For years, men had to walk into an office, sit in a waiting room and hope they didn’t see someone they knew before they could talk about sex or porn addiction. Today most of my work happens by video, with men, women and couples who would never have walked through that door.
On consultation calls, I’m often asked whether online sessions really work for something this serious. Here’s my honest answer: what the research shows, what I see in practice, and when another option makes more sense.
One note up front: if you live in New York, my sessions are psychotherapy. If you live elsewhere, my work with you is coaching and consultation. More on that below.
Does online therapy work for sex and porn addiction?
The research so far is encouraging. A 2025 meta-analysis of 20 studies with 2,021 participants found that psychological help, mostly cognitive behavioral therapy and acceptance and commitment therapy, led to significant improvements in problematic pornography use. The studies have limits, but they point one way: structured help improved outcomes.
The study, by López-Pinar, Esparza-Reig and Bőthe, was published in the Journal of Behavioral Addictions (read it on PubMed Central). The authors are open about its limits: many of the included studies had a high risk of bias, and they call for more rigorous trials. That’s a fair description of the field as a whole. The evidence is promising, not final. Those studies also looked at psychotherapy, not coaching.
In my own work, the method matters more than the screen. What helps is a clear picture of what’s going on, a written plan, steady accountability and work on what drives the behavior. All of that translates well to video.
Is online therapy as effective as in-person therapy?
In that same 2025 meta-analysis, outcomes did not differ significantly between online and face-to-face delivery. The authors call this preliminary evidence, so it isn’t the last word. But it matches what I see: for most people, the quality and consistency of the work matter far more than the room.
The authors also note something I hear constantly: shame stops many people from seeking face-to-face help at all. For those people, the best session is the one they’ll actually attend.
What do online sessions look like week to week?
Online sessions look a lot like sessions in an office. We meet by video at a regular time, review the past week, work on your plan, and go deeper into what drives the behavior. Between sessions, you have practical tasks: check-ins, reading, writing, meetings or changes to your devices.
A typical rhythm with me:
- At least weekly sessions, and twice a week for many clients, at a set time, scheduled in New York time, with early morning and weekend hours available.
- A written plan that names your bottom lines, warning signs and the people you call.
- Tasks between sessions, often based on Dr. Patrick Carnes’s 30-task model, which I explain in What is a CSAT?
- Partner or couples work where it fits, scheduled separately.
What gets easier online, and what gets harder?
Starting is easier online. So is keeping a regular slot when you travel for work, and talking about shameful things from your own space. What can be harder is privacy at home, distractions, and the temptation to cancel at the last minute. Most of these have practical fixes we can plan for together.
A few things I’ve learned from years of online work:
- Men often say more, sooner, on video than they would in an office. The distance can make honesty feel safer.
- Sessions from the same private place each week work better than sessions squeezed in wherever you happen to be.
- The device you use for sessions is often the same one you’ve struggled with. We talk about that openly and set up safeguards together.
- Travel stops being a reason to miss sessions, which matters, because travel is often a high-risk time.
Is online sex addiction therapy private?
Online sessions can be more private than an office: no waiting room, no receptionist, nobody seeing you arrive. The privacy that matters most is on your side. Use a personal device, a room with a door or a parked car, and headphones. Keep messages brief and save the details for sessions.
For New York residents, my online sessions are psychotherapy; for clients elsewhere, they’re coaching and consultation, not psychotherapy. I don’t bill insurance, so no claim is filed on your behalf. More on fees, platforms and confidentiality is in practical questions.
Can couples and partners do this work online?
Yes. Partners can have sessions of their own for betrayal trauma, and couples can meet together by video. Online work often makes it easier to fit sessions around work and children, and lets each partner join from somewhere private. Preparing a therapeutic disclosure can also happen in online sessions.
You can read more about couples therapy and betrayal trauma and partner therapy.
When is in-person or intensive work a better fit?
Online weekly sessions aren’t right for everyone. If you have no private space at home, if weekly work has stalled, or if a crisis needs a strong, fast response, a more concentrated option may fit better. Serious substance use or safety concerns may also call for a higher level of care first.
For some men, an intensive program, in person or online, gives recovery a focused start before weekly sessions resume. I explain the differences in What is a sex addiction intensive?
How do I choose an online CSAT?
Look for a specialist with real training in sex and porn addiction, such as a Certified Sex Addiction Therapist (CSAT). IITAP’s public directory lets you search for CSATs who offer telehealth. Then check their licensing, ask how they work online, and book a short consultation before you commit.
Licensing matters when you work online, because it depends on where you are, not where the clinician is. If you live in New York, my sessions are psychotherapy under my New York LCSW license; if you live elsewhere, my work with you is coaching and consultation, not psychotherapy.
Common questions
Do I need special software?
No. You need a phone, tablet or computer with a camera and a reliable connection. I send you a link before your first session.
Can I have sessions from work?
You can, if you have a private room and use your own device and network. Many clients prefer a parked car or a quiet room at home.
What if I live in a different time zone?
Sessions are scheduled in New York time, and early morning and weekend hours often make it work for clients in other time zones.
Is online work enough if my partner just found out?
It can be, alongside separate support for her. If the situation is very unstable, we may discuss a more concentrated start.
Talk it through
If you’ve been wondering whether online sessions could work for you, a short conversation is the place to start. I offer a free, confidential 15-minute consultation. There’s no pressure to commit to anything.
If you’re in danger or thinking about harming yourself, call 911, or call or text 988 in the US. Outside the US, call your local emergency number or find a helpline at findahelpline.com.