Is Diagnosed and Assessed Clinically

Clinical assessment begins with more than just checking symptoms. It involves a careful, professional evaluation guided by international standards such as the ICD-11. Our team works to understand not just what you’re struggling with, but how it impacts your daily life, relationships, sense of self, and emotional wellbeing. Part of this includes ruling out other conditions and identifying any co-occurring challenges that may be present.

At our rehab centre in Cape Town, we take time to build trust and truly understand your unique experience. Our assessments are compassionate, thorough, and tailored to you and are carried out in a structured, residential setting where you’re supported every step of the way.

Screening Tools and Intake Process

Our intake process is designed to feel respectful and supportive. During your initial conversations, our clinicians gently explore what behaviours you’re struggling with, how frequently they occur, and how they’re impacting your emotional wellbeing. As part of this, we may use structured screening tools like the Sexual Addiction Screening Test-Revised (SAST-R), alongside open, thoughtful dialogue.

These tools help us understand your patterns, emotional drivers, and any risks so we can offer care that truly fits you. We also consider your readiness for change, mental health needs, and whether our residential setting is appropriate. Eligibility is based on psychological stability, ability to engage in therapy, and the absence of conditions requiring hospital-level care.

Ruling Out Other Conditions

It’s completely normal to feel unsure or even confused about what’s really going on at first. During the assessment process, we take care to rule out other medical or neurological conditions, like certain medications or disorders, that can sometimes cause behaviours that resemble compulsivity. We also help distinguish between compulsive sexual behaviour and things like a naturally high libido or consensual, non-traditional sexual interests.

These don’t require treatment unless they’re clearly causing distress or interfering with daily life. If other mental health issues, such as bipolar disorder or substance use, are present, we factor those into a broader picture so any treatment plan is thoughtful and individualised. You don’t need to have every answer upfront; just starting the conversation is a meaningful and non-judgemental step forward.

Evidence-Based Therapies for Sex Addiction Treatment

Effective care for compulsive sexual behaviour begins with evidence-based, trauma-informed psychotherapy. At Liberty Home, our experienced clinical team works closely with you to design a therapeutic plan that meets you emotionally, psychologically, and relationally. We don’t just apply techniques; we build trust, listen closely, and create space for difficult conversations to unfold safely.

Our sex addiction treatment in Cape Town draws on structured approaches that respect your story and support your growth. Every aspect is carefully adapted to your emotional history, co-occurring conditions, and personal readiness to engage. You’ll be supported throughout by clinicians who are not only skilled but genuinely committed to helping you explore the deeper patterns behind your behaviour in a non-judgemental, supportive environment.

CBT, DBT, and Psychosexual Therapy

Many people with compulsive sexual behaviour struggle with shame-driven or rigid thought patterns. Cognitive Behavioural Therapy (CBT) helps reshape these into healthier ways of thinking, while Dialectical Behaviour Therapy (DBT) builds emotional regulation skills to manage distress and reduce impulsive reactions.

Psychosexual therapy invites you to explore the deeper emotional and relational factors that may shape your sexual behaviours; things like fear of intimacy, unresolved trauma, or difficulty connecting. These evidence-based approaches are not used in isolation; we blend them to support the full complexity of your experience.

Trauma-Informed Approaches and Group Work

Trauma-informed care recognises the deep connection between past experiences and current patterns in sexual behaviour. We provide a safe, supportive space to explore those histories with the guidance of experienced clinicians. Group therapy builds on that foundation, offering connection, mutual support, and gentle accountability. Over time, the insights and relational skills developed in group can help strengthen how you connect with others outside of treatment, offering new ways to relate with honesty and respect.

Culturally Sensitive and LGBTQ+ Inclusive Care

At Liberty Home, we understand that your cultural background, gender identity, and sexual orientation all influence how you experience intimacy, trauma, and healing. That’s why we actively create a space where every client feels seen, heard, and safe. Our team is trained to provide affirming, respectful care that acknowledges the impact of stigma and discrimination without making assumptions about your story.

Inclusive care is embedded in our daily practice. This includes using your chosen name and pronouns, offering group topics that reflect diverse relationship identities, and adapting therapeutic content to honour cultural and personal values. We remain committed to meeting you where you are, with compassion and clinical integrity at the heart of our work.

What to Expect in a Structured Programme for Sex Addiction

From the moment you arrive, our structured programme helps create a sense of safety and rhythm. Each day follows a therapeutic schedule designed to support your progress without feeling overwhelming. You’ll have regular one-on-one therapy, group sessions, and psychoeducational workshops.

