Problematic Pornography Use

Transform your ability to work with people whose lives are affected by the physical, mental and social impact of pornography. Learn best practices from experts on how to overcome problematic pornography use and achieve sexual health. 6 hours CPD

Enroll for free

Do you work with people who struggle with anxiety, depression, poor sleep, other mental health issues or sexual difficulties?
Have you ever considered that watching too much pornography could cause their symptoms?
Are your patients/clients/colleagues/pupils/service users concerned about the way they use pornography?
Do you want to support them better?

If so, this course is for you.

This self-paced course is especially relevant for GPs, nurses, social workers, mental health professionals, psychologists, counsellors, criminal justice professionals, guidance teachers, school and university counsellors, sexual health services workers, psychosexual therapists, youth workers, pharmacists, and religious ministers. If you are only interested in one area of problematic pornography use, such as intimate partner violence (sexual strangulation), or adolescents for example, you can download the course and just focus on Basics and the module on intimate partner violence, or adolescents etc. that suits your purposes. You're not obliged to do the whole course unless you'd like to. This course was accredited by the Royal College of General Practitioners until August 2024 when they ceased accrediting this type of training. The course was assessed and passed by five senior RCGP clinicians.

Meet our experts

Why take this course?

You support people who struggle with mental health, problematic pornography use issues and/or sexual dysfunction symptoms

Mental health symptoms including anxiety, social anxiety, depression, poor sleep, lack of motivation, brain fog, constant sexual fantasy, negative body image...
Problematic pornography use symptoms including no interest in sex with a partner, lack of sexual satisfaction with a partner, inability to orgasm with or without porn/sex toy, delayed orgasm, erectile dysfunction, arousal dysfunction, premature ejaculation…

Scientific research has shown that problematic pornography use can be the reason behind many of these symptoms.

If you work with people who struggle with these symptoms, it’s essential that you learn how to support them effectively so they can avoid damaging consequences especially to their sexual relationships. Once you understand how pornography affects the brain, you'll be equipped to recognise its role as an underlying issue and help your patients/clients who have developed problematic pornography use.

After taking this course, you will:

Know when to ask questions about pornography use to uncover the root causes of symptoms
Feel confident dealing with concerns around pornography use and its consequences
Learn to spot the signs of sexual dysfunctions, problematic pornography use and compulsive sexual behaviour disorder in men, women and teenagers and when they are caused by pornography
Learn about the links between pornography and intimate partner violence and how to detect issues
Learn about teenagers’ behaviour around pornography and its potential negative consequences
Learn how to support people in a practical way who are struggling with pornography which is having a negative impact on their lives

Doctor, Stratford

“This was one of the best courses I have attended as it was all new learning for me. I was unaware of the addictive danger of internet pornography. Now I know.”

GP, Plymouth

“I learned a lot more about how pornography affects mood, behaviour and relationships.”

"It was a new area, particularly relevant to my population. I got insight into a whole new aspect of discussing depression. I will ask about porn use now!"

"I now have the confidence to ask about porn, particularly when people present with other issues."

I found this extremely informative and it highlights the true impact of internet pornography on child development and problematic/harmful behaviours in children, adolescents and through to adulthood.

An evidence based approach

This course is evidence-based and is supported by a large amount of scientific research. All research is referenced in the course.
It was developed with world-leading clinicians and academics and draws on their knowledge and experience.
This online course was approved by five senior clinicians as part of the accreditation process by the Royal College of General Practitioners in London in late 2023. The RCGP changed its business model in 2024 and no longer accredits this type of training. Without the high accreditation fee, we can now offer the course for free. The current version has been slightly revised to reflect recent changes in the literature.

