Women are directly impacted by a spouse’s problematic sexual behavior. As a result, women in affected marriages may have diverse needs that require a variety of supports, including coping supports, and change-oriented supports, such as recreational, relational, professional, spiritual, and conceptual. Responding to problematic sexual behavior is also moderated by numerous internal and external factors which make pathways to support appear both vastly different and strikingly similar to one another. Differences in the types of supports used and preferred are not only determined by personal tastes, but also factors such as financial resources, availability of qualified resources where one lives, awareness of available supports, intrapersonal functioning, history of abuse, and personal or religious beliefs. Similarities in support seeking and support preferences are moderated by commonalities in emotional, spiritual, and physical reactions, and the cultural and clinical milieu in which these women live; all of them live in an era where addressing problematic sexual behavior is in its infancy. The study provides a useful template for clinicians, support networks, and researchers to begin understanding what is helpful and unhelpful when working with this population. Reading, immediate family, specialized therapists, group therapy, informed clergy, and conceptual ideas that heighten understanding or resiliency are considered key components of effectively supporting women responding to problematic sexual behavior at this time. The sample consisted of 22 women from Utah, Minnesota, and Alberta, Canada who were more than 25 years of age, were married, and had presented a spouse’s sexually addictive or compulsive behavior as the primary presenting problem in therapy. One hundred percent of the women reported pornography use by their spouse as a problem, with some women reporting additional distress related to affairs, cross-dressing, compulsive masturbation, criminal charges for sexually indecent exposure in public, or fetishes. Table, references