There’s also dedicated time for reflection and personal tasks that deepen your recovery work. Our multidisciplinary team is here to guide you with compassion, addressing not just compulsive behaviours, but also underlying mood, anxiety, or relationship challenges you may be facing. Daily structure includes shared meals, guided activities, and accountability practices that help anchor your routine.

Privacy, Safety, and Patient Rights

Your privacy, dignity, and autonomy matter deeply to us. At Liberty Home, we follow South African privacy laws and ethical standards to ensure your personal health information is always treated with care and confidentiality.

Our safety protocols, including clear boundaries around relationships and internet use, exist to support healing and provide structure and not to limit your freedom. You’ll be asked to sign an informed consent agreement when you join us, and remain an active participant in shaping your own recovery journey throughout your stay. We also integrate harm reduction into our programme.

Stabilisation Without Medical Detox

While Liberty Home does not offer medical detox services, we’re here to support you through the early emotional and behavioural challenges that often arise at the start of recovery. It’s common to feel anxious, unsettled, or overwhelmed in these first days, especially if you are without substances that once felt like a way to cope. Our team provides steady therapeutic support, grounding techniques, and compassionate monitoring to help ease this transition.

We focus on stabilisation; ways in helping with disrupted sleep, strong urges, and emotional intensity so you can begin deeper recovery work with greater safety and clarity.

Residential vs Outpatient and Day Programmes

Our residential programme offers a level of structure and support that goes beyond what part-time treatment can provide. While outpatient and day programmes may work for individuals with strong daily routines and external support systems, our immersive approach is designed for those whose lives have been disrupted by compulsive behaviours, trauma, or co-occurring mental health conditions. We provide 24/7 supervision, therapeutic consistency, and a connected community environment; key elements that help you reset patterns and begin long-term change with safety and guidance.

Residential Treatment at Liberty Home in Cape Town

Stepping into residential treatment provides the stability and structure needed to interrupt harmful patterns and begin lasting change. We offer clinically guided care in a supportive, non-hospital setting that encourages honesty, routine, and personal growth. Our environment blends daily therapeutic work with clear boundaries, which is ideal for those needing to step away from high-risk situations and rebuild self-regulation.

We support clients with behavioural addictions beyond substance use through an integrated residential programme in Cape Town. Our immersive, 24/7 structure addresses co-occurring mental health challenges and provides consistent guidance and accountability beyond what outpatient care offers.

Addressing Co-Occurring Mental Health and Digital Compulsions

Compulsive sexual behaviour often co-occurs with depression, anxiety, trauma, or attention-related difficulties, with digital habits like pornography use becoming intertwined with stress, shame, and emotional pain. While these behaviours may begin as coping strategies, they frequently lead to greater distress over time.

At Liberty Home, we treat these challenges holistically by integrating mental health care into every stage of our residential programme. We address both underlying psychological patterns and the environments that reinforce them, helping you build clarity, regulation, and healthier ways of coping.

Integrated Mental Health Support

We recognise that you may be feeling overwhelmed or unsure whether your challenges can really be addressed in one place, but they can. Our integrated approach explores compulsive sexual behaviour alongside underlying issues such as unresolved trauma, anxiety, low mood, burnout, or patterns shaped by digital overuse.

Support is always tailored to what’s clinically appropriate within our non-acute residential environment. When needed, psychiatric consultation can be included as part of your care plan to help clarify diagnoses and guide treatment. In some cases, medications, such as selective serotonin reuptake inhibitors (SSRIs), may be recommended to help manage urges, reduce depressive symptoms, or support emotional balance. These decisions are made carefully and coordinated with licensed external providers to ensure safe, personalised care.

Managing Online and Pornographic Patterns

It's not uncommon to feel overwhelmed by compulsive online behaviours like excessive pornography use or cybersex. These patterns often bring a mix of shame, distress, and confusion, but they are treatable.

Our therapeutic approach includes practical tools to set healthy boundaries with devices, build accountability, and strengthen emotional regulation. As part of our porn addiction treatment focus, you’ll learn to recognise triggers, manage urges, and create supportive routines that work in real life. Together, we help you understand how digital stimulation affects the brain’s reward system and relationships, while guiding you toward greater clarity, connection, and choice over time.

