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Psychotherapy for problematic pornography use: A comprehensive meta-analysis
Carlos López-Pinar1, Javier Esparza-Reig1, Beata Bőthe2,3
11Department of Psychology, European University of Valencia, Valencia, Spain.
Journal of Behavioral Addictions
|March 24, 2025
Summary
Psychotherapy, including cognitive behavioral therapy and acceptance and commitment therapy, effectively reduces problematic pornography use (PPU) and related issues. Further research with rigorous methods is needed to confirm these findings.
Area of Science:
- Psychology
- Clinical Psychology
- Behavioral Science
Background:
- Problematic pornography use (PPU) causes distress and functional impairment.
- Psychotherapy is a primary intervention, but its efficacy for PPU is understudied.
- Therapists often lack awareness of evidence-based PPU treatments.
Purpose of the Study:
- To systematically review and synthesize evidence on psychotherapy for PPU.
- To evaluate the efficacy of interventions for PPU and associated craving.
- To inform clinical practice with evidence-based treatment strategies.
Main Methods:
- Conducted a meta-analytic systematic review.
- Included 20 studies with 2,021 participants.
- Analyzed data using random-effects models, subgroup analyses, and meta-regressions.
Main Results:
- Psychotherapy significantly improved PPU, pornography use frequency/duration, and sexual compulsivity (large effect sizes).
- Craving showed smaller effect sizes; depression symptoms had moderate effects.
- Single-case designs confirmed clinically significant reductions in PPU and craving.
Conclusions:
- Cognitive behavioral therapy and acceptance and commitment therapy are effective for PPU.
- Findings support using evidence-based interventions in clinical practice.
- High risk of bias necessitates more rigorous future research, including RCTs.
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