Pedophilic disorder treatment options include medication, hormone, and psychosocial therapies. “Stigma often discourages people from seeking help, but resources are available.
Pedophilic disorder (formerly known as pedophilia) occurs when someone experiences or engages in sexual fantasies, urges, or behaviors involving prepubescent children ages 13 and under.
Pedophilic disorder treatment usually involves a combination of:
- medications, such as hormone therapy
- therapies, such as cognitive behavioral therapy (CBT)
- other psychosocial methods, like group therapy or family systems theory
When approaching treatment, it’s important to consider how an individual views their inappropriate thoughts and impulses.
It’s also important to consider any co-occurring conditions, such as:
- antisocial personality disorder (ASPD)
- substance use disorder (SUD)
- bipolar disorder
- depressive and anxiety disorders
- other paraphilias
Here’s a deeper dive into former and current treatments.
Androgen deprivation therapy (ADT) involves hormone-inhibiting medications to diminish sex drive in a person with pedophilic disorder.
Hormone-inhibiting medications may include:
- gonadotropin-releasing hormone (GnRH) antagonist, such as degarelix
- cyproterone acetate (CPA)
- medroxyprogesterone acetate (MPA)
A 2022 review of several studies found that testosterone-lowering drugs can reduce sexual interests and behaviors in pedophilic disorder.
A randomized clinical trial in 2020 found that treatment with degarelix worked quickly (2 weeks) to reduce the risk that someone would sexually abuse a child. While a 2022 study found that after 10 weeks of degarelix treatment, 58% of participants reported no further sexual interest in children.
David Tzall, a New York psychotherapist with experience treating pedophilic disorder, states that injectable GnRH antagonists, like Lupron, have been effectively used on criminal offenders.
Some selective serotonin reuptake inhibitors (SSRIs), which are often used to treat obsessive-compulsive disorder (OCD)., may decrease sexual obsessions, improve disordered mood symptoms, and perhaps decrease impulsivity.
Pedophilic disorder is a type of
Paraphilias can sometimes be manifestations of OCD. People with pedophilia OCD (POCD) may experience repetitive thoughts and ruminations related to the fear of offending, and medications may help to reduce repetition.
Tzall notes individuals may view recurrent thoughts as ego-dystonic or “very unnatural to them.”
A 2022 review suggests that SSRIs and tricyclic antidepressants have been shown to treat compulsive sexual behaviors and other compulsive paraphilias.
What is POCD?
It’s important to note that POCD is a manifestation of OCD, not a paraphilic disorder. Those living with POCD aren’t physically attracted to children, but they have intense fears that they could be.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) doesn’t distinguish specific types of OCD. OCD is the only clinically recognized condition. But POCD is used as a descriptive term to help clients understand repetitive and obsessive thoughts.
CBT can encompass various therapeutic methods to change thoughts and behaviors related to pedophilia.
- Cognitive: cognitive distortion, pro-offending attitudes, impulse control deficits, social skills deficits, poor emotional regulation, and environmental triggers.
- Behavioral: masturbatory reconditioning, covert sensitization, or aversion therapy.
CBT may address denial or provide empathy training. Another goal may be to reduce offense-supportive beliefs, such as “children need to have sex to learn about it.”
“If you’re not interrupting those thoughts, they can potentially linger and become more distressing,” Tzall says. “It may increase the risk.”
Aversion therapy is a behavioral therapy based on Ivan Pavlov’s classical conditioning. A licensed psychologist provides an aversive stimulus, e.g., bad-tasting bitterroot or harsh-smelling ammonia, and pairs it with an inappropriate thought or behavior.
“When you have these thoughts, you smell the ammonia; when you want to take an action, you put the bitterroot in your mouth,” Tzall explains. “On a consistent basis, someone can use these items to interfere with internal impulses.”
Acceptance and commitment therapy (ACT) is a form of psychotherapy that may be particularly helpful for non-offending individuals.
ACT helps you accept your thoughts and feelings without trying to change them. With the support of a mental health professional, you will safely be guided through uncomfortable thoughts and feelings by using mindfulness and behavior-changing techniques.
“Maybe you experience pedophilic thoughts, and you never act out on them, but you’ve accepted them for what they are, and you’re able to live a good life,” Tzall says.
If you are seeking support, consider visiting Psych Central’s directory to find an online therapist or a mental health professional near you.
People with pedophilic disorder may attend group therapy to confront denial and justification. Group therapy can reinforce the idea that minors aren’t developmentally and cognitively mature, and they legally cannot give consent, Tzall explains.
“You don’t feel alone; you feel like there’s a community,” Tzall says. “If you’re with people like yourself, there’s an understanding that can help to build a support system and serve as a foundation.”
The causes of pedophilic disorder may be related to neurobiology, hormonal differences, and a history of childhood sexual abuse. But
The DSM-5-TR lists three specific criteria to diagnose a person with pedophilic disorder, which include:
- sexual arousal, fantasies, urges, or behaviors involving a prepubescent child or children.
- acting on sexual desires, or experiencing related significant distress or difficulty.
- being at least 16 years old, and at least five years older than the child or children.
- exclusive (attraction only to children) and non-exclusive (attraction to children and adults)
- sexual attraction to a specific gender
- an attraction to family members only (also referred to as incest)
Recognizing the symptoms of pedophilic disorder can help prevent an individual from acting on inappropriate thoughts.
During or after treatment or incarceration, people diagnosed with pedophilic disorder may be given instructions, such as no contact with minors, no cell phone use, and a curfew. When used properly, Tzall explains monitoring can sometimes be the best option available.
Though people with pedophilic disorder often learn about treatment options after entering the legal system, a recent 2022 analysis confirms the existence of a non-offending group seeking support.
Medications, such as hormone therapy and SSRIs, may be used to treat individuals who have offended. But treatment is an individualized issue and approaches may differ for people seeking help.
Research suggests prioritizing patient-centered care, patient-oriented goal-setting, and shared decision-making. As we learn more about the condition, we can better provide treatment to people living with pedophilic disorder.