Sexual Addiction-Assessment and Treatment

Sexual Addiction Conference – Assessment and Treatment


The training at this conference will enable professionals to identify 10 criteria for addiction. They will understand the addiction cycle. They will recognize how early trauma and other components enable an addiction to develop. Providers will be able to identify 10 types of compulsive behavior revealed through research.

Who Should Attend

Therapists who work with individuals and couples who are having personal and relationship problems. In some cases, the individual’s and couple’s struggles might be due to underlying sexual addiction issues.

Date: February 28, 2018

Time: 9:00 am until 12:00 noon

Location: Salt Lake City Public Library

Salt Lake City Public Library

210 East 400 South

Salt Lake City, UT 84111


Single Registrant: $45

Group Rate (4 or more): $35 each

Registration Link:

Continuing Education Credit: 3 hours

The following organizations have approved CE credit for this course:

The Utah Psychological Association

Utah Association of Social Workers

The course relates to Marriage and Family Therapy work. The training will help MFT providers identify sexual addictive behavior when applicable.

Course Director: Steven J. Chen, Ph.D.

Steven was trained in Clinical Psychology and obtained his Ph.D. in 1992. He has worked at a variety of settings and has more than 25 years’ experience in psychology. Steven has worked with numerous individuals suffering from addiction, including alcohol, sex, and drug dependence. He utilizes a unique intensive outpatient approach, which is highly effective in helping those with addiction as well as spouses and family members. He is a certified sex addiction therapist (CSAT).

For more information about the conference, please see the training section of the website.




Dear Dr. Chen,

I am very grateful for your guidance and instruction.  For over 50 years, I have dealt with sexual addiction.  I have found it unbeatable despite my most ardent, sincere and determined efforts to control it.  Almost three years ago my life hit rock bottom.  I finally understood my life was uncontrollable and I could not beat the addiction by myself.  Quite by chance I met with Dr. Chen.  I told him my story and he said that I was a sex addict.  He handed me a book about sexaholism and told me to attend a 12-step meeting.  He told me that sex addiction was a disease.  He would work with me to help me manage the disease, but that I would never be cured.  Since that time with Dr. Chen’s help, my personal surrender, and the help of other recovering addicts, I have embarked on a path of spiritual rebirth.  This spiritual rebirth consists of physical, mental and emotional recovery.

I think that recovery has many components.  I cannot be completely successful without religious, social and professional therapy components working together equally.  I am grateful to have found all three components.  Even more grateful that my recovery is happily proceeding with a life connected to God, loved ones, and others.  I have appreciated Dr. Chen’s wisdom, suggestions, and constant reinforcement of me as a person of value throughout the process.

Sincerely,  Grateful

Dear Grateful,

I appreciate your kind words.  It has been a pleasure helping guide you through the recovery process.  As we have discussed on many occasions, recovery is not a destination. Recovery  is a life long undertaking that one must recommit to each day.  The process is not easy.  As you have experienced, there are many challenges.  However, with patience and persistence, the life improvements you experience will be well worth the effort.

All the best,  Dr. Chen

Considering Different Aspects of Perfectionism


It is important to understand the differences in perfectionism.  There are two types of perfectionists, adaptive and maladaptive.   Although they tend to have similarly high levels of academic success, maladaptive perfectionists experience much higher levels of self-criticism.   These high levels of self-criticism may be related to depression.  This is according to a study appearing in the Journal of Counseling Psychology (Vol. 51, No. 2).

In the study, which is part of a research program led by psychologist Robert B. Slaney, PhD. of Pennsylvania State University, the team used Slaney’s Almost Perfect Scale.  The scale was used to measure 273 undergraduate students’ self-reported perfectionism.  The scale gauges the level of people’s high standards, associated with positive aspects of perfectionism.  It also measures their levels of “discrepancy,” a negative aspect of perfectionism associated with dissatisfaction with performance.

Grade point average (GPAs) for adaptive and maladaptive perfectionists did not differ significantly.  However, maladaptive perfectionists rated themselves as significantly, less satisfied with their GPAs, says one of the researchers, psychologist Jennifer Grzegoek, PhD, of Iowa State University.


“The amazing thing here is that maladaptive folks are meeting the same standards but feel more like failures,” Grzegoek says.

