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West Malling, Kent; Surrey & UK Online Therapy

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Problem Porn Use: Self-Assessment Questionnaire

Counselling for Porn Addiction

Take a simple, confidential porn use self-assessment to help you reflect on patterns and decide what next

Porn Use Self-Assessment | Your Relationship with Porn

Many people question their relationship with porn at some point.

You might be noticing it’s becoming more frequent, harder to control, or starting to affect other areas of your life. Or you may simply be curious about your habits.

This self-assessment is designed to help you reflect on your porn use over the past six months, including patterns around control, time spent, emotional triggers, and any impact you’ve noticed.

It’s not about labels or judgement. It’s about understanding your experience more clearly.

In this context, “porn use” can include any type of online sexual content that feels relevant to your experience.

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Self-Assessment Questionnaire - Problematic Porn Use

You can use the self-assessment below to get a clearer sense of what’s been happening for you. It takes a few minutes to complete and can be done in your own time. You’re free to use it for your own reflection, or as a starting point if you’re thinking about getting support.

Common questions

This self-assessment isn’t a diagnosis. It’s simply a way of helping you reflect on your porn use, notice any patterns, and decide whether anything feels worth exploring further.

Compulsive Sexual Behavior Screening Questionnaire (CSB-S)

About this questionnaire

This questionnaire looks at patterns in thoughts and behaviours around sex and/or porn over the past six months. It focuses on areas such as control, time spent, impact on daily life, emotional triggers, and any consequences you may have noticed.

In this context, “sexual thoughts and behaviours” is used broadly. This can include porn use, masturbation, sex with others, or anything else that feels relevant for you.

Once you’ve completed the form, you’re free to reflect on your responses in your own way. If you prefer a more structured view, you can add your scores together using the guide provided.

You’ll also have the option at the end to leave your first name and email if you’d like me to look over your responses and offer some feedback.

This isn’t a diagnosis or a label. It’s simply a way of building a clearer picture of what’s been happening for you, and whether anything feels difficult to manage or out of balance.

Some people complete this because they feel stuck in a pattern. Others are just curious about their relationship with sex, porn, or certain behaviours. There are no right or wrong answers. The aim is to respond as honestly as you can, based on your own experience.

If you decide to get in touch, your responses can also help guide an initial conversation and give us a useful starting point for understanding what’s going on for you.

Considering your behaviour or activities over the past past 6 months -

Please read each statement carefully and select the number that best describes how often it applies to you.

“Sexual thoughts and behaviours” includes porn use, masturbation, sex with others, or anything else you feel applies to you.

1 – Not at all | 2 – Rarely | 3 – Sometimes | 4 – Often | 5 – Very often

1. I experience sexual thoughts or urges that feel difficult to control*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

2. When sexual thoughts begin, I struggle to reduce or stop them.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

3. I engage in sexual behaviors even when I intend not to.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

4. I feel compelled to engage in sexual behavior despite wanting to resist.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

5. Sexual thoughts or behaviors take up a significant amount of my time.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

6. I spend more time on sexual activities than I plan to.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

7. Sexual behavior interferes with my daily responsibilities.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

8. I postpone or neglect important activities because of sexual thoughts or behaviors.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

9. I use sexual behavior to cope with stress or negative emotions.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

10. I engage in sexual behavior to manage feelings such as anxiety, sadness, boredom, or loneliness.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

11. Sexual behavior provides temporary relief from emotional discomfort.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

12. The relief I experience from sexual behavior fades quickly.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

13. My sexual behavior has caused problems or strain in my relationships.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

14. My sexual behavior has negatively affected my work, education, or finances.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

15. I feel distress, guilt, or shame related to my sexual behavior.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

16. I continue engaging in these behaviors despite negative consequences.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

17. Over time, I have needed more frequent or more intense sexual experiences to feel satisfied.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

18. I feel restless, irritable, or distressed when I try to reduce or stop sexual behavior*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

19. I have attempted to control or reduce my sexual behavior and found it difficult to do so.*

1 – Not at all

2 – Rarely

3 – Sometimes

4 – Often

5 – Very often

What Happens Next

This questionnaire is designed to help you reflect on patterns in your thoughts and behaviour. Rather than focusing on a total score, it can be more useful to notice:

Which statements felt most familiar
Where things feel hardest to control
Whether there’s any impact on your day-to-day life, relationships, or wellbeing
Any links between emotions and behaviour

If several of these areas feel relevant, it may be worth exploring this further in a confidential setting.

If you wished, you can give each answer a score (1–5) and add them together for a total. This isn’t about reaching a particular number, but about getting a general sense of how much these patterns may be present for you.

A higher overall score may suggest things feel more difficult to manage, while a lower score may indicate less impact. It’s simply a guide to help you reflect on what, if anything, you might want to do next.

You’re welcome to leave things here and simply take some time to reflect on your responses. For others, it helps to talk things through and understand what might be driving the pattern.

If you’d like to do that, you can leave your details below and I can come back to you. There’s no pressure to take things any further - this is simply an option if it feels useful.

Alternatively, if you wanted to arrange a free initial consultation fill in the contact form which can be found here

Confidentiality, Privacy & Consent

Any information you choose to share in this form will be treated as confidential and handled in line with my Privacy Policy and UK data protection law (UK GDPR and the Data Protection Act 2018).

This information is used to help me understand what may be bringing you to therapy and to guide any initial contact. It will not be shared with anyone else unless there is a legal or safeguarding requirement to do so.

Submitting this form does not establish a therapeutic relationship. If we go on to work together, we will discuss confidentiality, data storage, and your rights in more detail as part of the initial agreement.

You have the right to request access to your data, ask for it to be corrected, or request that it is deleted, in line with data protection guidance.

By submitting this form, you confirm that:

you have read and understood this information
you consent to your data being processed for the purpose of enquiry and potential therapy support
the information you provide is accurate to the best of your knowledge

I have read and agree to the confidentiality, privacy and consent information above

Email*

If you wish to receive feedback, please provide a valid e-mail address which will only be used for this purpose.

First name*

Get in Touch

If you’d like to talk about your porn use in a confidential and non-judgemental setting, you’re welcome to get in touch. You don’t need to decide what to call it. We can simply start with what’s been happening for you and take it from there.

If this hasn’t quite reflected your experience, there is also a similar self-assessment focused on sexual activity, which some people find more relevant.

For others, alcohol or drug use can play a part in porn use. If that feels like a factor, you can find further support options here. Relationship counselling may also be helpful, particularly where these patterns are affecting connection or intimacy.

Therapy provides the space to understand what may be driving these patterns, without judgement or assumptions.

You don’t need to have everything figured out before reaching out. Take your time with this - there’s no pressure to take the next step unless it feels right for you.

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Derek Flint Therapeutic Counselling

derekflint.counselling@yahoo.com

West Malling | Edenbridge | Carshalton | Online

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©2026 by Derek Flint Therapeutic Counselling. All rights reserved.

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