Pedophilia - Efficacy of Combination Therapy Term Paper

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Pedophilia - Efficacy of Combination Therapy Using Cognitive Behavioral Therapy in Combination with SSRIs for Treating Therapy-Resistant Pedophilic Behaviors

Pedophilia demonstrates a higher recidivism rate when compared to other sexual offenses. Pedophilia does not respond well to traditional treatment programs. The primary reason for this lack of response lies in the willingness of the pedophile to change their behavior. Unlike other sexual offenses, pedophilia involves cultural issues that could affect the willingness of pedophiles to change their behaviors. This study investigates the long-term recidivism rates among pedophiles that have undergone four of the most prevalent treatments available. The study compared groups that received group therapy, cognitive therapy, SSRIs and Chemical castration. It compared single therapies, as well as a number of combinations. The study indicated that a combination of cognitive therapy and SSRIs was the most effective means for reducing recidivism rates. The study indicates the need for ongoing therapy throughout the lifetime of the offender for best results.

Abstract

List of Illustrations

CHAPTER 1: INTRODUCTION

CHAPTER 2: LITERATURE REVIEW

CHAPTER 3: METHODOLOGY

CHAPTER 4: RESULTS

CHAPTER 5: DISCUSSION, CONCLUSIONS, RECOMMENDSTIONS

REFERENCES

TABLE: 4.1. TREATMENT TYPE and RECIDIVISM RATE

TABLE 4.2. SUMMARY of HYPOTHESIS ACCEPTANCE/REJECTION

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Figure 1: COMPARISON of RECIDIVISM OVER a TEN-Year

PERIOD for VARIOUS THERAPY TYPES

Efficacy of combination therapy using cognitive behavioral therapy in combination with SSRIs for treating therapy-resistant pedophilic behaviors.

CHAPTER I: INTRODUCTION

Term Paper on Pedophilia - Efficacy of Combination Therapy Using Assignment

Pedophilia is a complex psychological condition that is often unresponsive to standard treatment options. The goal of treatment is to curb behavioral expression of pedophilic fantasies and desire. It is considered unrealistic to expect to be able to measure, eliminate, or predict a person's innermost thoughts and feelings. Therefore, treatment is directed towards curbing undesirable behaviors that arise from these thoughts and feelings, rather than eliminating the feelings and desires themselves. This makes the treatment of pedophilia different from the treatment of other mental illnesses where the focus is on eliminating or promoting acceptance of ones actions or feelings.

There are several treatment options available for treating pedophiles. The most common treatment therapies include group therapy, cognitive behavioral therapy, SSRIs, and chemical castration. Other forms of therapy, such as aversion therapy, brain, or genital surgery are rarely used, particularly in the United States. This study will compare long-term effectiveness of the four most common treatment options in the United States. It will focus on providing information that will be useful in the development of best practices and policies regarding the long-term avoidance of undesirable behaviors related to pedophilic urges.

Background of the Study

What is Pedophilia?

Pedophilia is a deviant behavior where an adult is sexually attracted to a prepubescent or peripubescent child. Pedophiles are sexually attracted to children that are below the legal age of consent, which is currently 18 in the United States. Pedophiles present a danger to children because they can cause emotional or physical harm to the child of varying degrees. Pedophilia is considered criminal activity in the United States. One popular theory to explain pedophilia is that the pedophile uses the child as a surrogate for an adult that is not present. The classification, labeling, treatment and cultural constructs surrounding pedophilia are highly controversial.

Recent controversy stems from using the term "pedophile" to describe all child-related sexual offenders. The medical community uses the term to refer to someone with a preference for children. However, law enforcement uses the term to describe "situational offenders." This leads to a difference in opinion when it comes to diagnosis and treatment of an individual. There is a difference in the medical community between those that have a sexual orientation towards children and those that commit a one-time act from a clinical perspective. Law enforcement does not recognize this distinction.