More research is needed.  But evidence from this study indicates some potential applications in therapy:  Perfectionism has been associated with nonresponsive to short-term treatment for depression.  As a result of this, Grzegoek advises therapists to attend to signs of self-criticism and discrepancy in clients.

“Those patients often fail to see perfectionism as a problem, instead considering their high standards to be the secret of their success and something they’re very unwilling to talk about  giving up, ” She says.  “However, we are finding that it is discrepancy, rather than the mere presence of high standards, that is problematic in maladaptive perfectionism.  This may be helpful for perfectionistic clients who are willing to give up their high standards, but who are willing to examine their discrepancy, ” she says.

Source:  American Psychological Association:  Monitor:  Volume 35. No. 5 May 2004


What is Sex Addiction?

What is Sexual Addiction?

Sexual Addiction (SA) is a real diagnosis.   Sex addicts engage in persistent and escalating sexual behaviors undeterred by negative consequences such as health risks, legal problems, financial problems, and broken relationships.  Sex addicts try to escape reality by altering their mood using sex.  The illness is progressive and creates chaos in the lives of the addicts and their families.

John is a 40 year-old male, married for 15 years to an attractive woman he met in college.  They have two children, live in the suburbs, and make a comfortable living.  However, the financial stress of a mortgage, paying for two cars and feeling like they were on a financial merry-go-round led John to use pornography to escape into a fantasy world.  Over time he also began seeking massage parlors where the woman sometimes performed illegal sexual favors.  Gradually he slipped further and further into a negative place of depression, disconnection and irritability and anger.

Sex addiction affects males and females of all ages.   The early seeds of addiction frequently begin during the teenage years but may not start until the 20’s or even 30’s.   Estimates are that between 3% to 5% of the population seek treatment for this issue, though the actual number of people afflicted is likely much higher.  Nevertheless, some studies have placed the number of sex addicts at between 10 and 15 million people in the United States.  Research also suggests that 80% of sex addicts are male.  While the exact causes are unknown, males may have a higher prevalence due to the over sexualization of women via advertising messages and cultural influences objectifying women in the United States.  Many professionals believe that the proliferation of online sexual activity is a major contributor in the development of sexual addiction. 

Sex as a Drug

Sex addiction is included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) as hypersexual disorder.  It is not yet called “sex addiction” because studies are ongoing.  Professional associations have struggled with recognizing sexual addiction as an mental disorder or brain disease much like alcoholism was not recognized as a medical illness until relatively recently.  But the lack of formal acceptance of this condition by some mainstream professional associations does not diminish the hurt, pain and devastation this condition causes to millions of individuals, couples and families.

Neuroscience uses brain imaging to verify the existence of addictions.  Imaging reveals that all addictions, including sex addiction, stimulate the same pleasure centers of the brain.  When an individual views pornography, seeks sexual contact through a provider of sexual services or seeks sexual activity outside a committed relationship, a pathway is developed in the brain and repeated acting out behavior gradually deepens this neural pathway.  As time goes on, the desire and need for continued and even escalating sexual behavior can develop into sexual addiction. 

Sex and relationship addictions are considered intimacy disorders.  It is thought that an addict lacks the skills to develop close intimate relationship with a person, usually because these skills were not learned in early life.  Many people who were raised in a harsh, controlling or perhaps highly permissive environment are at higher risk to develop sexual addiction.  Feelings of inadequacy, rejection or low self-esteem can provide an environment for sexual addiction to flourish.   When a person isn’t able to connect with their primary caregiver or parental figures in a truly healthy manner, a lack of intimacy, emotional isolation and feelings of loneliness often develop

Sex addiction often progresses to the point that an addict will risk everything for sexual escape.  Many addicts feel deep shame about acting outside their values, and fear the risks and consequences, but are unable to quit.  Others minimize their problem or deny their addiction.

Warning Signs

Sex addiction is characterized by sexual preoccupation and an inability to stop detrimental behaviors.  The following are warning signs of sexual addiction:

Preoccupation with sexual thoughts and or behavior

Using sex to cope with anxiety or escape reality

Engaging in sexual behaviors that violate personal values

Lying to others to hide sexual acting out

Frequently engaging in online sexual activities

Loss of productivity at work

Loss of income

Participating in criminal sexual behaviors such as seeking out prostitutes or child pornography

Blaming other for one’s sexual behaviors

Engaging in high risk sexual behaviors

Putting self and others at risk for STDs

Loss of relationships due to sexual acting out

Feelings of guilt and shame after sexually acting out

Recovery from Sexual Addiction

Recovery from sexual addiction requires more than stopping the behavior, it depends upon behavioral change.  There are many components to sexual addiction.  A good psychological intake is helpful in determining underlying components.  The person may need medication to help with symptoms of depression, anxiety, obsessive compulsive disorder, etc.  They could also benefit from attending a support group.  If a person seriously engages in the recovery process, they can escape the chaos that sexual addiction creates.

