Effective intimacy? : Evaluating intimacy focused therapy for 'out-of-control' sexual behaviour : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Philosophy at Massey University, Manawatu campus, New Zealand
Difficulties with intimacy are considered to be important to the development and maintenance of ‘out of control’ sexual behaviours (OCSB) yet the small body of research into OCSB therapies has not included an intimacy-based therapy approach (Reid & Woolley, 2006). Specialist service Sex Therapy New Zealand (STNZ) uses such an approach which was formalised by the researcher and termed ‘Intimacy Focused Therapy’ (IFT) for the purposes of being evaluated in the current study. A single-case design with non-concurrent multiple baseline across participants was used with 12 volunteer men with OCSB who completed up to 12 sessions of IFT with STNZ therapists. Participants rated their sexual behaviour, negative consequences of sex, adult attachment, and fear of intimacy at baseline, post-therapy, and over a three-month follow-up phase. Weekly self-report data was collected on the duration and frequency of sexual activity as well as associated distress. Compared to baseline, there were improvements in participants’ control over their sexual behaviour, reductions in negative consequences experienced, as well as reduced distress regarding sexual behaviour post-treatment. Changes in fear of intimacy and attachment were less obvious, although dismissing and preoccupied attachment each slightly reduced or increased for several participants. Secure and fearful attachment showed limited change in either direction. Weekly sexual behaviour did not follow a clear pattern of change, although some behaviour’s reduced for some participants over therapy while others stayed the same or increased. Follow-up data showed that changes at the end of therapy were largely maintained or continued over three months post-therapy. These individual outcomes support the potential effectiveness of IFT as a treatment for OCSB, but do not support the notion that improvements to fear of intimacy or attachment are affected by this approach. Future research that examines IFT over a longer duration of time, utilising measures that capture the mechanisms that effect change in this therapy approach, are recommended to establish the role of intimacy and attachment in therapy for OCSB.