According to the American Psychological Association's Diagnostic and Statistical Manual of Mental Disorders (2000), pedophilia must meet three criteria. If the pedophile does not meet any one of the criteria, they are not diagnosed as a pedophile from a clinical perspective. In order to meet the criteria of pedophile, sexual urges with a prepubescent child must be recurrent and intense (APA, 2000). The person must have acted on these urges, or they must cause marked personal distress or interpersonal difficulty (APA, 2000). The third criteria is that the person must be at least age 16 and at least 5 years older than the child with whom the sexual act was performed (APA, 2000). Only if the person meets all three of these criteria will they be diagnosed as a pedophile in a clinical setting. Many pedophiles, particularly one-time offenders do not meet the criteria necessary for clinical treatment of their condition.

The APA criteria do not require actual sexual activity with a child. The person needs only to have fantasies or sexual urges towards children. In all cases where an offender is accused of child sexual abuse, they are labeled a pedophile by law enforcement, when in fact they do not meet the clinical requirements of clinical pedophilia. Sometimes the sexual act can have other causes such as stress, marital problems, or the unavailability of adult partners (Lanning, 2001). Those that commit sexual crimes against children, but that do not meet the criteria for diagnosis are referred to as situational, opportunistic, or regressed offenders (Lanning, 2001). Those that meet the criteria are referred to as structured, preferential, or fixated pedophiles (Lanning, 2001).

The American Journal of Psychiatry's most recent "Position Statement on Psychiatric Treatment and Sexual Orientation" cautions mental health professionals that there is little empirical evidence to support the efficacy of treatments designed to change sexual orientation (Berlin, 2000). The statement was intended to address homosexuality, but it has been extrapolated to include pedophilia, as a sexual orientation, rather than a mental illness (American Journal of Psychology, 1999). This statement is at the heart of whether to classify pedophilia as a mental disorder or another sexual orientation.

The key difference between pedophilia and other sexual orientations is the age of target. This rationale support the position that it is unlikely that treatments will ever result in a "cure" for pedophilia. However, societal constraints recognize the rights and vulnerability of the population that is the target of sexual preferences for children. In the case of homosexuality or heterosexuality, the object of attraction is an adult. As adults, this person has rights and the ability to express and enforce these rights. Children are taught to obey and respect adults. They do not have the same legal recourse afforded adults.

Therefore, although the adult perpetrator has a right to their preferred sexual orientation, the object of their preference does not have the same rights. When a pedophile acts on their urges, the child is at a legal and moral disadvantage to express and exercise their opinions and preferences. The expression of pedophilia is coercive, at the very least, and violent in the worst cases. Either way, acting on pedophilic urges violates the basic humanitarian rights of the child. This is the basis for considering pedophilic behavior a criminal offense in the United States. Even if the child "consents" to the acts, a certain degree of coercion is present due to societal rules governing adult-child relationships. The adult is supposed to represent an authority figure. It is difficult to eliminate the perception of authority in any adult-child interaction.

Problem Statement

In American society, and a majority of the societies around the globe, the adult is recognized for the learning resulting from life experience. Children are viewed as inexperienced and therefore, their rights and opinions are considered to be subordinate to those of the adult. When an adult uses their authority over a child, either consciously or subconsciously, societal rules compel the child to comply with the adult's wishes. In the case of pedophilia, this results in some degree of sexual contact. The rights of the child are violated causing varying degrees of emotional or physical damage to the child.

In a discussion of pedophilia, it is important to distinguish urges and feelings regarding sexual contact with children from actions. Urges and feelings, if well contained or in an appropriate context, do not violate the rights of the child. It can be argued that attempts to control the thoughts and feelings of an adult are a violation of their rights. Only when the rights of the adult impede the rights of the child, do these actions become criminal, or warrant intervention by law enforcement or the mental health community. Throughout this research study, reference to pedophilia as a mental disorder, only refers to pedophilia that is expressed through outward behavior towards a child. This study will explore the problem of how to curb expression of pedophilic behaviors that violate the rights of a child. It will focus on finding the most effective treatment for curbing these behaviors. It will not address the issue of sexual preferences that are unexpressed through behaviors towards children.

Purpose and objectives of the study

The purpose of the study is to explore the most prevalent treatment options for… [END OF PREVIEW] . . . READ MORE

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