Source – The Storm of Sex Addiction, Rescue And Recovery, by Connie A. Lofgreen, MSW, CSAT



We’ve probably all felt stress.  Sometimes it’s brief and highly situational, like being in heavy traffic.  Other times, it’s more persistent and complex – relationship problems, an ailing family member, a spouse’s death.  And sometimes, stress can motivate us to accomplish certain tasks.

Dangerous Stress

Stress becomes dangerous when it interferes with your ability to live a normal life for an extended period of time.  You may feel “out of control” and have no idea of what to do, even if the cause is relatively minor.  This in turn, may cause  you to feel continually fatigued, unable to concentrate, or irritable in otherwise relaxed situations.  Prolonged stress may also compound any emotional problems stemming from sudden events such as traumatic experiences in your past, and increase thoughts of suicide.

Natural Reactions

Stress can also affect our physical heath because of the human body’s built-in response mechanisms.  You may have found yourself sweating at the thought of an important date, or felt your heartbeat pick up while watching a scary movie.  These reacts are caused by hormones that scientists believe helped our ancestors cope with the threats and uncertainties of their world.

If the cause of your stress is temporary, the physical effects are usually short-term as well.  In one study, the pressure of taking exams led to increased severity of acne among college students, regardless of how they ate or slept.  The condition diminished after exams were over.  Abdominal pain and irregularity have also been linked to situational stress.

The longer your mind feels stressed; however, the longer your physical reaction system remain activated.  This can lead to more serious health issues.

Physical Wear and Tear

The old saying that stress “ages” a person faster than normal was recently verified in a study of women who had spent many years caring for severely ill and disabled children.  Because their bodies were no longer able to fully regenerate blood cells, these women were found to be physically a decade older than their chronological age.

Extended reactions to stress can alter the body’s immune system in ways that are associated with other “aging” conditions such as frailty, functional decline, cardiovascular disease, osteoporosis, inflammatory arthritis, type 2 diabetes, and certain cancers.

Research also suggests that stress impairs the brain’s ability to block certain toxins and other large, potentially harmful molecules.  This condition is also common to patients suffering from Alzheimer’s Disease.

Pressure Points

Although sudden emotional stress has been linked to severe heart dysfunction in otherwise healthy people, scientists are uncertain whether chronic stress alone causes cardiovascular disease.  What is clear is that excessive stress can worsen existing risk factors such as hypertension and high cholesterol levels.  Studies also show that people who are quick to anger or who display frequent hostility – a behavior common to those under stress – have an increased risk of heart disease.

Feelings of despair that accompany stress can easily worsen into chronic depression, a condition that can lead you to neglect good diet and activity habits.  This, in turn, can put you at a greater risk for heart disease, obesity, and kidney dysfunction.

Stress can also complicate your ability to recover from serious illness.  A Swedish study found that women who have suffered heart attacks tend to have poorer chances of recovery if they are also experiencing marital stressors such as infidelity, alcohol abuse, and a spouse’s physical or psychiatric illness.  On the other hand, stress management training is a proven method for helping speed recovery following a heart attack.

What Can You Do

Learning to deal with stress effectively is a worthwhile effort, even if you already consider yourself capable of handling anything life sends your way.  Many of the most common long-term stressors – family illness, recovery after injury, career pressures – often arise without warning and simultaneously.  Stress management is particularly valuable if your family has a history of hypertension and other forms of heart disease.  There does appear to be a mind and body connection with stress.

Source:  American Psychological Association


Attention-Deficit Hyperactivity Disorder

This article provides basic information on attention-deficit hyperactivity disorder (ADHD) in children and describes an approach to getting services and supports, called “systems of care,” that helps children, youth, and families thrive at home, in school, in the community, and throughout life.

