Wild Tamara S N, Müller Isabel, Fromberger Peter, Jordan Kirsten, Klein Lenka, Müller Jürgen L
Clinic for Psychiatry and Psychotherapy - Forensic Psychiatry, Human Medical Center Göttingen, Georg-August-University Göttingen, Göttingen, Germany.
Prevention of Sexual Abuse (PsM), Asklepios Psychiatric Clinic, Göttingen, Germany.
Front Psychiatry. 2020 Mar 3;11:88. doi: 10.3389/fpsyt.2020.00088. eCollection 2020.
In Germany, access to outpatient treatment services devoted to the prevention of (further) sexual offenses against minors and child sexual exploitation material (CSEM) offenses is often limited. The therapy project "Prevention of Sexual Abuse" tries to fill this gap by providing treatment to patients with a self-reported sexual interest in children and adolescents, irrespective of whether or not they are pedophilic or prosecuted by the legal justice system. Within the project, a treatment manual was developed which specifically addresses dynamic risk-factors in child sexual abusers and CSEM offenders. The treatment manual was conceived to reduce recidivism risk and to contribute to the enhancement of the patients' personal well-being. In this paper, results of the accompanying scientific research are presented: offense-supportive attitudes ( = 23), self-reported CSEM use ( = 10), emotional distress ( = 24), and participants' subjective risk perception of committing (further) sexual offenses ( = 25) reduced during the course of treatment. A reduction of offense-supportive attitudes was further observed from pre-intervention to 1-year follow-up ( = 8). Changes with regard to self-efficacy, quality of life, participants' self-perceived ability to control sexual impulses toward children and adolescents permanently, and several measures assessing different kinds of sexual recidivism did not, however, reach any level of significance. During an average observation period of 2.4 years, six patients confessed to have conducted new sexual exploitation material offenses, while no further sexual abuse cases were reported ( = 19). Due to the used research design and small sample sizes, treatment effects cannot be inferred and external validity is limited. This notwithstanding, results provide first evidence for a relationship between treatment participation and self-reported recidivism and psychological well-being.
在德国，专门针对预防针对未成年人的（进一步）性犯罪和儿童性剥削材料（CSEM）犯罪的门诊治疗服务往往有限。“预防性虐待”治疗项目试图填补这一空白，为自我报告对儿童和青少年有性兴趣的患者提供治疗，无论他们是否有恋童癖或是否受到司法系统的起诉。在该项目中，制定了一本治疗手册，专门针对儿童性虐待者和CSEM犯罪者的动态风险因素。该治疗手册旨在降低再犯风险，并有助于提高患者的个人幸福感。本文介绍了相关科学研究的结果：在治疗过程中，支持犯罪的态度（n = 23）、自我报告的CSEM使用情况（n = 10）、情绪困扰（n = 24）以及参与者对实施（进一步）性犯罪的主观风险认知（n = 25）均有所降低。从干预前到1年随访期间，还观察到支持犯罪的态度进一步下降（n = 8）。然而，在自我效能感、生活质量、参与者对永久控制对儿童和青少年性冲动的自我认知能力以及评估不同类型性再犯的若干指标方面，变化未达到任何显著水平。在平均2.4年的观察期内，有6名患者承认实施了新的性剥削材料犯罪，而未报告其他性虐待案件（n = 19）。由于所采用的研究设计和样本量较小，无法推断治疗效果，外部效度也有限。尽管如此，研究结果为治疗参与与自我报告的再犯及心理健康之间的关系提供了初步证据。
