A virtual IOP for sex addiction, anywhere in Texas

The same eight-week program we run in north Austin, delivered by secure video to men anywhere in Texas. Same clinicians, same hours, same price. You attend from a room with a door that closes, three evenings a week for group and once a week for individual therapy, and you keep your job and your life while you do the work.

At a glance

• When: three video group sessions a week, evening-weighted for working schedules, plus at least one individual session, two where the case calls for it. 9 to 12 clinical hours a week for eight weeks.
• Who: adult men living in Texas whose main problem is compulsive sexual behavior: pornography, affairs, paid encounters, online behavior. Not substance use, not a general mental health service.
• What you need: a laptop or tablet with a camera, a reliable connection, and a private room for each session. We send the video platform at admission; it is not Zoom.
• Cost: same as in person. Out-of-network billing to your PPO, a superbill, or private pay. Full pricing.
• Partners: a separate partner program by telehealth, with her own clinician, included.
• Working full time in a high-stakes role? The Professional Track: evening groups, a known end date, private pay with no claims.

Iron Ridge is Texas's only intensive outpatient program built exclusively for compulsive sexual behavior. The virtual program exists because the men who need it live in Houston, Dallas, San Antonio, El Paso and small towns as much as in Austin, and because a room full of men doing the same work is something a mixed-diagnosis IOP cannot offer. Our clinicians are licensed in Texas and the program is delivered to Texas residents; you need to be physically in Texas during sessions. In-person is available at the Austin clinic.

Is telehealth actually serious? The specifics

Men ask this directly, and they should. Video treatment has a reputation, earned by some of it, for being a chat window and a worksheet. Here is what makes the virtual arc the same program as the room in Austin, and what we hold the cohort to.

• Small groups, rolling admission. Group sizes are held small enough that every man is visible on screen and every man is expected to speak. Admission is rolling, so you start when you are admitted rather than waiting for a cohort, and the men around you are at different points in their own eight weeks; the ones further along are the ones who show you what the work looks like from the other side.
• Cameras on, every session. Not a listening-in format. Every man is visible to every other man for the whole of every group, and to his clinician for the whole of every individual session. A man who cannot keep the camera on is not in a session that can do him any good, and the cohort is held to that.
• A private room, checked before every group. A door that closes, no one able to overhear, and a HIPAA-compliant video platform we send at admission. It is not Zoom. Before group starts, each man is asked to show the room on camera so that everyone in the session knows it is private; that is how the other men's confidentiality is protected, not only yours. If a private room cannot be arranged, we do not admit; a video room without privacy is not a room the work can happen in.
• The same curriculum, hour for hour. Stabilization in weeks 1 to 3, trauma processing in 4 to 6, relapse prevention in 7 and 8: 9 to 12 clinical hours a week, 72 to 96 in total, the same clinical arc and the same clinicians as Austin.
• Accountability that does not depend on the room. Daily accountability contact in the early weeks, a written plan for the moments that reliably go wrong, and a group that notices when a man goes quiet. Concealment is harder in a group that sees you three times a week than in a weekly session across town.
• Intimacy on video. The thing men doubt most. What builds it is not the medium; it is the same men, three times a week, for weeks, doing the same work. By the third week most men know the group better than they know anyone.

What telehealth cannot do is remove you from your environment. That is the honest limit, and for a small number of men it is the reason residential is the right level. For most, it is the point: the work happens inside the life the man is keeping.

What virtual means at Iron Ridge

Virtual means the client attends group and individual sessions from a private, HIPAA-appropriate location of his own choice, most commonly a home office, spare room, or another confidential space, using a HIPAA-compliant video platform on a laptop, tablet, or desktop. It is not a chat app. It is not asynchronous. It is not a self-guided module. The clinical hours are live, scheduled, and delivered by the same clinical team that runs the Austin in-person program with the same 8-week clinical arc.

Virtual IOP is a level of care, not a level of clinical intensity. Clients live at home, work if their occupational picture allows it, and maintain the relational and family responsibilities of an outpatient level of care while completing the arc. That's the point of IOP as a level of care, clinical intensity without removing the client from the life he is working to repair. See what to expect for the operational walk-through, which applies to both the Austin and virtual formats.

Who the virtual program is for

The virtual program is for adult men who reside in Texas, who meet the ICD-11 6C72 criteria for CSBD as the presenting picture, and who have a comorbid mental health condition, OCD, ADHD, an anxiety disorder, depression, PTSD, attachment trauma, or an adjustment picture, that treatment is aimed at. The client is medically and psychiatrically stable enough for an outpatient level of care. He can attend 9 to 12 clinical hours per week reliably by video. He is not in acute crisis. He is not in active substance-primary treatment need. See the treatment programs hub for the complete admission criteria and exclusions.

The virtual program is best suited to men who live outside the Austin metro, Houston, Dallas–Fort Worth, San Antonio, El Paso, the Rio Grande Valley, West Texas, and the smaller Texas metros where a specialized CSBD IOP is not available locally. It is also appropriate for men in Austin whose schedule, mobility, or privacy considerations favor a virtual format over commuting to the clinic.