In a classroom of 30 children or youth, it is likely that at least two students are affected by ADHD.  This surprisingly common condition makes it hard for children and youth to control their behavior (sit still, think before speaking or acting, etc.) and/or to pay attention.  If left untreated, it can lead to school or job difficulties, depression, relationship problems, and substance abuse.

What is attention-deficit hyperactivity disorder (ADHD)?  There are three types of ADHD:  the hyperactive-impulsive type, the inattentive type, and a type that is a combination of both.  The severity of ADHD varies among children, even siblings, so no two children will have exactly the same symptoms.  Also, you may hear that girls have lower rates and less severe cases of the disorder than boys.  More research is needed on this subject, but girls may have lower rates of the hyperactive type.

ADHD signs of hyperactive and inattentive types are as follows:                                                                                                                                                                                                       beach

Hyperactive-Impulsive – Feeling restless, often fidgeting with hands or feet, or squirming while seated; running, climbing, or getting up in situations where sitting or quiet behavior is expected; blurting out answers before hearing the whole question; and having difficulty waiting in line or taking turns.

Inattentive – May appear not to be listening or seems easily distracted by irrelevant sights and sounds; often failing to pay attention to details, and making careless mistakes; rarely following instructions carefully, and often losing or forgetting things like toys, pencils, books or other tools needed for a task; and often skipping from one uncompleted activity to another.

Experts believe that in some cases, heredity plays a role in whether or not a child has ADHD.  Symptoms of ADHD are first seen in children before age 6 and may cause problems at home, at school, or in relationships.  Sometimes, it is hard to tell if a child has ADHD because symptoms can be mistaken for typical childhood behaviors or other mental health issues, and ADHD often occurs at the same time that other conditions are present.  Equally important are the roles that a family’s culture and language play in how causes and symptoms are perceived and then described to a mental health care provider.  Misperceptions and misunderstandings can lead to delayed diagnoses, misdiagnoses, or no diagnoses – which are serious problems when a child needs help.  That is why only qualified health care or mental health care providers can diagnose ADHD, and why it is important that supports be in place to bridge differences in language and culture.

What happens after an attention-deficit hyperactivity disorder diagnosis?  If a qualified health care or mental health care provider has diagnosed your child with ADHD, he or she may suggest several different treatment options, including a combination of strategies for managing behaviors, medications, and talk therapy.  Your child’s health care or mental heath care provider may also suggest enrolling in a system of care, if one is available.

What is a system of care?  A system of care is a coordinated network of community-based services and supports that are organized to meet the challenges of children and youth with serious mental health needs and their families.  Families – as well as children and youth – work in partnership with public and private organizations so services and supports are effective, build on the strengths of individuals, and address each person’s cultural and linguistic needs.  Specifically, a system of care can help by: tailoring services to the unique needs of your child and family; making services and supports available in your language and connecting you with professionals who respect  your values and beliefs; encouraging you and your child to play as much of a role in the design of a treatment plan as you want; and providing services from within your community, whenever possible.

Data collected nationally suggests that systems of care are effective in treating attention-deficit hyperactivity disorder.

Source – U. S. Department of Health and Human Services


Obsessive-Compulsive Disorder (OCD)


Do you feel the need to check and re-check things over and over?  Do you have the same thoughts constantly?  Do you feel a very strong need to perform certain rituals repeatedly and feel like you have no control over what you are doing?  If so, you may have a type of anxiety disorder called obsessive-compulsive disorder (OCD).

Everyone double checks things sometimes.  For example, you might double check to make sure the stove or iron is turned off before leaving the house.  But people with obsessive-compulsive disorder feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over.  The thoughts and rituals associated with OCD cause distress and get in the way of daily life.

The frequent upsetting thoughts are called obsessions.  To try to control them, a person will feel an overwhelming urge to repeat certain rituals or behaviors called compulsions.  People with OCD can’t control these obsessions and compulsions.

For many people, OCD starts during childhood or the teen years.  Most people are diagnosed by about age 19.  Symptoms of OCD may come and go and be better or worse at different times.

People with obsessive-compulsive disorder have repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; acts of violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly tidy.  They do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again.  They can’t control the unwanted thoughts and behaviors.  They don’t get pleasure when performing the behaviors or rituals, but get brief relief from the anxiety the thoughts cause.  They spend at least 1 hour a day on the thoughts and rituals, which cause distress and get in the way of daily life.

