Diagnose Early. Use Tests, Medicines, And Sex-Specific Treatment Therapies
Your Opportunity To Save Children
Early diagnosis saves children. Had early diagnosis occurred with the
admitted pedophiles in the Child Molestation Prevention Study, we
could have prevented nearly 28,000 children from being molested. We
could also have saved many of these children from being molested
repeatedly - preventing over 168,000 acts.
You can be a force to prevent child sexual abuse if you tell your family and friends that the power of early diagnosis is in their hands.
In this section, you will learn about the new kind of therapists and therapies that effectively treat a patient's sexual interest in children and the tests that assess for a sexual interest in children. You will learn:
Choosing A Therapist
If you are concerned that a child, teenager, or adult in your family
may have a sexual interest in children, finding the best therapist
for that child or adult is the most important thing you can do. Why?
A good sex-specific therapist is important because not only will he
or she have the state-of-the-art skills to best evaluate and treat
your family member, but he or she will also have the best ability to
move forward immediately to insure the safety of all the children in
the patient's family, social circle, and neighborhood.
What does a sex-specific therapist do? A sex-specific therapist
evaluates and treats men, women, teenagers, and children with
suspected paraphilias. The patients may be voyeurs (window-peepers),
exhibitionists (flashers), or have a sex drive directed toward
children. They may have a fetish (a sexual obsession with objects
such as women's shoes or lingerie). The therapist may be a
psychiatrist (M.D.), a psychologist (Ph.D.), a licensed clinical
social worker (L.C.S.W.) or a master's level counselor (M.S., M.A.,
It's essential that you proceed with caution. Why? Because today
anyone can simply say he or she is a sex-specific therapist. No
credentials are required: no degrees, no certification. So, the
variance between the 20-year-veteran therapist - who keeps up with
the field and uses the tests, medicines and sex-specific therapies
that are proven effective and are now a part of standard practice - and
the "therapists" who make up their own treatments is extreme.
As you have learned, there is one immense difference between you and
the family member who is sexually attracted to children - the
direction of your sex drive. So when you look for a therapist, you
are looking for one who knows how to teach the techniques that alter
Why Traditional Therapies Don't Alter Sex Drive
Dynamically oriented therapy, the kind where you tell a therapist
about your childhood experiences and your feelings, is what most
people think of when they think of therapy. It is the most widely
used form of psychotherapy, and it has proven effective with many
types of emotional problems.
However, wanting to be sexual with a child is not caused
by a person's emotions. It's also not caused
by problems of family dynamics.
When people - including psychiatrists and psychologists - say
that therapy or treatment does not work for patients with a sex drive
directed toward children, they are right if they are referring to
traditional, dynamically oriented psychotherapy, family therapy, or
general counseling. Most therapies are useless with teenagers or
adults who have a sexual interest in children. Why? Because
traditional therapies don't alter sex
And because traditional therapists lack the specialized training to
focus on preventing future acts that would harm children.
But there are tremendous differences between sex-specific therapy and
traditional therapy. First of all, sex-specific therapists are
intensely protective of children. They have a double focus:
protection of potential child victims, as well as evaluation and
treatment of the molesting patient. And it's in that order.
Children first. Molesting patient second. In contrast to traditional
therapists, whose first concerns are their patients' welfare, these
sex-specific therapists are immediately active to protect children.
A sex-specific evaluation always includes an assessment of the
patient's immediate risk to children. How much risk does the
patient present to the children around him or her? In treatment of
adults where the risk is especially severe, the therapist prescribes
medicine that chemically castrates the patient. In some instances,
the molesting patient must wear an electronic monitor on his ankle,
which tracks his whereabouts 24 hours a day. Those extreme measures
are useful in about five percent of cases.
Most patients pose considerably less threat to the children around
them, once they are involved in a sex-specific program that includes
medicines, sex-specific therapy, and various levels of supervision.
In sex-specific therapy, the patients with paraphilias meet in
groups. The group setting is helpful for two reasons. Group
confrontation from abuser-patients farther along in treatment helps
to break the new patient's denial and the group setting lowers
treatment cost. The therapist teaches them specific behavioral
techniques to lower or extinguish their paraphilic sex drive, and
they have assignments to practice that actually extinguish their
sexual interest in children.
To protect children, the therapist - rather than relying on the patient's word - retests patients at six-month intervals to measure their success. And there's yet another facet of this therapy that protects children: Molester patients are forbidden to be around children. This is monitored outside of the therapy hours by a supervision network that may include family members, friends, social workers, and in some cases probation or parole officers. In fact, the sex-specific therapist is often more protective of a family's children than is the family itself. The therapist outlines protective policies and insists that any family member with sexual interest in children be separated from children, regardless of how "trivial" a known incident might be in the eyes of the family.
