Term Paper on "Pedophilia - Efficacy of Combination Therapy"
Term Paper 30 pages (10745 words) Sources: 20 Style: APA
[EXCERPT] . . . .
Pedophilia - Efficacy of Combination Therapy Using Cognitive Behavioral Therapy in Combination with SSRIs for Treating Therapy-Resistant Pedophilic BehaviorsPedophilia demonstrates a higher recidivism rate when compared to other sexual offenses. Pedophilia does not respond well to traditional treatment programs. The primary reason for this lack of response lies in the willingness of the pedophile to change their behavior. Unlike other sexual offenses, pedophilia involves cultural issues that could affect the willingness of pedophiles to change their behaviors. This study investigates the long-term recidivism rates among pedophiles that have undergone four of the most prevalent treatments available. The study compared groups that received group therapy, cognitive therapy, SSRIs and Chemical castration. It compared single therapies, as well as a number of combinations. The study indicated that a combination of cognitive therapy and SSRIs was the most effective means for reducing recidivism rates. The study indicates the need for ongoing therapy throughout the lifetime of the offender for best results.
Abstract
List of Illustrations
CHAPTER 1: INTRODUCTION
CHAPTER 2: LITERATURE REVIEW
CHAPTER 3: METHODOLOGY
CHAPTER 4: RESULTS
CHAPTER 5: DISCUSSION, CONCLUSIONS, RECOMMENDSTIONS
REFERENCES
TABLE: 4.1. TREATMENT TYPE and RECIDIVISM RATE
TABLE 4.2. SUMMARY of HYPOTHESIS ACCEPTANCE/REJECTION
LIST of ILLUSTRATIONS
Figure 1: COMPARISON
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PERIOD for VARIOUS THERAPY TYPES
Efficacy of combination therapy using cognitive behavioral therapy in combination with SSRIs for treating therapy-resistant pedophilic behaviors.
CHAPTER I: INTRODUCTION
Pedophilia is a complex psychological condition that is often unresponsive to standard treatment options. The goal of treatment is to curb behavioral expression of pedophilic fantasies and desire. It is considered unrealistic to expect to be able to measure, eliminate, or predict a person's innermost thoughts and feelings. Therefore, treatment is directed towards curbing undesirable behaviors that arise from these thoughts and feelings, rather than eliminating the feelings and desires themselves. This makes the treatment of pedophilia different from the treatment of other mental illnesses where the focus is on eliminating or promoting acceptance of ones actions or feelings.
There are several treatment options available for treating pedophiles. The most common treatment therapies include group therapy, cognitive behavioral therapy, SSRIs, and chemical castration. Other forms of therapy, such as aversion therapy, brain, or genital surgery are rarely used, particularly in the United States. This study will compare long-term effectiveness of the four most common treatment options in the United States. It will focus on providing information that will be useful in the development of best practices and policies regarding the long-term avoidance of undesirable behaviors related to pedophilic urges.
Background of the Study
What is Pedophilia?
Pedophilia is a deviant behavior where an adult is sexually attracted to a prepubescent or peripubescent child. Pedophiles are sexually attracted to children that are below the legal age of consent, which is currently 18 in the United States. Pedophiles present a danger to children because they can cause emotional or physical harm to the child of varying degrees. Pedophilia is considered criminal activity in the United States. One popular theory to explain pedophilia is that the pedophile uses the child as a surrogate for an adult that is not present. The classification, labeling, treatment and cultural constructs surrounding pedophilia are highly controversial.
Recent controversy stems from using the term "pedophile" to describe all child-related sexual offenders. The medical community uses the term to refer to someone with a preference for children. However, law enforcement uses the term to describe "situational offenders." This leads to a difference in opinion when it comes to diagnosis and treatment of an individual. There is a difference in the medical community between those that have a sexual orientation towards children and those that commit a one-time act from a clinical perspective. Law enforcement does not recognize this distinction.
According to the American Psychological Association's Diagnostic and Statistical Manual of Mental Disorders (2000), pedophilia must meet three criteria. If the pedophile does not meet any one of the criteria, they are not diagnosed as a pedophile from a clinical perspective. In order to meet the criteria of pedophile, sexual urges with a prepubescent child must be recurrent and intense (APA, 2000). The person must have acted on these urges, or they must cause marked personal distress or interpersonal difficulty (APA, 2000). The third criteria is that the person must be at least age 16 and at least 5 years older than the child with whom the sexual act was performed (APA, 2000). Only if the person meets all three of these criteria will they be diagnosed as a pedophile in a clinical setting. Many pedophiles, particularly one-time offenders do not meet the criteria necessary for clinical treatment of their condition.
