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How do you intervene psychologically with pedophiles?

How do you intervene psychologically with pedophiles?

April 4, 2024

It is not uncommon to read in the press or hear on the news that they have arrested participants of networks linked to child pornography or cases in which an adult subject has sexually abused minors. Most of these subjects are pedophiles , people who feel sexual attraction for minors.

Pedophilia is a serious problem known since antiquity that can have serious effects both for the pedophile himself and for his object of desire if he comes to put his fantasies into practice. In addition, it is a problem classified as mental disorder, and as such is related to the intervention of psychology professionals. How do you intervene psychologically with pedophiles? Let's start with the fundamental.

  • Related article: "Pedophilia (sexual assaults on children): in the mind of the pedophile"

Brief previous definition: what is pedophilia?

Pedophilia is a paraphilia, disorder of sexual inclination or the choice of the object in which the subject presents for at least six months a series of recurrent and persistent fantasies of a sexual nature in which the object of his desire are prepubertal individuals, usually younger than thirteen years of age. These fantasies generate in the subject itself a high level of tension, discomfort or alteration of the usual functionality.

For a subject to be considered a pedophile, he must be at least sixteen years of age and at least five years older than the prepubert. It is important do not confuse pedophilia with pedophilia , the first being the existence of sexual attraction towards minors while the second indicates that real sexual abuse has occurred. That is, a pedophile does not have to take action: not all pedophiles are pedophiles (nor do all pedophiles have to be pedophiles, there being sexual abuse of minors for reasons other than sexual attraction).

For the most part, pedophiles are middle-aged males , usually heterosexual, which usually have links with the victims (family, neighborhood or work) and who do not usually use violence to approach their object of desire. However, there are also pedophiles (which statistically tend to be preferred by adolescents and children under three years of age), as well as pedophilia targeting minors of the same sex.

Although it is considered a disorder, in most cases the subjects who suffer from it are fully aware of their actions, enjoying freedom and willingness to carry or not carry out sexual abuse. That is why most of them are criminally imputable subjects. Despite this there are exceptions in which other psychic alterations occur.

  • Related article: "The main sexual and psychosexual disorders"

Types of pedophiles

There are many different types of pedophiles. Some experience deep discomfort and guilt because of the attraction they feel, while others consider that it is right and justify their actions and even in some cases they may find themselves subject to sadistic and psychopathic tendencies.

In some cases they themselves have suffered sexual abuse during childhood, while others have not. Sometimes the pedophile feels a romantic attraction towards the minor in question, while in other cases it is a purely sexual interest.

When establishing a treatment, all these characteristics can greatly influence the strategies to be used and their possible effectiveness.

  • Maybe you're interested: "Differences between pedophilia and pederasty"

Perspectives on the treatment of pedophilia

The treatment of pedophilia is a complex reality that throughout history has received different considerations and in which different techniques have been used, acting both from psychology and from medicine.

Keep in mind that generally pedophiles they come to consultation due to environmental pressures or by court order , having few cases in which they do it of own will. This makes the treatment complex and there may be little adherence to it.

Medical treatments: pharmacology and surgery

The medical-type treatments for pedophilia can focus on two major groups: pharmacology and surgery. Many of the pedophile subjects who fear sexually assaulting minors or who do not want it to happen again ask for this type of intervention.

The use of pharmacology focuses on the control of sexual desire, the reduction of arousal, through hormonal regulation of the individuals.

The two most historically used elements have been cyproterone acetate, which blocks androgens and therefore reduces the production of testosterone, and the medroxyprogesterone acetate , which decreases androgens and therefore the production of testosterone. Psychotropic drugs have also been used as tranquilizers and antipsychotics (highlighting haloperidol). Fluoxetine has also been used, but only causes clear improvements in subjects with compulsive characteristics.

Regarding surgery, its use is controversial and risky, given that it can involve a serious permanent deterioration for the habitual functioning of the subject at the same time that its effectiveness is questionable, since even if the subject can not have erections, it is possible to perform of abusive practices that do not include the use of the gonads. In this sense, either physical castration or the elimination of the nuclei of the ventromedial hypothalamus in the brain is used.

A big problem with this type of treatment is that deep down I do not know the basic problem, but its manifestations . In fact, although there is no sexual desire, some subjects subjected to these interventions may continue to maintain different types of abuse.

Psychological treatments

The psychological treatment of the pedophile must take into account, in the first place, that he is in front of a patient regardless of whether he has committed sexual abuse or not. The professional who treats them must bear in mind that their attitude towards the individual can be decisive at the time. Is about maintain an attitude in which the subject is not judged and focused on getting their recovery.

It is essential that the treatment performed is adapted to each case, since there is a great diversity of factors that can influence each person and cause the treatment to be more or less effective.