How Effective Are The New Sex-Specific Therapies?
The families of children, teenagers, or adults who have a sexual interest in children can expect a good treatment success rate. How is success defined? No more child victims. No more sexual abuse acts.
Notice we said "the new sex-specific therapies are effective to
stop children, teenagers, and adults with a sexual interest in children". We did not say "child
molesters". The new sex-specific therapies are effective in making
the sexual desire for children inactive. That is the focus of the new
therapies - and their strength.
However, these therapies don't work for the abusers who commit 5
percent of the acts and molest 12 percent of the children. They don't
work when the child molestation is caused by: an older child's
sexual curiosity and experimentation; an adult's severe medical or
mental problem; or by a child molester with the general disregard for
other people that is associated with an antisocial personality
disorder. The treatments are exceptionally effective, however, in
stopping the future acts of child molestation caused by
a person's sexual interest in
Who are these people who can be treated so effectively? The ones who
have developed the sexual desire for children at puberty through
unknown development, by pairing adult-child sex thoughts with orgasm,
and by being in the group of boy victims who are handling their fear
and anxiety by becoming abusers themselves. Without treatment, these
are the abusers who commit 95 percent of all acts of child sexual
Finding A Sex-Specific Therapist
Sex-specific therapies bear little resemblance to traditional
therapies. It's for that very reason that they are effective. And,
of course, it's also for that reason that you must be sure you find
a well-trained experienced sex-specific therapist for yourself, your family
member, or friend. In Table 6, we highlight some basic differences
between the two forms of therapy.
So why have you never heard of these specialists and why can they be
difficult to find? Because of the general public's lack of accurate
information about child sexual abuse, most people are horror-struck
by the idea that a sexual abuser of children might be in a
therapist's office in their community. They believe in the
not-in-my-family/stranger with a candy bar myth of the child
And so, therapists who do this work usually keep a low profile.
Abuser patients whose lives have been turned around never tell
anybody about their sex-specific therapy. Families whose children
have been protected never tell anybody about the abuser's
sex-specific therapy. The patient's keep their treatment a secret
from their friends. The families keep their problems a secret. The
therapists keep the fact that they specialize in treating people with
paraphilias a secret.
Contrast: Traditional vs Sex-Specific Therapist
Offers dynamically oriented therapies (talking therapies) that don't directly reduce sexual interest in children.
Offers sex-specific treatments that use cognitive-behavioral techniques to drastically reduce or eliminate a patient's sex drive toward children.
Knows little about the development of a sex drive toward children and frequently reacts emotionally to a patient with this disorder.
Trained to deliver sex-specific therapies to patients with sex drives toward children and to maintain objectivity.
Not trained to proceed with those molesting patients who habitually lie, deny, conceal, and state that they don't want or need therapy.
Trained to proceed with the treatment of molesting patients irrespective of their denial.
Has one focus, the patient's welfare.
Has a double focus: The children who must be protected and the patient's extinction of sexual interest in children.
Trained to assess whether a patient is a danger to himself (suicide risk) or to others (murder risk).
Trained to assess murder risk, suicide risk, and the risk that the patient will molest a child.
Usually delivers outpatient therapy that begins and ends in the therapist's office.
Organizes a plan to monitor the patient's activities outside the treatment setting.
Tests: Rarely uses objective measures to monitor treatment success.
Tests: Uses objective measures to prove treatment success.
Medicines: Not trained in use of SSRIs and Provera to alter sex drive.
Medicines: Trained in use of SSRIs and Provera to alter sex drive.
Success: Partial degrees of recovery are acceptable.
Success: Sex-specific therapy must stop sexual desire for children and protect potential victims.
Patient determines when the therapy ends.
Therapist determines when therapy ends.
Having already read parts one and two of the Prevention Plan you have
a great deal of education, so you know most things that the
therapists know: That child molesters are already in the
neighborhoods where our children go to school, that they live next
door, attend our churches, and are in our families. More than 90
percent of them never touch a child outside of their family or social
circle. They are seldom reported and they seldom make it to a
The take-home message: Your family's children are far safer from
the sexual abuser in a sex-specific treatment program in their
neighborhood than they are from the undetected child molesters
already near them.
So, if you are a concerned family member, where do you start?
Help with finding a sex-specific therapist
You can find a list of sex-specific therapists in North America on
this website at Sex-Specific Therapy Sites by State. (Note:
inclusion on this list does not indicate an endorsement by the
Child Molestation Research & Prevention Institute. Please
carefully evaluate any therapy practice that you contact.) If you do
not find a sex-specific therapist near you on our list, you might
also contact the Association for the Treatment of Sexual Abusers at
www.atsa.com for listings close to you.
