3. ACT:

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:

  • the differences between traditional therapy and the new sex-specific therapy;
  • how to find the best sex-specific therapist;
  • answers to frequently asked questions about sex-specific tests.

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., L.P.C.)

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 sex drive.

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 drive.

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 children.

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 abuse.

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 sexual abuser.

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.

Table 6

Contrast: Traditional vs Sex-Specific Therapist

Traditional Therapist

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 sex-specific therapist.

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 children?"

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.

Table 7

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.


Question

What You Want To Hear

Why

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?

Yes

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?

Yes

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?*

Yes

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?

Yes

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.

Yes

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 probation requirements?"

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:

  1. Teenagers concerned that they may have a sexual interest in children;
  2. Boys who are victims of molestation;
  3. Boys and girls who are the older child in a sexual incident if the age difference is three to five years or more;
  4. Any child or teenager accused of sexually molesting a younger child.

Which adults should we test?

  1. Adults concerned that they may have a sexual interest in children;
  2. Adults who report child-centered sex fantasies for more than six months;
  3. Exhibitionists (flashers);
  4. Voyeurs (window-peepers);
  5. Adults who have been accused of sexually molesting a child;
  6. Adults convicted of sexually molesting a child.

Who should we treat?

Any patient who, in the opinion of a sex-specific therapist, could benefit.

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 love.

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.

A FACT

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.

Your Opportunity To Save 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 prevention.

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

Copyright 2014 © Child Molestation Research & Prevention Institute, Inc.
All content and works posted on this website are owned and copyrighted by CMRPI. All rights reserved.
Child Molestation Research & Prevention Institute 2515 Santa Clara Avenue, Suite 208 Alameda, CA 94501