Clinical Specialties
My practice is focused on three categories of behavioral addiction: gambling disorder, compulsive sexual behavior, and compulsive gaming and technology use. Each is a distinct clinical condition with its own presentation, its own treatment considerations, and its own research base.
All three share something in common that substance addictions also share: a loss of control over a specific behavior that continues despite meaningful negative consequences, and a set of neurobiological and psychological mechanisms that distinguish clinical addiction from ordinary behavior. Understanding behavioral addictions in this frame — as treatable conditions rather than as character problems — is where meaningful treatment begins.
What follows is an overview of each specialty. If any of these descriptions resonate with your experience, the first step is a short conversation.
Gambling Disorder
What it is:
Gambling disorder is a recognized behavioral addiction characterized by persistent and problematic gambling behavior that continues despite significant personal, financial, relational, or occupational consequences. The condition has measurable neurobiological features and responds to specific treatment approaches.
Gambling disorder was formally recognized in the DSM-5 (2013) as the first non-substance behavioral addiction, reclassified from its earlier designation as an impulse control disorder. The reclassification reflected a growing research base showing that gambling disorder shares clinical features, brain reward mechanisms, and effective treatment approaches with substance use disorders.
How it presents:
Gambling disorder presents differently than most people expect. The classical image — a man at a casino losing his paycheck — is increasingly the exception rather than the rule. Most current cases involve:
Mobile sports betting, which has expanded dramatically since 2018 and has become the fastest-growing vector for new gambling disorder cases
Online casino play, poker, and fantasy sports
Day trading and speculative investing that has crossed into compulsive patterns
Cryptocurrency trading with the structural features of gambling
Common features across presentations include: gambling more money than planned, gambling to recover losses (chasing), hiding gambling from family or partners, borrowing to gamble or to cover gambling losses, neglecting work or family responsibilities, and continued gambling despite clear negative consequences.
Many clients arrive at specialty care only after a financial disclosure, a partner's discovery, or a professional or legal consequence has forced the problem into the open.
How I work with it:
I hold the Internationally Certified Gambling Counselor – I (ICGC-I) credential from the International Gambling Counselor Certification Board, and I've treated gambling disorder in residential and outpatient settings throughout my career. Treatment typically includes assessment of the specific gambling pattern and its function, motivational and cognitive-behavioral work around the disorder itself, financial and relational repair planning, and ongoing work with co-occurring conditions where relevant. I collaborate with financial counselors, debt advisors, and family therapists when appropriate.
If gambling has become a serious problem in your life or the life of someone you're advising, I'd welcome the conversation.
Compulsive Sexual Behavior
What it is:
Compulsive sexual behavior is a clinical pattern of loss of control over sexual thoughts, urges, and behaviors that continues despite meaningful negative consequences. The condition is recognized in the ICD-11 as Compulsive Sexual Behavior Disorder (CSBD), and there is a substantial clinical and research literature supporting its treatment as a specialty condition.
The defining feature of compulsive sexual behavior is not the specific behavior but the relationship to it. Many people engage in the same behaviors without clinical problems. What distinguishes a clinical presentation is the pattern of loss of control, continued behavior despite consequences, use of the behavior for emotional regulation or escape, escalation over time, and the sense of distress and secrecy the behavior generates.
How it presents:
Compulsive sexual behavior presents across a range of specific patterns:
Problematic pornography use, often escalating in content, time, or privacy concerns
Compulsive use of sexual services, massage parlors, escorts, or sugar arrangements
Repeated infidelity or secret sexual relationships that the client is unable to stop
Compulsive use of hookup apps, dating apps, or anonymous sexual contact
Compulsive masturbation patterns that interfere with relationships or functioning
Escalation into higher-risk or more secretive sexual activities
For many clients, the condition is marked by a profound double life: a public self that is often highly functional, and a private pattern that has become increasingly unmanageable. Shame and secrecy are defining features, and these features are often what prevent clients from seeking help for years.
Many clients arrive at specialty care after disclosure to a partner, a consequence at work, or a personal moment of recognition that the pattern has become clearly unsustainable.
How I work with it:
I hold the Certified Sex Addiction Therapist – Supervisor (CSAT-S) credential from the International Institute for Trauma and Addiction Professionals. The CSAT-S designation authorizes both practice in this specialty and supervision of other clinicians pursuing CSAT certification. I've worked with compulsive sexual behavior in residential and outpatient settings throughout my career.
Treatment typically includes thorough assessment of the sexual behavior pattern and its function, work on the underlying emotional regulation and attachment patterns that often drive compulsive sexual behavior, integration with partner work or couples treatment when appropriate, and trauma-informed work where relevant. Where a partner has been affected by disclosure, I can provide referrals to partner specialists, since clinical work with the client and the partner simultaneously is generally not recommended.
If compulsive sexual behavior is a concern for you or for a client you're considering referring, the first step is a short conversation.
Compulsive Gaming and Technology Use
What it is:
Compulsive gaming and problematic technology use are emerging clinical concerns with a growing research base. Gaming disorder is recognized in the ICD-11, and broader patterns of compulsive technology use — including social media, streaming, and digital content consumption — are being studied as related phenomena sharing common features with behavioral addictions.
The defining features are similar to other behavioral addictions: loss of control over the behavior, continued use despite significant negative consequences, use of the behavior for emotional regulation or escape, and meaningful impairment in functioning, relationships, or development.
How it presents:
Compulsive gaming and technology use present across several patterns:
Compulsive video gaming, often online multiplayer games with social or competitive features, that has begun to interfere with work, education, sleep, or relationships
Compulsive use of streaming platforms, YouTube, or on-demand content that has become escape behavior
Compulsive social media use with features resembling addiction (cycles of anticipation, reward, dysregulation, and repeated return)
Smartphone overuse that the client recognizes as excessive and unwanted but feels unable to change
Pattern of nights lost to technology, with daytime functioning impaired
In adult men, these patterns often present alongside gambling or sexual behavior concerns and rarely arrive at specialty care as a standalone primary complaint. More often, compulsive gaming and technology use are identified during assessment for another behavioral addiction, or are raised as a concern by a partner or family member before the client views them as clinically significant.
How I work with it:
My practice addresses compulsive gaming and technology use both as primary clinical concerns where the client presents with them as their primary issue, and as components of a broader behavioral addiction picture where they co-occur with other patterns. Treatment approaches draw on cognitive and behavioral work, motivational interviewing, assessment of the behavior's function in the client's broader life, and environmental and structural interventions around technology access. When the pattern co-occurs with gambling or compulsive sexual behavior, I address the full clinical picture rather than treating each pattern as separate.
If compulsive gaming or technology use is affecting your life or the life of someone you're advising, I'd welcome the conversation.
Let's talk before you decide.
Consultations are 15 minutes, at no cost, and carry no obligation. We'll discuss what's going on, whether my practice is the right fit, and what a potential path forward might look like.