Typical Length of Stay in Residential Care

While everyone’s journey is unique, residential stays at Liberty Home generally start at 28 days. Many residents extend to 60–90 days or longer, depending on their progress and personal goals. These extended stays allow time to explore deeper issues around identity, attachment, and the patterns that may lead to relapse.

Decisions about the length of stay are made collaboratively with you, based on your needs, growth, and readiness for the next step.

Relapse Prevention, Peer Networks, and Alumni Support

In the later stages of treatment, we focus on helping you build practical tools for long-term relapse prevention, which includes emotional regulation techniques, healthy coping strategies, and a personalised plan for maintaining progress. Just as important is the sense of connection that grows through peer support. We help you tap into local and online recovery communities where shared experiences can offer validation and strength.

These include SAA (Sex Addicts Anonymous), SLAA (Sex and Love Addicts Anonymous), and SMART Recovery, depending on what fits you best. After you leave residential care, our alumni network provides a steady thread of support. Whether it’s a check-in call from a former fellow resident, group discussions, or continued coaching with someone who truly understands the process, this community helps you feel seen, encouraged, and grounded as you navigate life beyond structured care.

Measuring Progress and Long-Term Outcomes

During residential treatment, we work closely with you to set personalised goals and track your emotional, behavioural, and relational growth over time. Progress isn’t always linear, and that’s okay because our team is here to help you navigate the ups and downs with care and clarity. Many clients find that tools like journalling, regular reflections, therapeutic check-ins, and celebrating small milestones help them stay centred and motivated.

After you leave, ongoing alumni check-ins and outcome reviews offer continued accountability and insight, supporting your long-term healing and helping you recognise just how far you’ve come.

Programme Duration, Ongoing Support, and Aftercare Planning

Our approach at Liberty Home doesn’t stop with initial treatment. Most residents engage in a phased programme, gradually transitioning into extended care options that promote consistency and safety.

This long-term structure helps build a strong foundation for lasting recovery. The familiar environment, growing peer connections, and steady routine offer many people the grounding and confidence they need to face life’s challenges without slipping back into old patterns.

Costs and Medical Aid Coverage in South Africa

We understand that navigating the financial side of treatment can feel overwhelming, especially during a time when you or your loved one needs stability and support. That’s why we’re upfront about how our costs and coverage work, and here to guide you through the process wherever we can. Liberty Home operates as a private-pay facility, and we don’t bill South African medical aids directly.

However, many of our clients can submit claims for partial reimbursement, depending on their specific plan, diagnosis, and the pre-authorisation steps required. We’ll provide you with detailed invoices and the clinical documentation needed to support these claims. To avoid surprises, we encourage you to speak directly with your scheme to clarify what coverage is available for mental health or rehabilitation services.

And if you’re unsure about the process, our team is happy to walk you through the steps and help you feel more confident in the next move forward.

References

Sexual Addiction Screening Test

Sex Addicts Anonymous (SAA)

Sex and Love Addicts Anonymous (SLAA)

SMART Recovery

Frequently Asked Questions

How is sex addiction treated in a Cape Town rehab setting?

Sex addiction is treated through a personalised, residential programme at our facility in Cape Town that combines evidence-based care with a structured, home-like setting. Our experienced team uses a mix of individual and group therapy, psychoeducation, trauma-informed approaches, and relapse prevention planning to support your long-term recovery.

How long will I need to stay in rehab for sex addiction?

Most stays begin at a minimum of 28 days, but some individuals find that remaining for 60 or 90 days allows for deeper therapeutic progress. Recovery from sex addiction can be complex, and the right length of stay depends on your personal goals, clinical needs, and where you are in your journey.

Does medical aid cover treatment for sex addiction in South Africa?

Some medical aids in South Africa may offer partial cover if a co-occurring psychiatric condition is formally diagnosed and pre-approved. While we don’t bill medical aids directly, our team is happy to provide the clinical documentation you may need to support a claim.

What are the signs I may need sex addiction rehab?

If you feel like your sexual behaviour is out of control and causing emotional distress, or is leading to harmful consequences in your life, but you struggle to stop, that’s often a sign it’s time to reach out. Many people also notice they use sex as a way to cope with pain, isolation, or stress.

Can sex addiction be treated alongside depression or trauma?

Yes, and in many cases, it should be. At Liberty Home, we approach compulsive behaviours like sex addiction through an integrated lens, recognising that they often occur alongside mental health concerns such as trauma, anxiety, or mood disorders.