If you've searched online for help with a sexual or relational difficulty, you've probably noticed something confusing: the same issue seems to have two different names. One is the term everyone uses — "sex addiction," "sex therapist," "low sex drive." The other is the term you'll find in a diagnostic manual or a professional register — "Compulsive Sexual Behaviour Disorder," "psychosexual therapist," "Hypoactive Sexual Desire Disorder."
Neither version is "wrong." But knowing the difference matters, because it shapes what kind of help you're actually looking for, what a practitioner can honestly promise you, and how much shame you carry into that first conversation. As a practitioner working across individual counselling, couples work, and psychosexual and relationship therapy, this is a distinction I find myself explaining often — so it felt worth writing down.
"Sex Therapist" vs. "Psychosexual Therapist"
In everyday use, "sex therapist" is the catch-all term — it's what people type into Google, and it's understood by almost everyone. Within the UK profession, however, the more precise and commonly used title is psychosexual therapist, or psychosexual and relationship therapist (PSRT), and it's the title used by the College of Sexual and Relationship Therapists (COSRT), the main professional body for this work in the UK.
The distinction isn't just semantic. "Psychosexual" signals that the work sits at the intersection of the psychological and the physical — that a sexual difficulty is rarely only about sex. It might involve anxiety, a relationship dynamic, a medical condition, past experience, or a mix of all four. A psychosexual therapist is trained to work across that whole picture, within a structured, evidence-informed model, rather than offering sex-specific advice in isolation.
If you see a practitioner describe themselves as a "trainee" psychosexual therapist, that also means something specific: they are working toward full COSRT accreditation, typically already holding core counselling qualifications and seeing clients under supervision, but not yet fully accredited in this specialism. A clear, honest practitioner should always be upfront about exactly where they sit on that path.
"Sex Addiction" vs. "Compulsive Sexual Behaviour Disorder (CSBD)"
This is probably the pair that causes the most confusion — and the most shame.
"Sex addiction" is a widely used lay term, popularised through media and self-help culture. It isn't a recognised diagnosis in the World Health Organization's ICD-11 or in the DSM-5. The clinically recognised term is Compulsive Sexual Behaviour Disorder (CSBD), which the WHO added to the ICD-11 in 2019. CSBD describes a persistent pattern of failing to control intense, repetitive sexual impulses or urges, resulting in significant distress or impairment to a person's life — it's classified as an impulse-control disorder, not formally as an addiction, which is an important and still-debated distinction in the field.
That debate matters clinically. Some researchers and clinicians — including Paula Hall, whose work I draw on regularly in my own practice — use an addiction framework, arguing it captures the compulsive, escalating, relief-seeking pattern clients describe. Others, including sex therapist and author Marty Klein, have argued strongly against pathologising high sexual desire or frequent pornography use as "addiction," warning it can pathologise shame and normal variation in desire rather than treat genuine distress.
I flag this openly with clients rather than picking a side for them: whichever term is used, what actually matters clinically is the person's own experience — whether the behaviour is causing them distress, damaging relationships or self-esteem, or conflicting with their values — not whether it fits a label.
Other Term Pairs Worth Knowing
A few more come up regularly in this work, and might be worth their own line in a glossary or FAQ on a practice website:
Low sex drive (everyday) vs. Hypoactive Sexual Desire Disorder / HSDD (clinical) — a persistent, distressing lack of sexual desire, as opposed to natural fluctuation in libido, which is normal and not a disorder on its own.
Painful sex (everyday) vs. Vaginismus and Dyspareunia (clinical) — distinct diagnoses with different causes and treatment pathways, often confused with one another.
Premature ejaculation (used both clinically and colloquially, but with a specific clinical definition involving ejaculation latency and perceived control, not just subjective speed).
Porn addiction (everyday) — usually falls under the same CSBD/compulsivity debate above, rather than being a distinct diagnosis.
Couples counselling (everyday, general) vs. Psychosexual and Relationship Therapy (clinical, specific) — the former can cover any relational difficulty; the latter specifically integrates sexual and relational work.
Why This Distinction Actually Matters for Clients
A few practical reasons this is worth understanding before you reach out to anyone for support:
It shapes expectations. If a service is described as "sex therapy" but is really general counselling with an interest in the topic, you may not get the structured, sexuality-specific approach a psychosexual therapist offers.
It reduces shame. Framing something as a recognised clinical pattern (CSBD, HSDD) rather than a moral failing ("addict," "broken") often changes how safely a client can talk about it.
It clarifies what a diagnosis does and doesn't do. A clinical label like CSBD isn't a life sentence or a personality trait — it names a pattern that can be understood and worked with, nothing more.
It helps you check a practitioner's honesty. Any practitioner using clinical language should be able to tell you plainly where a term comes from (ICD-11, DSM-5, a professional body) and where it's contested — rather than presenting debated terms as settled fact.
A Closing Note
Language in this field is still evolving, and reasonable, well-informed clinicians disagree about some of it — particularly around the addiction/compulsivity question. What I'd encourage anyone reading this to take away isn't a fixed vocabulary, but a habit: ask what a term actually means, where it comes from, and whether it's describing your distress accurately — rather than borrowing a label because it's the only word you'd heard before you looked.
If you're unsure which of these applies to what you're experiencing, that uncertainty is a perfectly reasonable place to start a first conversation.
References
World Health Organization, ICD-11 for Mortality and Morbidity Statistics — Compulsive Sexual Behaviour Disorder (6C72)
Hall, P., Understanding and Treating Sex and Pornography Addiction (Routledge)
College of Sexual and Relationship Therapists (COSRT) — practitioner standards and terminology
British Association for Counselling and Psychotherapy (BACP) — ethical framework and public-facing guidance
Klein, M. — writing and commentary on sexual desire, compulsivity, and the critique of the addiction model
Monica Chiorascu MBACP
Integrative psychotherapist I Psychosexual and relationship therapy I Sex and porn addiction
Therapy with Monica I hello@therapywithmonica.com I 07895053117
This article is for informational purposes only and is not a substitute for mental health care. If you need urgent support, please contact your GP or Samaritans at 116 123.