Recent surveys find that 11% of American men and 3% of American women self-identify as having an addiction to pornography. With an average of 7% between the two genders, it’s estimated that about 18,200,000 American adults struggle (as they see it) to maintain a healthy relationship with their consumption of sexually explicit content.
Given that problematic porn use is associated with symptoms that negatively impact emotional wellbeing, mental health, and overall quality of life, tens of thousands of Americans each month seek help from counseling services that specifically address the hyper-sexuality disorder. Among this group, are those who question or wonder about the efficacy of counseling for problem porn use.
Does pornography therapy work?
To answer this, clinicians employ measurement-based care (MBC) as a standard for monitoring treatment effectiveness, improving client outcomes, and facilitating communication between clients and clinicians. There are a number of measurements that clinicians use to determine positive outcomes when it comes to pornography therapy. One important measurement to look at, are engagement rates/scores. These generally refer to how often individuals participate in treatment or services, such as attending therapy sessions or using a digital mental health tool. It can also describe a client’s active involvement, commitment, and emotional connection to the therapeutic process, which involves more than just “showing up”. It is a strong predictor of recovery and positive outcomes. Engagement in counseling services can be understood in dimensions. Behavioral engagement refers to a client’s adherence to treatment, such as following through on session attendance, completing clinician-provided workbooks, or using virtual modules as intended. It also includes the active effort clients make within treatment, such as communicating openly and making real-life changes. Meanwhile, cognitive engagement references a client’s belief in the treatment rationale, perceiving it as appropriate for reaching their goals, and actively using their newly acquired (through counseling) skills. In addition, there is affective engagement, which relates to a client’s emotional experience, including their interest in and interaction with the content provided by a counselor and/or treatment platform, such as. this self-help guide for pornography.
It’s important to note that how engagement is measured and scored can vary by clinical setting.
Kindbridge Behavioral Health (KBH) uses TCU Treatment Engagement Data as a key component of measuring client outcomes. The TCU Treatment Engagement Form (ENGForm) is a self-report assessment developed by Texas Christian University (TCU) to measure client engagement in addiction treatment. It consists of three-dozen items across four scales, including the following:
- Treatment Participation: This assesses and tracks how actively clients are participating and engaging in their treatment.
- Treatment Satisfaction: This provides a more comprehensive picture of a client’s progress and the effectiveness of care.
- Counselor Rapport: This references the therapeutic relationship and/or emotional connection a counselor builds with a client, characterized by agreement, mutual understanding, and a harmonious relationship.
- Peer Support: This references engagement in a supportive environment (i.e. group counseling) where clients connect with peers regarding shared behavioral/mental health issues.
These scales are used to inform pornography treatment planning and track changes in client engagement over time. They are scored on a range from 10 to 50 and use Response Mapping that references 5-point scores (1 = “strongly disagree” to 5 = “strongly agree”) that are averaged and then multiplied by 10 to produce the final score. Scores above 30 suggest that a client is largely in agreement with the positive statements associated with that scale, while scores below 30 indicate that the client is largely in disagreement with the positive statements. Logically, higher scores reflect a stronger level of engagement while lower scores suggest a lower level of engagement.
With an understanding of what engagement in the context of pornography addiction treatment is, and how it is measured, we now look to the results of the most recent Treatment Outcomes (Q2, 2025) for Kindbridge clients who have entered into counseling for sexual health concerns, including problematic use of pornography.
Q2 2025 Treatment Report on Client Engagement Indicates Positive Outcomes for Those in Therapy for Problematic Use of Pornography
The table below shows the four scales used in measuring engagement, taken over three separate assessments (during Q2 of 2025) of KBH clients in therapy for sexual health concerns, including problematic use of pornography.
| SCALE | Assessment 1 Score | Assessment 2 Score | Assessment 3 Score |
| Counselor Rapport | 36 | 45.33 | 48 |
| Peer Suport | 32.8 | 38.67 | 30 |
| Treatment Participation | 36.2 | 42.67 | 44 |
| Treatment Satisfaction | 38.6 | 46.67 | 45 |
Average scores improved across the board from the first assessment to the second assessment. In all cases, with exception of “Peer Support”, the third assessment score was higher than the first. While fluctuations are absolutely expected, the lower “Peer Support” score in the third assessment may convey that individuals are somewhat less interested in group therapy environments for pornography when compared to other behavioral health issues. For instance, engagement rates for group counseling have shown to be VERY high in treating problem gambling (view recent data). People may view there to be more of a stigma in discussing a problematic relationship with sexually explicit content with peers. More data from Q3 and Q4 of the current annum will unveil if there is a trend, or if the decrease is an anomaly. In either case, overall engagement rate scores highlight that counseling for sexual health concerns, including problematic use of pornography, is effective.
Graph features scores for all KBH counseling services, pornography therapy included
Would you like to learn more about our pornography therapy services? Do you have additional questions about how we will measure your treatment progress? Or, are you ready to move forward with counseling, beginning with a FREE assessment for sexual health and potentially cooccurring issues? Reach out via your preferred form of contact provided below.
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