The APA criteria do not require actual sexual activity with a child. The person needs only to have fantasies or sexual urges towards children. In all cases where an offender is accused of child sexual abuse, they are labeled a pedophile by law enforcement, when in fact they do not meet the clinical requirements of clinical pedophilia. Sometimes the sexual act can have other causes such as stress, marital problems, or the unavailability of adult partners (Lanning, 2001). Those that commit sexual crimes against children, but that do not meet the criteria for diagnosis are referred to as situational, opportunistic, or regressed offenders (Lanning, 2001). Those that meet the criteria are referred to as structured, preferential, or fixated pedophiles (Lanning, 2001).
The American Journal of Psychiatry's most recent "Position Statement on Psychiatric Treatment and Sexual Orientation" cautions mental health professionals that there is little empirical evidence to support the efficacy of treatments designed to change sexual orientation (Berlin, 2000). The statement was intended to address homosexuality, but it has been extrapolated to include pedophilia, as a sexual orientation, rather than a mental illness (American Journal of Psychology, 1999). This statement is at the heart of whether to classify pedophilia as a mental disorder or another sexual orientation.
The key difference between pedophilia and other sexual orientations is the age of target. This rationale support the position that it is unlikely that treatments will ever result in a "cure" for pedophilia. However, societal constraints recognize the rights and vulnerability of the population that is the target of sexual preferences for children. In the case of homosexuality or heterosexuality, the object of attraction is an adult. As adults, this person has rights and the ability to express and enforce these rights. Children are taught to obey and respect adults. They do not have the same legal recourse afforded adults.
Therefore, although the adult perpetrator has a right to their preferred sexual orientation, the object of their preference does not have the same rights. When a pedophile acts on their urges, the child is at a legal and moral disadvantage to express and exercise their opinions and preferences. The expression of pedophilia is coercive, at the very least, and violent in the worst cases. Either way, acting on pedophilic urges violates the basic humanitarian rights of the child. This is the basis for considering pedophilic behavior a criminal offense in the United States. Even if the child "consents" to the acts, a certain degree of coercion is present due to societal rules governing adult-child relationships. The adult is supposed to represent an authority figure. It is difficult to eliminate the perception of authority in any adult-child interaction.
Problem Statement
In American society, and a majority of the societies around the globe, the adult is recognized for the learning resulting from life experience. Children are viewed as inexperienced and therefore, their rights and opinions are considered to be subordinate to those of the adult. When an adult uses their authority over a child, either consciously or subconsciously, societal rules compel the child to comply with the adult's wishes. In the case of pedophilia, this results in some degree of sexual contact. The rights of the child are violated causing varying degrees of emotional or physical damage to the child.
In a discussion of pedophilia, it is important to distinguish urges and feelings regarding sexual contact with children from actions. Urges and feelings, if well contained or in an appropriate context, do not violate the rights of the child. It can be argued that attempts to control the thoughts and feelings of an adult are a violation of their rights. Only when the rights of the adult impede the rights of the child, do these actions become criminal, or warrant intervention by law enforcement or the mental health community. Throughout this research study, reference to pedophilia as a mental disorder, only refers to pedophilia that is expressed through outward behavior towards a child. This study will explore the problem of how to curb expression of pedophilic behaviors that violate the rights of a child. It will focus on finding the most effective treatment for curbing these behaviors. It will not address the issue of sexual preferences that are unexpressed through behaviors towards children.
Purpose and objectives of the study
The purpose of the study is to explore the most prevalent treatment options for… READ MORE
Quoted Instructions for "Pedophilia - Efficacy of Combination Therapy" Assignment:
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Objectives of Graduate Research Project
Upon completion of the thesis, students will be able to:
1. Develop a research question
2. Formulate a testable research hypothesis
3. Conduct a literature review
4. Describe an appropriate research methodology to answer the research
question
5. Collect and analyze data
6. Draw conclusions and make recommendations based on the available
data;
7. Make an oral presentation of research findings;
8. Demonstrate an understanding of the ethical issues surrounding the
collection and reporting of research data;
9. Understand the role research plays in the development of forensic
science; and
10. Describe how diversity issues may influence choice of research
topics, research methodology, and the application of research findings
to the justice system.
Section 1: Organization of Contents
Elements
The following preliminary pages (numbered in lowercase Roman numerals)
precede the body of the thesis, in this order:
*****¢ Title page
*****¢ Thesis approval pages (one for chair and two supervisors & the 2nd
for the Forensic program director)
*****¢ Copyright page (if you plan to register a copyright)
*****¢ Dedication page (optional)
*****¢ Acknowledgments (optional)
*****¢ Abstract
*****¢ Table of contents
*****¢ List of tables (if appropriate)
*****¢ List of illustrations (charts, graphs, figures) (if appropriate)
*****¢ List of symbols (if appropriate)
*****¢ Preface (optional)
Paginated in Arabic numerals is the text and other pages following the
preliminary pages arranged in the following order:
*****¢ Text (chapters of the manuscript)
*****¢ Endnotes
*****¢ Appendices
*****¢ References
*****¢ Index (optional)
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Title Page
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A research project submitted to National University in partial fulfillment of
the requirements for the degree of Master of Forensic Sciences.