Course curriculum

1. Introduction by Mary Sharpe, CEO, course instructor
2. Expert advisors
3. Training Provider
1. Introduction
2. Learning objectives
3. History of pornography use
4. Typical patterns of pornography user behaviour
5. Nomenclature
6. Trauma in childhood
7. Impact of pornography
8. Neurosurgeon Don Hilton and two young men with problematic pornography use
9. Answers to quiz
10. Prevalence of pornography use
11. How much pornography is too much?
12. Issues linked to pornography use
13. World Health Organization diagnostic criteria for CSBD
14. Pornography related issues in the other main diagnostic manual
15. Dr Mateusz Gola discussing CSBD
16. Dr Gola discussing CSBD quiz
17. Addiction process - brain changes
18. Addiction - related brain changes in detail
19. Almost half of porn users escalate (tolerance)
20. A typical escalation pattern is reported by this young man on NoFap...
21. Pornography viewing outside stated sexual identity
22. Internet porn is free, but kids are paying the price - Age Verification
23. ISSM on Problematic Pornography Use and Sexual Dysfunctions
24. Limbic resonance
25. References for 'The basics'
1. Introduction
2. Learning objectives
3. I just have an addictive personality!
4. Addictive personality quiz
5. Pre-existing condition?
6. Perhaps I have performance anxiety?
7. Latest screening tools for CSBD
8. Screening tools quiz
9. Time to start thinking about pre-addiction?
10. Permissive sexual attitude was strongest predictor of PPU, not religiosity
11. How long does it take for CSBD to develop?
12. Developing CSBD quiz
13. Testing for Problematic Pornography Use
14. Brief Pornography Screener
15. Brief Pornography Screener download
16. Screening tools for women
17. Screening tools for women quiz
18. Screening for CSBD in women
19. Sexual minorities and CSBD
20. Sexual minorities and CSBD quiz
21. Need for flexibility in screening for certain groups
22. Need for flexibility in screening for certain groups quiz
23. Screening tools used in internet addiction rehab centre
24. CSBD and neurodevelopmental conditions
25. Screening tools for neurodiverse individuals
26. Neurodiverse screening tools quiz
27. Potential for escalation to Child Sexual Exploitation Material (CSEM)
28. Study by Professor De Win
29. Cyber Pornography Addiction Test - CYPAT
30. CYPAT quiz
31. International Index of Erectile Function (IIEF- 5) Questionnaire
32. Asking about pornography use
33. Guidance on asking about porn use
34. Asking about porn quiz
35. Screening for ED in people not having partnered sex
36. Screening for ED in people not having partnered sex quiz
37. References for 'Screening tools for CSBD and PPU'
1. Introduction
2. Learning objectives
3. Men's perceptions of pornography as an issue
4. Common sexual dysfunctions in men
5. What is problematic pornography use doing to the brain?
6. Recent research linking pornography consumption and sexual dysfunction in men
7. Situational ED in younger men
8. Situational ED quiz
9. Other highlights from the Jacobs et al (De Win) study
10. Sexual minorities
11. Sexual minorities quiz
12. The Chemsex Study
13. Is the ED just the result of a long refractory period?
14. Refractory period quiz
15. Porn is a part of a complex mix of factors underlying ED
16. Asking about porn use
17. When to refer to a specialist?
18. Diagnostic approaches quiz
19. Is Internet Pornography Causing Sexual Dysfunctions? A Review with Clinical Reports
20. Porn-induced arousal dysfunction (MS direct to camera)
21. Sexual dysfunctions in older, healthier men
22. Sexual dysfunctions in older, less healthy men
23. Potential for escalation to child sexual exploitation material (CSEM)
24. Vulnerability of the neurodiverse individual
25. References for 'Sexual dysfunctions in men who are pornography users'
1. Introduction
2. Learning objectives
3. WHO definition of sexual health
4. Pornography and violence against women
5. Pornography use by young women
6. Pornography use by young women quiz
7. Further mental health issues
8. CSBD in young women
9. CSBD in young women quiz
10. Jace Downey, recovering porn addict
11. Physical health risks
12. Rough sex and BDSM
13. Billie Eilish on pornography
14. Sexology research on sexual strangulation
15. References for problematic pornography use in women
1. Introduction
2. Learning objectives
3. Gina on ex-husband's addiction
4. Pornography watching and couples