OCD sometimes runs in families, but no one knows for sure why some people have it, while others don’t.  Researchers have found that several parts of the brain are involved in fear and anxiety.  By learning more about fear and anxiety in the brain, scientists may be able to create better treatments.  Researchers are also looking for ways in which stress and environmental factors may play a role.

When seeking treatment for OCD, you should talk to your doctor to make sure another physical problem isn’t causing the symptoms.  OCD is generally treated with psychotherapy, medication or both.  Doctors  commonly prescribe anti-anxiety and antidepressants for OCD.  Talk to your doctor about any side effects you may have.  Cognitive behavioral therapy is especially useful for treating OCD.  It teaches a person different ways of thinking, behaving and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively.  Exposure and response therapy can also be helpful in reducing obsessive-compulsive disorder behaviors.

National Institute of Mental Health – Obsessive-Compulsive Disorder:  When Unwanted Thoughts Take Over

Panic Disorder

People with panic disorder have sudden and repeated attacks of fear that last for several minutes.  Sometimes symptoms may last longer.  These are called panic attacks.  Panic attacks are characterized by a fear of disaster or of losing control even when there is no real danger.  A person may also have a strong physical reaction during a panic attack.  It may feel like having a heart attack.  Panic attacks can occur at any time, and many people with panic disorder worry about and dread the possibility of having another attack.

A person with panic disorder may become discouraged and feel ashamed because he or she cannot carry out normal routines like going to the grocery store or driving.  Having panic disorder can also interfere with school or work.

Panic disorder often begins in the late teens or early adulthood.  More women than men have panic disorder.  But not everyone who experiences panic attacks will develop panic disorder.

What are the signs and symptoms of panic disorder?

Sudden and repeated attacks of fearspin

A feeling of being out of control during a panic attack

An intense worry about when the next attack will happen

A fear or avoidance of places where panic attacks have occurred in the past

Physical symptoms during an attack, such as a pounding or racing heart, sweating, breathing problems, weakness or dizziness, feeling hot or a cold chill, tingly or numb hands, chest pain, or stomach pain


Panic disorder sometimes runs in families, but no one knows for sure why some people have it, while others don’t.  Researchers have found that several parts of the brain are involved in fear and anxiety.  By learning more about fear and anxiety in the brain, scientists may be able to create better treatments.  Researchers are also looking for ways in which stress and environmental factors may play a role.

The first step in treating panic disorder is to talk to your doctor about symptoms.  Your doctor should do an exam to make sure that another physical problem isn’t causing the symptoms.  The doctor may refer you to a mental health specialist.  Panic disorder is generally treated with psychotherapy, medication, or both.

A type of psychotherapy called cognitive behavior therapy is especially useful for treating panic disorder.  It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious and fearful.  Doctors also may prescribe medication to help treat panic disorder.  The most commonly prescribed medications for panic disorder are anti-anxiety medications and antidepressants.  Anti-anxiety medications are powerful and there are different types.  Many types begin working right away, but they generally should not be taken for long periods.

Antidepressants are used to treat depression, but they also are helpful for panic disorder.  They may take several weeks to start working.  Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping.  These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time.  Talk to your doctor about any side effect you may have.

It’s important to know that although antidepressants can be safe and effective for many people, they may be risky for some, especially children, teens, and young adults.  A “black box” – the most serious type of warning that a prescription drug can have – has been added to the labels of antidepressant medication.  These labels warn people that antidepressants may cause some people to have suicidal thoughts or make suicide attempts.  Anyone taking antidepressants should be monitored closely, especially when they first start treatment with medications.

Another type of medication called beta-blockers can help control some of the physical symptoms of panic disorder such as excessive sweating, a pounding heart, or dizziness.  Although beta blockers are not commonly prescribed, they may be helpful in certain situations that bring on a panic attack.

Some people do better with cognitive behavior therapy, while others do better with medication.  Still others do best with a combination of talk therapy and medication to treat panic disorder.

National Institute of Mental Health



Post-Traumatic Stress Disorder (PTSD)

Post-Traumatic Stress Disorder (PTSD) is a real illness.  You can get PTSD after living through or seeing a dangerous event, such as war, a hurricane, or a bad accident.  PTSD makes you feel stressed and afraid after the danger is over.  It affects your life and the people around you.  If you have PTSD, you can get treatment and feel better.

