Pedophilia - Efficacy of Combination Term Paper

Excerpt from Term Paper :

It will focus discovering the treatment option, or combination of options that results in the lowest incidence of recidivism for the longest period following the treatment. It is difficult to predict future events, therefore the research will take a historical perspective on the problem.

This study will compare recidivism rates for the four most common treatments used for pedophile offenders. It will only consider treatment for those that were convicted of their crimes. It will compare those that received group therapy only, cognitive behavioral therapy only, treatment with SSRIs only, and chemical castration only. Many treatment plans include a combination of treatments. Therefore, a comparison of the most common treatment combinations found during the course of the research will be compared as well. The most common treatment combinations include Group therapy and cognitive therapy, SSRIs and cognitive therapy, chemical castration and cognitive therapy. The most common combination treatment involves use of cognitive behavior therapy with SSRIs (Barbaree & Seto, 1997).

It will explore these combinations in terms of reduction in recidivism rates over time. It will compare recidivism rates for the seven treatment categories at 1 year after discontinuation of treatment and every year after that up to 10 years following treatment. If recidivism occurs in a sample subject, then time will only be counted from the end of the first treatment session. Repeat recidivism will only be considered as an occurrence recidivism, regardless of the number of reoccurrences. The objective of this study is to isolate the single best treatment option for affecting a long-term change in behavior.

It will address the following research questions in relation to the objectives of the research study.

1. Which types of pedophiles can be successfully treated using cognitive therapies alone?

2. Is pedophilia too resistant to psychological interventions such that it can only be treated with medical therapies?

3. Which medical strategies are most effective in treating pedophilia?

4. Which treatment strategies produce the most reliable long-term results?

Rationale of the Study

The research objectives of the study address the most prevalent concern of those involved in both the law enforcement and mental health professions concerning the prevention of unlawful acts against children. Regardless of one's feelings on the rights on an adult to determine their own feelings regarding the topic, when urges and feelings become behaviors, the rights of children are at stake. Society places a high priority on the safety of children. Therefore, reducing behaviors related to pedophilia are an important issue for society and those that are responsible for upholding societal ideals. Pedophilia is considered to be a heinous crime by a majority of society, therefore academic attention to reducing the future occurrence of such acts is held in high regard by many.

Definition of Terms

Several terms regarding pedophilia have become obscured through colloquial or non-academic usage. Therefore, it is necessary to explain the definitions of these terms as they will apply to the current research study. The following definition will be used throughout the research study.

Adult. An adult will mean a person over the age of 18, either male or female.

Age of consent. The age of consent varies in different countries around the world. For the purposes of this study, the age of consent will refer to that of the United States, 18.

Castration. A procedure the reduces sexual urges in the individual by external means. For the purposes of this study, it refers to the administration of certain pharmaceutical compounds, prescribed by medical personnel that are known to reduce or eliminate sexual urges. It does not refer to the physical removal of genitalia in this study.

Child. Any person below the age of 18 is considered to be a child for the purposes of this study.

Co morbidity. This term refers to the presence of pedophilia in combination with any other DSM-IV defined condition.

Law enforcement. Law enforcement refers to any member or branch of the law enforcement branch of the government. It is used in general terms throughout the research study and does not delineate rank or position in the law enforcement hierarchy.

Mental health professional. This means any member of the medical or mental health community that is involved in the diagnosis or treatment of pedophilia.

Offender. This term refers to a person that has been criminally convicted of a sexual offense related to a child, regardless of the severity or circumstances of the activity.

Pedophile. For the purposes of this study, a pedophile will mean a person that has been convicted of an unlawful sexual act involving a child. In some circumstances, it will refer to a person with sexual urges and fantasies, but that have not acted upon them.

Pedophilic behavior. This term refers to acting on pedophilic feelings and urges by engaging in any sexually related act with a child. The act does not have to involve sexual intercourse, but means any activity prohibited by law such as touching or suggestive verbal or visual behavior.

Pedophilic fantasies. This term refers to dreams or thoughts that involve the adult interacting in a sexual manner with a child. They may or may not be expressed outwardly.

Pedophilic urges. This term refers to physical and mental arousal in response to a child stimulus.

Recidivism. This is a legal term referring to repeat offenses of the same crime. In the case of pedophilia, it does not have to be the exact same crime. For instance, if an offender is convicted of sexual intercourse with a minor, but is later convicted of possession of sexually explicit material involving a child, it will still be considered recidivism for the purposes of these research.

Therapy. Any treatment designed to reduce the occurrence of pedophilic behaviors is considered to be therapy for the purposes of this study. This includes non-medical, medical and combination therapies.

Limitations of the Study

There are several limitations that will impact the interpretation and context of the research study. Some of these limitations stem from the social definitions and current controversies over pedophilia. Others are the result of limitations inherent in the research methodology. The definition of these limitations and their impact on the conclusions of the study will be addressed. Some of these limitation will be addressed more thoroughly in the appropriate chapters of the text.

This study will be limited to those pedophiles that have been convicted of criminal offenses involving children under the age of 18. There are several reasons for this. The first reason is that those that have been convicted of child related sexual offenses are easily quantified through a law enforcement records search. Quantification of those that have not committed crimes must be measured using mental health records or self-reporting measures. These methods are considered to be unreliable for several reasons.

One of the key difficulties in interpreting statistics related to pedophilia is that they reflect "averages" within groups. However, it tells us nothing about the likelihood that any certain individual will be likely to become a repeat offender. Within these statistics, are individuals that committed repeat offenses and those that did not. The key to lowering these figures relies on the ability to provide the most effective treatment for each and every individual involved. This is one of the most important reasons for the conduct of this research project. This project will focus on discovering which treatment methods offer the best answer to the problem of repeat offenses among pedophiles. The ultimate goal is to provide a means to determine which treatment methods will be the most likely to prevent recidivism in the individual. Finding the best treatment method for each individual means

Scales and other assessment instruments are used to measure the "progress" of the pedophile in returning to correct patterns of thinking. However, pedophiles are aware of the ramifications of expressing these feelings outwardly. They know which answers are "politically correct." Therefore, the validity of self-reporting measures for pedophiles must be questioned. For this reason, scales that measure the "thoughts and feelings" of the pedophile will not be considered a reliable means to assess the success or failure of a treatment method.

In addition to a compulsion to appear to be "politically correct" in the eyes of society. The pedophile might also falsify answers in order to avoid potential legal ramifications of their answers. It is not likely that they would be willing to provide answers that will incriminate themselves. These same limitations affect studies found in the literature review that use self-reporting questionnaires as a means to measure the effectiveness of treatment methods. Self-reporting methods are more reliable for conditions that do not carry the legal and social ramifications that pedophilia does.

There are simply too many confounding variables and limitations to conducting a study that measures the feelings of the pedophile. This study will focus on the social goal of reducing outward expression of pedophilia. This study will rely on recidivism as the measurement tool. Recidivism is easily…

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