5. Pornography watching and couples quiz
6. Pornography and married people’s satisfaction with sexual life
7. Wives' experience of husbands' secret pornography use
8. Dealing with disclosure
9. Are Pornography Users More Likely to Experience a Romantic Breakup?
10. Men in a heterosexual couple who fantasize about men
11. Pornography and heterosexual women’s intimate experiences with a partner
12. Pornography’s impact on strangulation
13. Pornography's impact on sexual strangulation quiz
14. Women and anal sex
15. Health issues with anal sex - BMJ editorial
16. My partner, a rapist?
17. References for 'Pornography use in stable couples'
1. Introduction
2. Learning objectives
3. Definition of sexual health versus the impact of pornography
4. Media reports of sexual strangulation
5. The role of pornography use in intimate partner violence in different-sex couples: a prospective longitudinal study
6. "The neuropsychological outcomes of non-fatal strangulation in domestic and sexual violence: A systematic review"
7. Definition of strangulation
8. Definition of strangulation quiz
9. Prevalence of strangulation
10. Prevalence of strangulation quiz
11. Amount of pressure required to injure?
12. Pressure quiz
13. Diagram of the neck
14. Rough sex and BDSM
15. Driver of strangulation?
16. Driver of strangulation quiz
17. Strangulation and stroke in young women
18. Strangulation and stroke in young women quiz
19. How long does it take to cause injury?
20. How long does it take to cause injury quiz
21. Neurological signs and symptoms of strangulation
22. Neurological signs quiz
23. Psychological signs of strangulation
24. Psychological signs quiz
25. Behavioural and cognitive changes
26. Behavioural and cognitive change quiz
27. Other injuries from strangulation
28. Other injuries from strangulation quiz
29. Questions for family doctors
30. Questions for family doctors quiz
31. Training Institute on Strangulation Prevention
32. References for 'Pornography and Intimate Partner Violence'
1. Introduction
2. Learning objectives
3. Sleep deprivation
4. Hunter talks about his age of exposure to pornography
5. Pornography use by children in Poland
6. Porn use by children in Poland quiz
7. Evolving trends in use by gender
8. Evolving trends in use by gender quiz
9. Sexual dysfunctions in adolescents
10. Sexual dysfunctions in adolescents quiz
11. Stress and ED in young men
12. Stress and ED in young men quiz
13. Harms inflicted on children
14. The choking game in kids
15. The choking game in kids quiz
16. Not all sexual behaviour displayed by children or young people is normative
17. Anal heterosex among young people and implications for health promotion: a qualitative study in the UK
18. Children’s access to pornography
19. Billie Eilish on porn - a teen perspective
20. References for 'Pornography and adolescents'
1. Introduction
2. Learning objectives
3. Treatments and interventions focusing on problematic pornography use
4. Approach to talking about erectile problems
5. Approach to talking about ED quiz
6. Treatment options
7. Treatment options quiz
8. Drug treatment options for CSBD
9. Treatment for sexual addiction
10. Effectiveness of medications
11. Effectiveness of medications quiz
12. Risk of buying ED medication online
13. Risk of buying medication online quiz
14. Porn Induced Erectile Dysfunction or Porn Induced Arousal Disorder?
15. PIED or PIAD quiz
16. Stress and protective factors
17. Stress and protective factors quiz
18. Quitting porn and the flatline
19. Quitting porn and the flatline quiz
20. Family therapies
21. Residential rehab for internet addiction
22. 12 Step programmes
23. Mutual aid organisations
24. References for 'Treatment options'

About this course

Free
3.5 hours of video lessons
Interactive quizzes and reading
Total learning time: 6 hours

Who are we?

The Reward Foundation

The Reward Foundation is a health education charity established in 2014. We focus on internet pornography and its impact on mental and physical health, relationships, productivity and criminality. We make scientific research around pornography accessible to non-scientists and scientists so everyone is aware of the risks and solutions.

As seen in

The Times, The Sunday Times, The Guardian,The Telegraph, The Daily Mail , The Mail on Sunday, The Sunday Post, The Herald, The Scotsman, BBC Radio 4 PM, LBC, BBC Scotland and more.