In addition, your state maintains a list of psychiatrists,
psychologists, social workers and counselors available in your city.
Your local mental health center probably has the listing of the
respective organizations and how to contact them.
To find a sex specific therapist, say this: "I'm concerned
that my son (or daughter, or husband, or brother, or friend) is sexually attracted to young children.
Can you direct me to a therapist who can evaluate a sexual attraction
To help you find the best sex-specific therapist, we've given you
six questions to ask the therapist or the therapist's office
manager before you make the first appointment. (See
Table 7). Should the therapist be unwilling or unable to answer these
questions, seek out a therapist who is willing to give you this
information. Do not be bashful about asking such questions, since
having a competent therapist is essential not only for a competent
evaluation and for effective treatment, but also for the protection
of the children in the patient's family and social circle.
If, after your first or second contact with the therapist, you are
still confused about his or her methods of evaluation and treatment,
you shouldn't assume that you absolutely must stay with that
therapist. Having a "good fit" with the therapist is important
for effective therapy.
Six Questions to Ask When Selecting a Sex-Specific Therapist
* Details about these medicines and therapies may be found in: The Stop Child Molestation Book, by Gene G. Abel, M.D., and Nora Harlow.
What You Want To Hear
How many patients with a sexual interest in children do you treat in a year?
20 or more cases
Generally, the more experienced the therapist, the more knowledgeable he or she is about effective treatment.
Do you use sexual interest testing,
plethysmography or polygraphs as part of your evaluation?
Without objective testing, the therapist has
to make recommendations based on incomplete information.
If you are a psychiatrist, do you prescribe
medications such as SSRIs or Provera for some of your patients
with paraphilias?* If you are a licensed therapist, do you have a
working relationship with a physician?
Ideally, you want a therapist who can prescribe medication if needed, or who works closely with a physician who can prescribe.*
Do your treatments include covert sensitization, aversion or satiation to directly reduce sexual interest in children?*
Sexual interest in children is associated with child molestation; therefore, a sex-specific therapist should have this skill.
Do you use cognitive-behavioral and relapse-prevention therapies?
Cognitive-behavioral therapies are the most effective means of preventing child molesters from molesting again.*
Do you belong to ATSA (the Association for the Treatment of Sexual Abusers)? This is the national association for sex-specific therapists.
Membership suggests a greater likelihood that the therapist has had appropriate training.
The New Tests: What They Are and Why We Need Them
If there is one reason we can, today, protect three million children,
it's the new tests made possible by computer technology.
What causes 17-year-old George to molest his ten-year-old stepsister
and then 22 more little girls? He has a sex drive directed at
children. (To read George's Story, go to Who is the child
molester? Who causes so much damage to our children? under 1.
Tell others the facts.)
Many people will be surprised that we have tests that identify this
sex drive. Actually the tests have existed for 30 years and have been
commonly used for 20 years. There are two types of objective tests:
the sexual arousal tests and the sexual interest tests. Both measure
the patient's sex drive toward children against his sex drive
toward adults. The sexual arousal tests are suitable for use on adult
men and are rarely used with anyone less than 16-years-old. The
sexual interest tests may be used on adults, teenagers, and children
as young as age 12. The question both tests answer: In relation to
this patient's sex drive toward adults or age-appropriate individuals,
how strong is his sex drive toward children?
Another test used is the polygraph or "lie detector test." While
not a sex-specific test, the polygraph is often used with patients
who have paraphilias. Sex-specific therapists most often use the
polygraph with the sexual arousal tests or the sexual interest test
to get answers to specific questions. They are used as an additional
check on the patient's account of his sex history, to verify
specific paraphilic incidents, and to verify his ability to maintain
his treatment gains. For instance, a sex-specific therapist might
have the polygrapher ask a patient: "Have you been honest with your
therapist about your sexual history with children?" "Since you
entered treatment have you touched a child for sexual gratification?" "Since you've been on probation, have you been compliant with your
The Most Frequently Asked Questions About Sex-Specific Tests
Who could find out your family member is being evaluated?
Psychiatric test records are confidential. The patient (or the
parents of an underage patient) controls the release of his (or her)
records and must sign consent for release of records if he wishes
someone else - his lawyers, church officials, family members - to
have access to them.
If you test positive, can you be arrested?
No. The sexual arousal tests and the sexual interest tests do not
test for guilt or innocence. What most people want is to relieve
their anxiety by getting an answer to the question: Did the patient
molest that child? Neither test answers that question. The question
they answer is: Does the patient have an ongoing sexual interest in
children that could be stopped by medicines and therapies?
