Program Description

The Pathway to Freedom IOP for sexual addiction of Meier Clinic is a program of intensive psychoeducation and group psychotherapy designed to focus on recovery from compulsive sexual behavior. The core curriculum used is the Recovery Start Kit created by Dr. Patrick Carnes. The first 130 days of recovery is the focus, as research shows that a solid foundation of information, structure, and accountability is crucial to long-term success. The IOP is appropriate for (1) adults experiencing a current crisis related to sexually acting out, (2) an acute escalation of addictive sexual behaviors, (3) those struggling with chronic relapse, continuing out-of- control behaviors despite therapy or 12-Step work, or (4) having recently been discharged from a treatment center. While clients can benefit from working through RSK individually with a trained sex addiction therapist, it is by far superior to do it as part of a group. The Pathway to Freedom program is the ideal vehicle.

Contact us for more information about this exciting, ground-breaking program.

An Intensive Outpatient Program for Treatment of Sex Addiction

It is no secret that our culture has become increasingly sex-obsessed for the past 50 years. The “Playboy” generation has brought new, more liberal views of how sexuality is viewed and practiced in our western society. Many thought that this would bring healthier, more flexible and fulfilling sexual lifestyles. The reality, however, is that, in alarming numbers, men and women have now experienced painful consequences to various sexual behaviors--and are finding themselves unable to stop or reduce sexual behaviors that are destroying them emotionally, vocationally, relationally, and spiritually. Patrick Carnes, the leading researcher and clinician on this phenomenon known as sex addiction, has been working for 30 years to learn the dynamics, underlying issues, and best practices in the treatment of this compulsion. Out of this experience he created a treatment modality known as the Task-Centered Model, which has been proven to be highly effective in the treatment of sexual compulsivity. RECOVERY START is the crown jewel in guiding the client toward successful engagement in this process.

Program Structure

The program model is an 8-week module. Each of the 8 Saturdays focuses on a specific task of recovery. Clients meet on Saturdays from 9:00 a.m-12:00 p.m. and 1:00 -4:00 p.m. Wednesday evenings 6:15-9:15 p.m. consist of 1 1/2 hours of group psychotherapy and 1 1/2 hours of processing assignments from Saturday’s module. The Recovery Start Kit and the workbook Facing the Shadow are required materials and are included in the fee.

Spouses are, when appropriate, encouraged to be involved at some point in the IOP process. From the 3rd Saturday on, spouses are offered couples sessions by phone or in person. There are special psycho-educational sessions available for family members to help direct and support them during this difficult period in their lives. Additionally, we have extensive material on our site for

Program Components

  • Task-centered approach
  • Didactic-recovery modules
  • Group psychotherapy
  • Cost effective as compared to inpatient treatment
  • Provides more focus and structure than is possible in outpatient therapy
  • Opportunity to continue trauma work, couples therapy, and 1:1 sessions concurrently with primary therapist
  • Consultation and coordination of treatment with referring therapist
  • Referrals to other professionals familiar with the treatment of sexual addiction, for medication, couple work, substance abuse or ongoing individual therapy


"What I have seen is that people who use it [Recovery Start] as it is intended to be used are making significant changes in their recoveries. Specifically, I see it being helpful in two ways; first, for clients who have been unable to maintain sexual sobriety and are experiencing chronic relapse, it affords them an opportunity to raise their focus to a new level so they can gain a foothold and stop the bleeding. Secondly, it allows clients who are at various stages of recovery to gain a deeper understanding of themselves, especially regarding how they have been vulnerable to this particular form of acting out. The core dialogues in the 40 Day Focus are so effective in helping clients attain this insight.

I have worked with at least 10 clients through the RSK and have seen people move from chronic relapse to actually gaining a foothold on sobriety. I’ve seen others who have years of sobriety go deeper into their recoveries than ever before. For both groups, the result is a sense of empowerment and healing.” Bill B., CSAT

Recovery Start Author Details Science Behind Curriculum

{The following is an excerpt from the introduction of the RSK. Dr. Carnes describes some of the neuroscience foundations of the Recovery Start process.}


The Hijacked Brain

We sometimes use the term “hijacked brain” to describe addictions. It helps to understand that the brain makes three billion decisions a second. Most of that activity we are not aware of. You do not think about your heartbeat or your breathing, let alone the complex neural circuits that manage hormone balance, waste management, or disease containment. These functions literally are on “automatic pilot". Some people who have mastered deep focus abilities have been able to alter these on-going parts of our body’s functioning. Most of us rely on our built-in wiring and give it no thought.

Our brain streamlines learning so that we don’t have to think about it further. Once a bicycle is mastered, it only takes moments to reorient those skills and use them without thinking. Learning becomes part of the automaticity of the brain. Learning a language is awkward at first, but when fluent we do it without thinking. The term for this is "unconscious competence". Our remarkable brains have become so efficient that we streamline our learning so that we no longer have to think about it.

Sometimes this backfires on us. eg. you might be driving on the freeway and you are late for a meeting. You come to the exit that you usually take to go home. You turn off the freeway as if you were going home. You become angry with yourself; “How could I do that!” This habitual behavior will now make you even later. What you experienced was a hijacked brain. You intended to go one place, but ended up going another. Your brain was doing what it was programmed to do. This is how addiction works. The addict intends to go one way--sometimes with great resolve. Yet despite best efforts and intentions he/she goes another way. All of this is followed by the addict’s despair because an addict sees “out-of-control” choices as a matter of willpower.