Clinical hours and schedule

The virtual program delivers the same 9 to 12 clinical hours per week over eight weeks as the in-person program. The total clinical exposure across the arc is 72 to 96 hours. Hours are distributed across:

• Group therapy, three video group sessions per week. Admission is rolling: a man starts his own eight-week arc when he is admitted rather than waiting for a start date, and the group at any time holds men at different points in the arc, which is part of how it works; the man in week seven is the one who shows the man in week one what week seven looks like. Group sizes are held to a range that keeps the video room clinically usable, small enough that every man is visible, contributes, and is held accountable in group process.
• Individual therapy, weekly video session with a primary clinician licensed in Texas.
• Assessment and integration, scheduled at baseline, week 4, week 8, and six-month follow-up, delivered by video.

The standard virtual schedule is evening-weighted for compatibility with a working schedule. Specific times are set at admission based on cohort composition and the time zones represented in the cohort, Texas spans Central and Mountain time, and cohort scheduling accounts for that.

What the clinical work looks like in the virtual setting

The clinical arc, stabilization in weeks 1 through 3, trauma and mental health processing in weeks 4 through 6, relapse prevention in weeks 7 through 8, is delivered identically in the virtual and in-person formats. The clinical modalities used across the arc, cognitive-behavioral therapy, acceptance and commitment therapy, internal-family-systems-informed work, psychodynamic and attachment work, are all delivered by clinicians credentialed and experienced in telehealth delivery of these modalities.

What is specific to the virtual setting is the operational care taken to make a video room clinically usable for this population. Group is delivered on a HIPAA-compliant platform with clinician-controlled admission, no session recording, and a video-room protocol that clients are oriented to in the first session, camera on for the duration, no other people in the room, no screenshots, a private space with the door closed. These operational details are not administrative, they are what makes a video room a place where a man carrying CSBD-specific shame can actually speak.

Partner programming for virtual clients

The Partner Programming track is available by telehealth for partners of virtual IOP clients located anywhere in Texas, directed by Roxcy Brown, LMFT-Associate, CCPS-C (supervised by Billy Myers, LMFT-S, Texas license 201183). Partners are seen for their own clinical work, in their own scheduled hours, with their own clinician. Partner programming is coordinated with the men's IOP but is not a couples format, the partner is treated as a client with a primary clinical picture of her own. See the Partner & Family Program for the partner-facing entry point.

Technology and privacy requirements

To participate in the virtual program, the client needs:

• A laptop, desktop, or tablet with a working camera and microphone.
• A reliable internet connection.
• A private location for the duration of each scheduled clinical hour, a room with a door that closes, where the client will not be interrupted or overheard.
• The ability to use the HIPAA-compliant video platform we send at admission. We do not use Zoom for group. The platform is BAA-covered and configured for clinical group delivery.

Clients who do not have a suitable private location at home sometimes use a home office, a private space at their workplace before or after hours, or another arrangement worked out at admission. The clinical team screens for this at intake, a video room without privacy is not a video room the client can use for this work, and we do not admit if we cannot solve the privacy question.

Payment and confidentiality

Iron Ridge is out-of-network with insurance. Clients can have Iron Ridge bill their PPO out of network, pay directly and submit a superbill for potential partial reimbursement, or pay privately with no claim submitted to insurance. Because CSBD is coded in the ICD-11 impulse control chapter and not in the substance use chapter, the clinical record is governed by standard HIPAA rules, 42 CFR Part 2 does not apply to Iron Ridge. See how the superbill process works and DSM-5-TR coding when CSBD is the clinical picture for the mechanics.

Serving Texas

Dallas–Fort Worth. Men in Dallas, Fort Worth, Plano, Frisco, Keller, Southlake, Arlington and the rest of the metroplex take the program by telehealth. There is no intensive outpatient program in DFW built for compulsive sexual behavior; the virtual arc is the same program, the same clinicians, and the same price as in Austin, with evening groups. Weekly therapy with a local CSAT and the Iron Ridge program run well together, and we coordinate with a referring therapist where the client consents.

Houston, San Antonio, El Paso and the rest of the state. The same applies. Wherever a man lives in Texas, the constraint is a private room and a connection, not geography.

The virtual program serves men across all of Texas, from the major metros (Houston, Dallas–Fort Worth, San Antonio, El Paso, Austin) to the smaller markets where a specialized CSBD IOP is not available locally (Corpus Christi, Lubbock, Amarillo, Waco, Midland–Odessa, Beaumont, McAllen, Killeen, College Station, Tyler, Longview, Abilene, and the balance of Texas). See Areas Served for the full list. Clients located outside Texas are not eligible for the virtual program because our clinicians are licensed to practice in Texas.

What to do next

The next step is a clinical consultation. The consultation is a clinical conversation, not a sales call. Its purpose is to formulate the case, to determine whether Iron Ridge is the right level of care, and to answer the specific questions that decide whether the virtual program is the right fit, versus the Austin in-person program, versus a different level of care, versus a different specialization altogether.