Who will pay for the tests?
Insurance companies that pay for psychological testing also pay for
these tests. Occasionally, the patient's employer will pay for
testing. With destitute teenagers, the state often pays. And, of
course, some patients or their families pay for their own tests.
Why are these tests effective?
The reason these tests work so well is that there is actually an
enormous difference between men and women who have an ongoing sexual
interest in children and men and women who don't.
How do these tests help us protect children?
We know that the child molesters who have this unusual sex drive are
the ones who molest 88 percent of our children. And we know that this
sex drive toward children appears during puberty, and that the
majority have their first victim while they are teenagers. With those
two facts in mind, the most sensible thing we could do is test early
and treat early.
Which youth should we test?
We should test:
Which adults should we test?
Who should we treat?
Any patient who, in the opinion of a sex-specific therapist, could
But will the treatment actually extinguish the patient's sex drive
toward children? He'll say he's fine, but is he? Here again, the
tests give our children protection. We don't have to rely on the
patient's word - or the therapist's impressions. We can check the
test results to see if the treatment has worked to extinguish the
patient's child directed sex drive. We can also measure any
reoccurrence of the sexual interest in children in the years
following treatment. Tests to identify people with a sexual interest
in children are all about sex drive.
The Biggest Obstacle To Protecting Children
So, what's our biggest obstacle here? Most people have never heard
of the tests. A sex test scares them. Why? Because they have it
backwards. If you tell them that there is an immense difference
between pedophiles and all the people who aren't pedophiles,
they'll absolutely agree. But they won't talk about a sex drive
directed at children.
They'll tell you that pedophiles are immensely different in their
obvious outward characteristics. They'll say - a
mistaken belief - that pedophiles neither look nor behave like any
friend of theirs or any member of their family. Pedophiles, they'll
say, are single men who have no education, who never date, have no
interest in religion, and are unable to support themselves. They'll
go on to say - again mistakenly - that they look strange and they act
strange. In fact they are strangers. They are strange men who hang
around the schoolyard with candy bars to lure our children away.
We showed you that most men who admitted to molesting a child were
just like everyone else in their outward characteristics. In fact,
they are a mirror image of this country's population. They are
married, educated, working, and religious. And perhaps their most
confusing characteristic: one part of their sex drive is like
everyone else's - their sex drive toward adults. (Only 7 percent of
pedophiles have no sexual interest in adults).
The difference for the 93 percent with sexual interest in adults
is - and this is immense - that they also have a sexual
interest in children.
The pedophile is dealing with a sex drive so immensely different from
the sex drive of most of us that people who don't have it can
barely imagine it exists.
Since most people don't understand what causes a man like George to
(in the minds of his neighbors), suddenly sexually molest a child;
they don't believe a test could possibly work.
They mistakenly believe that when they hug a child or hold a child on
their lap that an evaluator might mistake that act for child
molestation. It's a needless worry; a sex-specific physician or
therapist recognizes the difference between someone who wants sexual
gratification from a child and a person who touches a child to show
On a test that measures sexual interest in children, someone
who hugs and cuddles children as part of a loving family will react
radically different from a person who is interested in a child
sexually. Why? Because the loving adult who hugs a child has a sex
drive that leaves out children, it's directed at adults. The
pedophile's immensely different sex drive works to our advantage.
We can test for it, we can offer medicines and therapies to reduce or
extinguish that child-directed sex drive. It's because that sex
drive is so immensely different that the tests work so well.
The medicines are effective. The therapies are successful. Families can expect a 77 to 97 percent success rate when they seek out treatment by a sex-specific therapist who uses a combination of
objective testing, medication, and the most advanced cognitive-behavioral therapies, all directed toward eliminating the abuser's sexual desire for children.
As you go about your everyday life, if you hear someone you know talking about the discovery of an incident of child sexual abuse, you could save many children by giving these suggestions.
To the victim's family: Please insist that the abuser be
required to complete sex-specific treatment. This is not
"helping" or "coddling" the abuser. This is child molestation
To the abuser: You must commit yourself to a sex-specific
program (even if you are going to jail) that will give you the
control to stop and to never approach another child.
To the clergy and therapists counseling the victim or the abuser:
Please protect all children by making sure that the abuser
completes a sex-specific program.
For more detailed information about the causes of child sexual abuse,
the tests, medicines, and treatments that are effective at preventing
it, and the sex-specific specialists who provide this treatment,
please read The Stop Child Molestation Book: What Ordinary
People Can Do In Their Everyday Lives To Save Three Million Children
by Gene G. Abel, M.D. and Nora Harlow. Just click here to order.
Back to: Main Page of the Prevention Plan.
Back to: Preventation Plan Reference Notes