INITIAL ASSESSMENT INFO

Why Your Therapist Referred You for an Assessment With Josh Lewis

A clear, supportive explanation for clients entering the recovery process

When a therapist refers you to me for an assessment, it is not a diagnosis, a punishment, or a label. It is a clarifying step—a way to understand why certain patterns are happening in your life and what form of support will actually work for you.

Most people are referred because their therapist wants a fuller picture of what’s driving their behaviors, stress, or relationship struggles. In other words:

Your therapist is not “handing you off.” They’re strengthening your treatment by bringing in a specialist.

Here’s what that means, and what the process looks like.

 

1. Why You Were Referred

Therapists refer clients to this assessment when they recognize that deeper forces may be shaping their behavior or emotional world. This often includes:

• Compulsive or out-of-control sexual behavior
  
  
• Difficulty stopping behaviors despite consequences
  
  
• Relationship turmoil, secrecy, or shame
  
  
• Emotional reactions that feel “bigger than the moment”
  
  
• Long-standing avoidance, anxiety, or intensity in intimacy
  
  
• A history of trauma or inconsistent caregiving
  
  
• Questions about whether sexual behavior has crossed into addiction
  
  

Rather than guessing, we measure it.

Research shows that compulsive sexual behavior is best understood through four specific dimensions:

Preoccupation, loss of control, relationship disturbance, and affect disturbance.

Identifying which of these are present ensures you get the right level of care, rather than spending months—or years—in a treatment approach that isn’t matched to your actual needs.

 

2. What the Assessment Actually Is

Your assessment includes standardized clinical tools, relational and psychological measures, and a full one-hour conversation with me. Together, they provide a comprehensive understanding of your patterns and your strengths.

A. Screening Tools

Depending on your situation, the assessment may include:

• Sexual Addiction Screening Test (SAST / SAST-R)

A validated, research-based tool used worldwide to identify compulsive or addictive sexual patterns and determine which addictive dimensions are active for you.

• Attachment Style Assessment

This helps us understand how you connect, bond, distance, pursue, or protect yourself in close relationships. Early attachment patterns often shape adult intimacy, emotional regulation, and triggers.

• Love Languages Profile

A simple but powerful way to understand how you naturally give and receive emotional connection—important for rebuilding trust and repairing relational wounds.

• ADHD Screening, Learning Style, and Personality Measures

These factors greatly influence how you respond to stress, structure, accountability, and emotional discomfort. Many people struggle not because they’re “unwilling,” but because the support they receive doesn’t fit how their brain actually works.

• ACEs (Adverse Childhood Experiences)

This helps identify whether earlier adversity or trauma is playing an active role in present-day coping or relational strategies.

B. The One-Hour Conversation With Me

This is where all the data becomes meaningful.

The tools give us numbers.

The conversation gives us your story.

During our time together, we explore:

• What your scores mean—specifically for you
  
  
• Which patterns are rooted in coping, trauma, attachment, habit, or fear
  
  
• What qualifies as addiction, what does not, and where the line actually is
  
  
• How your behaviors developed and what maintains them
  
  
• What level of support (therapy, IOP, coaching, accountability, etc.) will actually work
  
  
• What strengths, resources, and capacities you already possess for change
  
  

Many clients say this hour is the first time their entire story made sense—not as a list of mistakes, but as a pattern that can be understood and changed.

3. What This Is Not

This assessment is not:

• A moral judgment
  
  
• A diagnosis of “what’s wrong with you”
  
  
• An attempt to pathologize your sexuality
  
  
• A commitment to any program
  
  
• A requirement that you join anything afterward
  
  

It is your information, organized clearly and compassionately, so you and your therapist can make the right decisions together.

4. Why This Step Matters in Recovery

Compulsive sexual behavior exists on a spectrum. Some people require simple structure and education; others need trauma-informed care, accountability, or more intensive support.

Without a structured assessment, people often:

• Underestimate the seriousness of their patterns
  
  
• Get stuck in cycles of relapse and shame
  
  
• Receive too little—or the wrong type—of help
  
  
• Spend months spinning their wheels
  
  
• Misunderstand the real source of their behavior
  
  
• Burn out their therapist, partner, or themselves
  
  

A specialized assessment prevents this and ensures you get exactly what you need.

5. What You Will Walk Away With

After your assessment and our session, you will leave with:

A Clear, Personalized Map of Your Situation

Including:

• SAST interpretation
  
  
• Attachment style insight
  
  
• Trauma and childhood patterns
  
  
• Strengths and vulnerabilities
  
  
• Relationship and intimacy patterns
  
  
• Whether your behaviors fit compulsive/addictive profiles
  
  
• What interventions are most effective for someone with your profile
  
  

Specific, Actionable Recommendations

You will know:

• What level of care is appropriate
  
  
• Whether intensive outpatient (IOP) is needed
  
  
• Whether weekly therapy alone is sufficient
  
  
• Whether couples work is indicated
  
  
• What daily tools and habits support stability and recovery
  
  
• Whether medical or psychiatric support should be integrated
  
  

And something most people have never received:

A non-shaming, nonjudgmental explanation of why your behaviors make sense—and how to genuinely change them.

6. Why This Is a Gift to Your Future Self

Compulsive patterns silently cost people years of their lives—emotionally, relationally, financially, and professionally. Many clients say they’ve lost opportunities, relationships, and inner peace because they didn’t understand what was driving their behaviors.

Doing this assessment is a way of saying:

“I’m not going to let this keep running my life.”

It is a powerful, responsible, and courageous step toward health.

In Summary

Your therapist referred you because they care deeply about your healing and want you to receive the most accurate, personalized guidance possible.

The process is simple:

1. Complete the assessment tools.
   
   
2. Meet with me for a one-hour session.
   
   
3. Walk away with clarity, direction, and a plan that fits your life, patterns, and brain.
   
   

This is not about labeling you.

This is about empowering you.

If at any point you feel anxious, uncertain, or curious about the process, please reach out. My role is to help you feel safe, understood, and guided toward the next right step.