If you've been searching for help with sex addiction or compulsive sexual behavior, you've probably encountered the acronym CSAT. It appears on therapist profiles, in directory listings, and in the bios of clinicians who specialize in this area. Here's what it actually means, what the training involves, and why it matters when you're choosing a therapist.
What CSAT Stands For
CSAT stands for Certified Sex Addiction Therapist. It's a post-graduate certification issued by the International Institute for Trauma and Addiction Professionals — IITAP — a professional organization dedicated to training clinicians in the treatment of compulsive sexual behavior and its relational impact.
The CSAT is not a license. It doesn't replace state licensure as a therapist, counselor, social worker, or psychologist. It's a specialty credential layered on top of existing licensure, similar in spirit to certifications in EMDR, dialectical behavior therapy, or equine-assisted therapy. What distinguishes it is the specificity of focus: CSAT training is devoted entirely to compulsive sexual behavior, sex addiction, betrayal trauma, and the clinical work that surrounds those concerns.
What the Training Involves
Earning the CSAT requires completing a structured curriculum developed by IITAP, including coursework on assessment and diagnosis, treatment planning for compulsive sexual behavior, the neurobiology of addiction, trauma-informed approaches, partner and family impact, betrayal trauma, the formal disclosure process, group therapy facilitation, and working with co-occurring conditions.
Beyond coursework, candidates must complete a defined number of supervised clinical hours working specifically with sex addiction populations, pass a written examination, and submit case consultation documentation. The process typically takes one to two years after meeting the baseline education and licensure requirements.
There is also an ongoing continuing education requirement to maintain the credential. CSAT holders are expected to stay current with developments in the field.
Why It Matters
Compulsive sexual behavior is not a presenting concern that responds well to generic therapeutic approaches. A skilled therapist who is excellent at treating depression, anxiety, or general relationship conflict may not have the specific knowledge base to treat sex addiction effectively. The two are different clinical problems requiring different frameworks.
This isn't a criticism of general therapists — it's simply how specialization works in every medical and mental health field. You would look for a cardiologist for a heart problem, not a family physician who also sees some cardiac patients. The parallel holds here.
Specific things CSAT training addresses that general training typically does not:
- How to assess the severity and pattern of compulsive sexual behavior
- Treatment planning that accounts for both the behavior and its underlying drivers
- The formal disclosure process — a structured clinical intervention for couples
- Betrayal trauma as a distinct clinical phenomenon, separate from general relational distress
- Group therapy models specific to sexual compulsivity
- Partner treatment and the distinction between couples work and individual partner support
What to Ask When Looking for a CSAT
The credential itself is a starting point, not a guarantee. When evaluating a CSAT therapist, it's reasonable to ask whether sex addiction and compulsive sexual behavior is their primary clinical focus or one of many concerns they see. There's a meaningful difference between a specialist and a generalist who holds the credential.
It's also worth asking whether they facilitate formal disclosure, whether they see partners individually (not just in couples sessions), and what their treatment approach looks like in practice. A good CSAT should be able to answer those questions clearly.
Finding a CSAT in New York
The IITAP website maintains a directory of certified therapists searchable by location. For clients in New York State, telehealth has made geography less of a barrier — most CSAT-trained therapists who serve New York clients do so via secure video sessions.
OBR Counseling is a specialized practice focused exclusively on compulsive sexual behavior, sex addiction, betrayal trauma, and their relational impact. All sessions are provided via telehealth throughout New York State. If you'd like to discuss whether the practice is a good fit, a complimentary 15-minute consultation is available.