PTSD can happen to anyone at any age.  Children can get PTSD too.  You don’t have to be physically hurt to get PTSD.  You can get if after you see other people, such as a friend or family member, get hurt.

Living through or seeing something that’s upsetting and dangerous can cause PTSD.  This can include death or serious illness of a loved one, war, combat, car accidents, plane crashes, hurricanes, tornadoes, fires, violent crimes – like a robbery or shooting.

There are many other things that can cause PTSD.  Talk to your doctor if you are troubled by something that happened to you or someone you care about.  Call your doctor if you have any of these problems for at least 1 month:

Suffering from bad dreams

Feeling like the scary event is happening again (flashbacks)bythelake

Experiencing scary thoughts you can’t control

Staying away from places and things that remind you of what happened

Feeling worried, guilty or sad

Sleeping too little or too much

Feeling on edge

Fighting with loved ones or frequent angry outbursts

Thoughts of hurting yourself or others

Feeling alone

Children who have PTSD may show other types of problems such as behaving like they did when they were younger, being unable to talk, complaining of stomach problems or headaches a lot, refusing to go places or play with friends.

PTSD starts at different times for different people.  Signs of PTSD may start soon after a frightening event and then continue.  Other people develop new or more severe signs months or even years later.

PTSD can be treated.  A doctor or mental health professional who has experience in treating people with PTSD can help you.  Treatment may include “talk” therapy, medication, or both.  Treatment might take 6 to 12 weeks.  For some people, it takes longer.  Treatment is not the same for everyone.  What works for you might not work for someone else.  Drinking alcohol or using other drugs will not help PTSD go away and may even make it worse.

This article is from NIH – National Institute of Mental Health.

Family Therapy & Substance Abuse Cost Analysis

Family therapy & substance abuse cost analysis shows the value of these interventions.  Substance abuse has the potential for recovery & improved functioning.  The guideline developers reviewed published cost analyses.  Only a few studies have assessed the cost benefits of family therapy or have compared the cost of family therapy to other approaches such as group therapy, individual therapy, or 12-Step programs.  A small but growing body of data; however, has demonstrated the cost benefits of family therapy specifically for substance abuse problems.  Family therapy also has appeared to be superior in situations that might in some key respect be similar to substance abuse contexts.

For example, Sexton and Alexander’s work with functional family therapy (so called because it focuses its interventions on family relationships that influence and are influenced by, and thus are functions of, positive and negative behaviors) for youth offenders found that family therapy nearly halved the rate of re-offending – 19.8 percent in the treatment group compared to 36 percent in a control group.  The cost of the family therapy ranged from $700 to $1,000 per family for the 2-year study period.  The average cost of detention for that period was at least $6,000 per youth; the cost of a residential treatment program was at least $13,500.  In this instance, the cost benefits of family therapy were clear and compelling.  Other studies look at the offset factors; that is, the relationship between family therapy and the use of medical care or social costs.  Fals-Stewart et al. (1997) examined social costs incurred by clients (for example, the cost of substance abuse treatment or public assistance) and found that behavioral couples therapy was considerably more cost effective than individual therapy for substance abuse, with a reduction of costs of $6,628 for clients in couples therapy, compared to a $1,904 reduction for clients in individual therapy.

Similar results were noted in a study by the National Working Group on Family-Based Interventions in Chronic Disease, which found that, 6 months after a family-focused intervention, reimbursement for health services was 50 percent less for the treatment group, compared to a control group.  While this study looked at chronic diseases such as heart disease, cancer, Alzheimer’s disease, and diabetes, substance abuse also is a chronic disease that is in many ways analogous to these physical conditions.  Both chronic diseases and substance abuse:fam

* Are long-standing and progressive

* Often result from behavioral choices

* Are treatable, but not curable

* Have clients inclined to resist treatment

* Have high probability of relapse

Chronic diseases are costly and emotionally draining.  Substance abuse is similar to a chronic disease, with potential for recovery; it even can lead to improvement in family functioning.  Other cost benefits result from preventive aspects of treatment.  While therapy usually is not considered a primary prevention intervention, family-based treatment that is oriented toward addressing risk factors may have a significant preventive effect on other family members.  For example, it may help prevent substance abuse in other family members by correcting maladaptive family dynamics.