Mental health articles

Treatment of paedophilia

Social constraints

One way in which society has dealt with issues of paedophilia has been to try to control – not treat – the actions of paedophiles. A number of laws have been instituted to facilitate this process in the UK, including:

The Sex Offenders Act 1997 : lists all people convicted of acts ‘of a sexual nature involving an abuse of power, where the victim is unable to give informed or true consent’. It covers a range of offences, including rape, incest, child abuse and indecent assault. Offenders have to register with the police and notify them of any changes in their name and address. People who do not register can be imprisoned or receive a £5000 fi ne. People stay on the register for differing times, depending on the nature of their conviction. People who receive a non-custodial sentence or caution stay on the list for fi ve years: those given sentences of 30 months or over stay on indefi nitely. Crime Sentence Act 1997 : allows for sex offenders who are convicted of a second serious sex offence to be automatically given a life sentence. Crime and Disorder Act 1998 : gives police particular powers against sex offenders, allowing them to apply for a ‘Sex Offenders Order’ for any offender who can reasonably be considered a public risk. Courts can impose conditions on offenders, such as banning them from places where children are likely to come together, such as parks and schools.

Treatment programmes

As sexual activity with young persons is against the law, treatment is usually initiated in a prison or a secure forensic facility. Even here, engagement in treatment programmes is not compulsory, and only about 25 per cent of those offered treatment choose to engage in treatment programmes.

Physical treatments

Physical treatments suppress sexual urges and behaviour, but do not change the object of sexual desire. Two surgical procedures, castration and neurosurgery, are no longer considered ethically acceptable. However, chemical approaches involving administration of drugs that block the production or action of androgens, hormones that infl uence the male sexual response, remain in use. These have achieved modest results. Berlin and Meinecke (1981), for example, followed 20 men treated with androgen-blocking drugs; 3 repeated their offences while taking medication, but relapse rates were high following cessation of therapy. A major problem for antiandrogen treatments is that between 30 and 100 per cent of the people prescribed these drugs do not take them (Barbaree and Seto 1997). Many of those who stop taking them presumably do so because they want to re-offend, as they do not change any of the beliefs or attitudes that drive deviant sexual behaviours. In addition, the drugs have a number of side-effects, including weight gain and reducing the size of testes, which may discourage their use. Finally, these treatments are effective only in individuals with abnormally high testosterone levels. Most paedophiles do not have these levels of testosterone, so would not benefi t from the treatment even if they were fully compliant with the therapy. Summarizing the research on another biochemical treatment, luteinizing hormone-releasing hormone (LHRH) agonists (which prevent luteinizing hormone being released in the pituitary gland to stimulate the production of testosterone), Briken et al. (2003) identifi ed four case reports, seven uncontrolled studies and only one study comparing LNRH agonists with an androgen antagonist. Thus the total sample of patients treated (often in an uncontrolled study) was 118, and all outcomes were self-report. With these cautions in mind, they concluded that the LNRH was an effective form of treatment. Of course, treatment does not come without its problems, which as well as sexual dysfunction include loss of body hair, hot fl ushes, mood swings, breast growth and weight gain.

Tags: paedophilia, treatment