Psychological Treatment of Hypersexuality: a Clinical Trial With Acceptance and Commitment Therapy
Phase: NA
Conditions: Compulsive Sexual Behavior, Hypersexuality
Sponsor: Universidad Europea de Madrid

 
 
 
 
 
 
 
Psychological treatment of hypersexuality: a clinical trial with 
Acceptance and Commitment Therapy 
ID: CIPI/21/003 
Document date: 8th January 2021 
IP: Francisco Montesinos, Ph.D. 
Study Protocol and Statistical Analysis Plan  
 
 
 

Study Protocol:  
• Objective: To study the efficacy of an abridged intervention aimed at 
increasing psychological flexibility and sexual impulse control in 
people with clinically significant hypersexuality. 
• Design: Open clinical trial without control group 
• Methods.  
 
After being informed about the study, all patients giving written 
informed consent will be assessed to determine eligibility for study 
entry. Patients who meet eligibility requirements will receive 
psychological intervention consisting in an 8-session individual on 
line-delivered ACT-based treatment. The participants will be 
assessed through self-report instruments before and after treatment 
and at 3 months follow-up. Self-monitoring measures will be 
completed before every session. 
Intervention protocol. 
Session 1. Values clarification. Funeral exercise (Hayes et al., 2012). 
Garden metaphor (Hayes et al., 2012).  
Session 2. Creative hopelessness. Sharing functional analysis with 
the client. Control in the problem, not the solution. Hungry tiger 
metaphor (Eifert & Forsyth, 2005). Chocolate Cake task (Hayes et 
al., 2012). Establishing valued commitments in the presence of 
craving or discomfort. 
Session 3. Increasing awareness of physical sensations and 
consequences of avoidance behaviors. Training cognitive defusion 
and promoting self-as-context. Physicalizing Exercise (Hayes et al., 
2012). The Soldiers in the Parade exercise (Hayes et al., 2012). 
Exposure to cravings and discomfort exercise. Learning to choose 
which train to take. Establishing new valued commitments. 
Session 4. Increasing psychological flexibility: learning how to 
choose. Training cognitive defusion and promoting self-as-context. 
Body-scan exercise (Segal et al., 2015, p.67). Exposure to cravings 
and discomfort exercise. Establishing a commitment of reducing 
hypersexual behaviors. 

Session 5. Listening to the messages from our mind. Shops Street 
metaphor (Wilson & Luciano, 2002, p.115). Leaves on a stream 
meditation (Hayes et al., 2012). Establishing a new commitment of 
reducing hypersexual behaviors. 
Session 6. Deepening in body awareness. Taking care of “my 
garden”. Training cognitive defusion and promoting self-as-context. 
Body-scan exercise (Segal et al., 2015). Physicalizing Exercise 
(Hayes et al., 2012). Differentiating between values, goals, 
committed actions and barriers in on valued areas. Establishing new 
commitments. 
Session 7. Making peace with emotional pain. Training cognitive 
defusion and promoting self-as-context. Learning to choose opening 
to discomfort in order to live a fulfilling life. Exposure exercise to 
deep pain. Self-compassion exercise. 
Session 8. Relapse prevention. Bycicle metaphor (Hayes et al., 
2012). Identifying future risk situations. Exposure exercise to future 
risk situations. Renewing commitments. 
 
Statistical Analysis Plan (SAP):  
The results will be analysed through non-parametric techniques 
(comparisons of pre, post and follow-up group means). Within-subject 
analyses will be performed. Non-overlap effect size measures will be used 
to estimate the magnitude of therapeutic change. The statistical approach of 
Jacobson and Truax (1991) will be used to estimate the clinical significance 
of the effect.