These treatments, which are carried out in the form of various programs, must take into account not only the modification of sexual preferences but also the pedophile's linkage and the search for cognitive changes . The paradigm most used in this type of cases is usually cognitive-behavioral, although other approaches have also been used, such as psychodynamic.

Addressing the problem

One of the first approaches that must be taken into account is the development of positive linkers through the training in social skills and empathy . It is recommended the use of cognitive restructuring and training in stress management (because in some cases impulsive behaviors are linked to impulses linked to anxiety).

It is necessary to work on aspects such as the significance for the subject of the fixation by the minors, the existence of possible causal elements and their treatment in case of having them. For example, if the victim suffered sexual abuse in childhood, work should be done to restructure the cognitions that such abuse may have caused in the pedophile and make him see what the act may mean for his own victims.

The possible perceived ineffectiveness to maintain relations with adults can be in some cases one of the causes that causes that the pedophile has been interested in minors. In this case also work can be done in the reinforcement of self-efficacy and in the training in assertiveness and social skills.

In order to try to modify sexual behavior, different alternatives and programs have been proposed, with the majority of the techniques used similar to those used in the rest of paraphilias or those used in cases of substance addiction. For example, contingency control is usually an element to be used, as well as assistance to support groups and group therapy in some cases.

It has been shown that a combination of pharmacological therapy together with psychological therapy is usually the most successful methodology.

Some techniques applied in different programs

As we have seen, one of the main ways to deal with a paraphilia from the cognitive-behavioral paradigm is the search for a development of positive connections that allow to enhance sexual arousal in non-paraphilic situations. In this sense, the analysis and modification of fantasies is usually used to later perform a masturbatory reconditioning.

In the first case, the patient is tried detect and classify your sexual fantasies in normal and parafílicas , so that the subject tries to maintain the first ones when it is given to the practice of onanism. It is intended to gradually get the subject more attracted to more common stimulations, such as contact with adults.

The masturbatory reconditioning consists in that when the subject masturbates several times in a row with non-paraphillic stimuli, indicate aloud the components of the fantasies that do include paraphillic elements. Wanted associate fixation by minors with the refractory period in which there is no excitement, so that little by little a lesser activation will be generated before the image of minors.

Then usually proceed to Deserotize the paraphillic stimulus . To do this, we try to alter the sequence of action that leads the subject to become excited by the idea of ​​interacting with a minor sexually.Different strategies are designed in order to generate incompatible behaviors with each of the steps that can lead to this excitement.

You can also apply aversive techniques such as disguised aversion (in which the subject is asked or exposed to imagine situations that would stop him from acting) or the olfactory (before the excitement of the subject to paraphilic stimuli is subjected to odors unpleasant so that the stimulus is associated with it instead of with sexual arousal). Initially electrical aversion was used, but at present it is not a usual practice.


Prevention is fundamental in order to prevent the pedophile subject from taking action or repeating if he has already committed an act of pedophilia.

Pedophiles are frequent live in environments close to places with an abundance of children or work in environments linked to childhood. This is not advisable, given that the subject is exposed to their object of desire and puts both minors and the individual at risk. It is not about the subject being isolated, but about not facilitating their access to minors for the duration of the treatment.

  • Related article: "Prevent and detect early childhood sexual abuse"


Keep in mind that treating a paraphilia such as pedophilia is a complex and difficult challenge to achieve. In fact, part of the scientific community considers that pedophilia does not yet have a treatment that allows it to be eliminated, on the basis of modifying the behavior of pedophiles so that they do not commit any abuse. However, treating the symptoms themselves would not address the underlying problem, thereby recidivism is possible . It is therefore necessary to further research on this phenomenon and how to deal with it effectively.

Another aspect to note is that there is a wide variety of cases with different characteristics: while some suffer and feel guilty for being pedophiles, others consider their acts legitimate or even hold the minor responsible for possible abuses. All these elements have to be taken into account and dealt with differentially.

Finally, it is important to consider that, as indicated above, a pedophile does not have to be a pedophile. Not because he is attracted to minors he has committed or will commit abuses, and he has the right to be treated without being prejudged by something you have not done . However, if a psychologist or other professional does not feel qualified to work with a person with this disorder should refer it to be treated by another professional.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Balbuena, F. (2014). Mapping pedophilia: efficacy of treatments and future strategies. Notes of Psychology, 32 (3). 245-250.
  • Salazar, M., Peralta, C., & Pastor, F.J. (2009). Treaty of Psychopharmacology (2nd Ed.). Madrid: Editorial Panamericana.
  • Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J .; de los Ríos, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Thief, A and Álvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE Preparation Manual PIR, 02. CEDE. Madrid.

Sexual Offending: Measuring and understanding paedophilic sexual interest | Dr Caoilte Ó Ciardha (April 2024).

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