1. Were you sexually abused as a child or adolescent?
2. Have you subscribed or regularly purchases/rental sexually explicit magazines or videos?
3. Did your parents have trouble with their sexual or romantic behaviors?
4. Do you often find yourself preoccupied with sexual thoughts?
5. Has your use of phone sex lines, computer sex lines, etc, exceeded your ability to pay for these services?
6. Does your significant
other(s), friends or family ever worry or complain about your sexual behavior? (Not related to sexual orientation.)
7. Do you have trouble stopping your sexual behavior when you know it is inappropriate and/or dangerous to your health?
8. Has your involvement with pornography, phone sex, computer board sex, ext. become greater than your intimate contacts with romantic partners?
9. Do you keep the extent or nature of your sexual activities hidden from your friends and/or partners?
10. Do you look forward to events with friends or family being over so that you can go out to have sex?
11. Do you visit sexual bathhouses, sex clubs and/or video bookstores as a regular part of your sexual activity?
12. Do you believe that anonymous or casual sex kept you from having more long-term intimate relationships or from reaching other personal goals?
13. Do you have trouble maintaining intimate relationships once the "sexual newness" of the person has worn off?
14. Do your sexual encounters place you in danger of arrest for lewd conduct or public indecency?
15. Have you spent time worrying about being HIV positive & continue to engage in risky or unsafe sexual behavior anyway?
16. Has anyone ever been hurt emotionally by events related to your sexual behavior, e.g., lying to partner or friends, not showing up for event/appointment due to sexual liaisons, etc.,? (not related to sexual orientation)
17. Have you ever been approached, charged, arrested by the police, security, etc., due to sexual activity in a public place?
18. Has sex been a way for you to escape your problems?
19. When you have sex, do you feel depressed afterwards?
20. Have you made repeated promises to yourself to change some form of your sexual activity only to break them later? (Not related to sexual orientation.)
21. Have your sexual activities interfered with some aspect of your professional or personal life, e.g. unable to perform at work, loss of relationship? (Not related to sexual orientation.)
22. Have you engaged in unsafe or "risky" sexual practices even though you knew it could cause you harm?
23. Have you ever been paid for sex?
24. Have you ever had sex with someone just because you were feeling aroused and later felt ashamed or regretted it?
25. Have you ever cruised public restrooms, rest areas and/or parks looking for sexual encounters with strangers?
+13 yes answers is a potential problem
CREDIT TO Patrick Carnes, Ph.D & Robert Weiss, CSW
MEN'S
SEXUALITY GROUP THERAPY
1. Were you sexually abused
as a child or adolescent?
2. Have you subscribed or
regularly purchases sexually explicit magazines like Playboy or Penthouse?
3. Did your parents have
trouble with sexual behavior?
4. Do you often find
yourself preoccupied with sexual thoughts?
5. Do you feel that your
sexual behavior is not normal?
6. Does your spouse (or
significant other(s), ever worry or complain about your sexual behavior?
7. Do you have trouble
stopping your sexual behavior when you know it is inappropriate?
8. Do you ever feel bad
about your sexual behavior?
9. Has your sexual behavior
ever created problems for you or your family?
10. Have you ever sought
help for sexual behavior you did not like?
11. Have you ever worried
about people finding out about your sexual activities?
12. Has anyone been hurt
emotionally because of your sexual behavior?
13. Are any of your sexual
activities against the law?
14. Have you ever made
promises to yourself to quit some aspect of your sexual behavior?
15. Have you ever made
efforts to quit a type of sexual activity and failed?
16. Do you have to hide some
of your sexual behavior from others?
17. Have you attempted to
stop some parts of your sexual activity?
18. Have you ever felt
degraded by your sexual behavior?
19. Has sex been a way for
you to escape your problem?
20. When you have sex, do
you feel depressed afterwards?
21. Have you felt the need
to discontinue a certain form of sexual activity?
22. Has your sexual activity
interfered with your family life?
23. Have you ever been
sexual with minors?
24. Do you feel controlled
by your sexual desire?
25. Do you ever think about
sexual desire is stronger than you are?
+13 YES
ANSWERS IS A POTENTIAL PROBLEM
credit to Patrick Cornes, Ph.D
MEN'S
SEXUALITY GROUP THERAPY
