I’m Brad Salzman, LCSW, a Certified Sex Addiction Therapist (CSAT) since 2011 and the founder of the New York Sexual Addiction Center. I trained with Dr. Patrick Carnes from 2008, have treated sexual addiction for about 25 years, and work online with clients in New York and worldwide, along with 1 to 4 week in-person and online intensive programs.
People often ask me what the letters after my name mean. This article explains the CSAT credential, how it compares with other credentials, whether you need a CSAT, and how to find one who works online.
What does CSAT stand for?
CSAT stands for Certified Sex Addiction Therapist. It is a specialist credential awarded by the International Institute for Trauma and Addiction Professionals (IITAP) to licensed mental health professionals who complete advanced training and supervised casework in compulsive sexual behavior. I have held it since 2011.
It is not a license to practice. A CSAT must already be a licensed clinician, and the certification adds structured, specialist training on top of that license.
Who awards the CSAT credential?
The credential is awarded by IITAP, which began as a training program founded by Dr. Patrick Carnes.
Dr. Carnes has worked in the treatment of compulsive and addictive sexual behavior for more than 40 years. He developed assessment tools and the 30-task model that the training is built on. That original program became known as the CSAT program. IITAP has since added training in areas such as betrayal trauma, trauma and sex therapy.
Who can become a CSAT, and what does the training involve?
To be a CSAT, a clinician must already be licensed, hold a master’s degree or higher, and have at least five years of clinical experience. They then complete four IITAP training modules spaced months apart, 30 hours of supervision with an approved CSAT supervisor, and a final application. Certification is renewed every two years with continuing education.
The modules cover, among other things:
- Assessment: how to assess compulsive sexual behavior carefully, telling it apart from other problematic sexual behavior, validated assessment tools, ethics and treatment planning.
- Partners and families: the impact of discovery, how to handle disclosure, and supporting partners through betrayal, anger, shame and isolation.
- Addiction interaction and trauma: how sexual compulsivity connects with other addictions, sexual health, and trauma work using the task-model approach.
- Long-term recovery: resilience, shame and grief, sexual health, cultural considerations and ethics.
The supervision happens while treating active cases, and the final application includes colleague recommendations and the supervisor’s evaluation. Requirements have changed over the years; this describes IITAP’s current program, as set out in its training FAQ.
I trained with Dr. Carnes from 2008, completed my supervision under this program, and received my certification in 2011. You can read more about my training and background.
What is the difference between a CSAT, an ASAT, a CSAT candidate and a CSAT-S?
A CSAT has completed the full program with at least five years of clinical experience. An ASAT (Associate Sex Addiction Therapist) completed the same training with less experience. A CSAT candidate is still in training under supervision and not yet certified. A CSAT-S is an experienced CSAT approved to supervise candidates. Ask which one your therapist holds.
IITAP explains each level on its certifications page.
How is a CSAT different from a regular therapist?
Any licensed therapist can help with many problems. A CSAT has added structured training in assessing compulsive sexual behavior, handling disclosure to a partner, working with the trauma underneath, and planning long-term recovery.
In my experience this matters, because sexual compulsivity is often hidden, wrapped in shame, and easy to under- or over-estimate without the right questions and tools.
Do you need a CSAT for sex or porn addiction?
Not always. A CSAT credential is not a guarantee of good therapy, and some skilled clinicians without it do excellent work. What it does mean is training in a specific, tested model for this problem. Whoever you choose, ask how much of their practice is compulsive sexual behavior, how they assess it, and how they involve partners.
What does treatment with a CSAT look like?
In my practice, treatment starts with a careful assessment, then follows Dr. Patrick Carnes’s 30-task model, with concrete assignments for each task. I combine it with approaches such as cognitive behavioral therapy, DBT and EMDR, depending on what each person needs.
Early tasks include breaking through denial, understanding the problem, limiting the damage the behavior has caused and establishing sobriety. Later tasks address shame, grief, other addictions and past abuse. The structure gives therapy a clear direction while leaving room to adapt to each person.
Most of my clients work with me weekly. When weekly therapy isn’t enough, an intensive can give recovery a concentrated start. I explain how that works in What is a sex addiction intensive? and on my intensive programs page.
Can a CSAT help my partner, or us as a couple?
Yes, though the partner’s healing deserves its own space. Discovering a sex or porn addiction often causes betrayal trauma, with shock, hypervigilance and grief. I help partners directly, and I work with couples once there is enough stability and honesty to rebuild. A structured therapeutic disclosure is often a key step.
You can read more about betrayal trauma and partner therapy, therapeutic disclosure and couples therapy, or my article on how partners heal after discovery.
How do you find a CSAT who works online?
Start with IITAP’s public therapist directory, which lets you look for certified therapists who offer telehealth. Then check that the therapist is licensed where the law requires it, confirm their CSAT status is active, and book a short consultation.
I work online by video with clients in New York and worldwide, and I offer a free, confidential 15-minute call. I am licensed (LCSW) in New York only. For clients outside New York, my work is coaching and consultation, not psychotherapy.
What should you ask a CSAT before you start?
Ask about their experience, their approach, and how they involve partners. A trained specialist will answer clearly. These are the questions I would want answered if I were choosing a therapist myself:
- How long have you treated compulsive sexual behavior?
- How do you assess it?
- How do you define sobriety with clients?
- How do you handle disclosure to a partner?
- Will my partner get separate support?
- What happens if weekly sessions aren’t enough? (Some therapists, including me, offer intensive programs.)
Talk it through with a CSAT
If you would like to talk about your situation with a Certified Sex Addiction Therapist, I offer a free, confidential 15-minute consultation. There is no pressure to commit to anything.