Mental Health and COVID-19: Understanding Stress During a Pandemic

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Mental health is complicated. Navigating our mental and emotional burdens is difficult under the most routine circumstances. But during a pandemic? You may have found that it’s a totally different ballgame.

If you are having a hard time maintaining your mental health since COVID-19 turned the world upside down, you are not alone. Living through a pandemic is stressful. In fact, this pandemic has unleashed a uniquely potent combination of stressors on, well, the entire world, in a manner that has yet to be experienced or studied.

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Mending a Shattered Heart

A Guide for Partners of Sex Addicts

Edited by Stefanie Carnes, PhD
Chapter 10

What Does It Mean if My Partner Has Shown an Interest in Minors?
Written by Barbara Levinson, PhD, RN, LMFT, CSAT-S

What Does It Mean if My Partner Has Shown an Interest in Minors?

Barbara Levinson, PhD, CSAT-S

Nearly every day you hear or read something about pedophiles, predators, child molesters, or the abduction of children. We are so aware of the issue that we have become a society that sees the boogeyman around every corner. It is important to be knowledgeable about these issues and be sensitive to the needs of our children and keep them safe. (more…)

Sex Addict or Sex Offender?

There is a growing concern regarding those who view and download child pornography. Clinicians who specialize in the treatment of sexually compulsive behavior/sex addiction are often challenged when confronted with a client who has accessed child pornography, downloaded images and/or chatted with teenagers. It is clear that the possession of child pornography is illegal and having sexual chat with a minor is very serious. Those who treat sex offenders are often baffled as to how to use the existing actuarial tools to assess risk, or whether any of them are even appropriate with this population.

There are important points regarding risk that need to be taken into account when a patient discloses their behaviors or the patient’s partner presents with the complaint that their spouse/partner has been looking at child pornography. Before even determining the risk, a thorough psychosexual assessment needs to be performed including a history of the current behavior, past behaviors, and a comprehensive sexual history. In addition, a complete psychosocial evaluation needs to be undertaken. Of significant importance is the assessment and diagnoses of the presence of any Axis I and Axis II disorders. Leaving out any portion of this comprehensive assessment will not provide the clinician with the correct information to determine risk.


There’s More to Addiction than Booze and Pills

“I never knew what a sex addict was or that I was one until I offended. This term was not in my vocabulary of facts. It wasn’t until I checked into one of the local hospitals, did I become aware that such a term existed. Up to this point in my life, I thought I was normal. At the hospital, I was placed in their sex-addiction program, which at that time was made up of two people, me and another person. A horrendous amount of shame and guilt came over me when “sex addict” was first spoken. I had received a label of “SEX ADDICT”. We were grouped together with the alcoholics, drug addicts, overeaters, and suicidal people. People laughed when we said that we were sex addicts and made side remarks like “boy I wish I had that problem”. That dug deep into my soul, it hurt . . . people just don’t understand. I would exchange my addiction for any other type at any time. People seem more willing to come to the aid of people wanting to recover from other addictions but they shun sex addicts. We are like the lepers of old, condemned by society. Society is filled with sex addict, too many to counts. Look at all of the cars parked at the adult book stores, men’s clubs, bathhouses, at night at Memorial Park and the streets of Lower Westheimer. Most are either engaging or about to engage in some type of sexual activity that could lead them to end up like me. The only difference between them and me, right now, is that I got caught. My addiction took me to offend against another human being. I am now a sex offender and a sex addict. I am getting help now and with the proper treatment, I can control my compulsive sexual behaviors. “

This is just one of the many stories from the men in my sexual addiction program. Unfortunately, there are so many more.


Ethical Dilemmas Related to Disclosure Issues

Ethical Dilemmas Related to Disclosure Issues:
Sex Addiction Therapists in the Trenches
By Jennifer P. Schneider and Barbara Levinson Ph.D., RN, LMFT
Sexual Addiction & Compulsivity, 13:1-39, 2005.


Therapists who treat sex addicts are often faced with ethical dilemmas. Almost every therapist has encountered some unexpected situation that has put us in a quandary and by its very nature calls for decisions that could challenge our code of conduct. In this article the authors describe several types of ethical dilemmas related to disclosure. The focus is on revelations made by the patient, the therapist or a third party. Disclosure was chosen as a focus of this paper because of to its potential consequences and the possible risks when handled inappropriately. The authors illustrate their findings with insightful examples and give a broad range of possible solutions while describing the potential positive or negative outcomes. They give their opinions and their collective wisdom based on their own research and clinical practice. Several therapists also contributed to this article by generously stating their experiences.


Ethics as discussed in the following paper relates to a code of conduct that should be followed by all treatment providers. It implies the highest standard of care and protects the community and the treatment provider. Some believe it implies the difference between right and wrong. (more…)