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Reality is different. Addiction starts with a hijacked brain. In addiction, the brain has damage and has been altered so that the addict invariably repeats bad choices. Perhaps you have seen a tree that has grown up shaded by larger trees. As a result it has grown in some grotesque ways in order to get some share of the sun’s rays. Similarly, the dendrites (branches of your brain’s neurons) grow differently. Whether it is methamphetamines, machine video poker, or cybersex, each binge alters the biology of the brain. The pulse of pleasure becomes a way that the brain uses to balance itself. Hunger becomes a deep craving that grows, like the shaded tree requiring more sun in its distorted reach for the sky. And it becomes part of the brain’s automatic pilot.


Parallel to all addictions, sex addiction appears to involve disconnecting from the judgment and “common sense (frontal lobes) part of the brain. It is biologically driven verses “will” driven. Addicts want and know which way they wish to go but end up going the other way. Outsiders see it as a moral issue, but addicts have long known there was something different about them. Even the Big Book of Alcoholics Anonymous spoke of “some of us crying for sex, never seeming to have enough.” For sex addicts, early research shows that the anterior cingulate (the part of the brain that multi-tasks and shifts gears) will get locked into craving more novelty, intensity, danger, and risk in order to get the same result. We call this tolerance, which basically means the automatic pilot quickly makes the routine not enough. While much more research needs to be done, it is very clear that the deep mid-brain, which is so involved in our sexual wiring, is also involved. Early sexual, physical, and emotional trauma, for example, can fundamentally alter our sexual responses--and our responses in general. Some recent preliminary research indicates that of all stimuli, including violence, the brain codes erotic scenes twenty percent faster. Sex addicts tap into one of the most easily accessed and most potent parts of our neurochemistry. So when courtship goes awry in the brain, the loss of choice becomes a big problem.

Part of recovery in general will be to learn about how your brain works and how addiction is now a biological problem. This series is designed to help you start changing how your brain responds to sexual cues. The process takes ultimately three to five years before cravings cease to be a day-to-day problem. It takes a while to grow your brain into new patterns. We have to start by understanding that what your brain perceives as real might not be reality at all. This shift requires a shift in “paradigm” or how you see the world personally and sexually.

The good news is that change is possible. And the rewards for changing are rich. Most recovering people ultimately regard their addiction as a gift. Recovery gives a depth most humans never acquire. The process teaches skills, provides wisdom and wonderful experiences that powerfully improve life. When you are in the midst of wreckage because of the problem behavior, this concept is tough to grasp. Many have gone before you and know that this is true. While hard to believe, it is important that you understand that the reprogramming part, while difficult, is achievable and worthwhile.

How Recovery Start Retrains the Brain

The bad news is that starting is difficult because addicts battle their own bodies. Beginning recovery requires deep attention. The Recovery Start program is designed to help you with that. Progress starts with establishing sobriety. Like a stroke victim, an addict has “regrow” parts of the brain. The first steps are agony. Some people can do this on an outpatient basis. Others need the structure of an inpatient setting. Recovery Start works in both. The first 130 days are critical to being able to do the deep, long-term reprogramming necessary. After completion of the 130 days, the program that follows this, The Recovery Zone, will guide you through this deeper work--which you cannot do well if you are still “in the problem."

The principles of Recovery Start rely on what we have learned about engaging the brain in those first agonizing steps. First, we have to fundamentally involve the “common sense” or executive function of the brain. Each exercise or process is designed to help your brain focus. Some activities, for example, require copying over work to consolidate or add to the process. This “rerecording” may seem like busy work but actually is of great importance. Research shows that the physical process of handwriting (as opposed to typing) engages the brain, creating a refining process very similar to adjusting the focus as in a microscope or camera. The actual physical act enhances change. Additionally, there is an important consolidation process which affects learning and memory. RS was carefully designed to impact your change on a daily and weekly basis over the 130 days. The recipe of focussing on various aspects of your behavior and the early “tasks” of your recovery will work, but only if you follow the steps.

Another example is that RS,as well as recovery in general, relies on sharing your work with others. Explaining what you have learned and receiving feedback stimulates the neurons. Your brain has to shift gears which deepens new learning. Equally important to significant brain change is the process of bonding to those you share with. Few things impact change in the brain more than attachment. For many addicts this is where some of their deepest wounding has occurred. So when an assignment is to share your work with others, it is very important to follow the recipe. Recovery demands living “in consultation” because living in isolation did not work. The deficits need to be made up and the brain will incorporate new learning at a profound level. Your brain will become healthier. Much of recovery is learning how to care for this important organ.

Therapy is a critical part of this interaction process. Your therapy relationship will be different than other relationships. Your therapist has been specially trained to work with the gear-shifting parts of the brain that maximizes the stimulation. A well-trained therapist teaches specific strategies to help your brain to manage better. Your brain will actually become more functional over time as a result. In some ways it is like having a good piano teacher. By reading a book you may learn to read the notes and play the keys but never really capture the melody. A good teacher brings out the melody and assists until it becomes effortless (unconscious competence). We cannot stress strongly enough the importance of doing this program with a trained therapist.

Pat Carnes, 2006