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Project Approval Page
A completed thesis must have the signatures of the three committee members,
and the forensic program lead faculty. Type only as many lines as there are
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Copyright Page
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Acknowledgments
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Abstract
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The abstract can be no more than 150 words.
5
Table of Contents
The table of contents is designed for the convenience of the reader. It should
include the acknowledgment page, abstract, list of tables, list of illustrations, list
of abbreviations or symbols, appendices and references as well as the major
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List of Symbols
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Preface
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justify your choice of a topic. The preface is also an appropriate place to present
an overview of the project, including a description of what is to be found in
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Roman numerals) and therefore precedes the main text.
Text
The organization of the text varies somewhat with the subject matter. The
project is divided into five chapters, each chapter titled and beginning on a new
page. In general, the content of the five chapters include:
Chapter I: Introduction
The first chapter provides an overview of the project. The specific subsections
of this chapter will vary, depending on the subject matter. In general, the first
chapter should include the following information:
Background of the Study: provide a brief history of the ideas and issues
related to the research topic. This section should not be a review of the literature
(though some information may be repeated in the literature review), but a
description of the events leading up to this research.
Problem Statement: this is the heart of the research project. This subsection
states the reason(s) why this research project is important. A good way to
approach the Problem Statement is to address the following: Because of x and y,
there is a problem in society (or the criminal justice system or the field of
forensic science); if only we knew more about things might be better. The
research project should be designed to answer z, which is the research question.
Purpose and objectives of the Study: list the component parts of the research
question. Rarely is a problem in forensic sciences one-dimensional. This
subsection should describe the specific elements of the problem being addressed
by the research.
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Rationale of the Study: develop the reasons for examining the elements
described in the purpose and objectives section. Explain why those elements
were selected, how they relate to the topic of the research, and how they related
to each other. In other words, explain how will accomplishing the purpose and
objectives answers the research question, and is something we should care
about.
Definition of Terms: list definitions for only those terms which might be
unfamiliar to the reader, especially those which can be considered terms of art
and operational definitions.
Limitations of the Study: describe self-imposed limits on the research,
including those that relate to both the breadth and depth of the inquiry. Also
include limitations that exist due to factors beyond your control. Describe the
(potential) effects the particular limitations may have on your research.
Theoretical Framework: if the research is driven by, or relates to, a particular
theoretical orientation, provide a brief overview of that orientation and how it
relates to the research.
Research Hypotheses: based on the purpose and objectives, what are the
expected outcomes for the research? Hypotheses are essentially predictions
about the answers to the research question and its component parts. The
research hypotheses are a critical element of the research project: they will
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focus for data analysis, discussion, conclusions, and recommendations.
Summary of Remaining Chapters: include a brief summary of the first
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utilized, this subsection is not necessary.
Summary of Remaining Chapters: Describe the content of the remaining
chapters. If a preface is utilized, this subsection is not necessary.
Chapter II: Literature Review
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The introduction provides a review of the topic; the Literature Review
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writings about the research question in general, followed by (b) a closer
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Purpose and Objectives subsection of Chapter I. It is very helpful to the reader if
the ideas are presented in the same order throughout the thesis.
This chapter will contain the greatest number of citations, so it is important that
they be done correctly. Each citation must have a corresponding listing in the
Reference section.
The Literature Review should not include data that will be used to answer the
research question or test your research hypotheses. If the project is utilizing an
analysis of published research to answer the research question, the Literature
Review should provide the background and take the reader up to the point
where those studies begin.
Chapter III: Methodology
In general, this chapter describes how the data were collected that answer the
research question and its component parts. It is important to utilize appropriate
methods of data collection in order to be able to support or reject the research
hypotheses. This chapter should begin with a description of the research
methods used in the research, including a description of the dependent and
independent variables, if any. Chapter III will most likely include the following
subsections:
Setting: if important to the research, describe the time and place of data
collection.
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this subsection can include either subjects involved in primary data collection,
or those described in published research studies. If the project involves human
subjects, it is necessary to first obtain their consent in writing.
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and tests, if appropriate. Include a copy of questionnaires in the Appendix.
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or reject the research hypotheses.
Chapter IV: Results
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chapter is purely objective, devoid of assumptions and interpretations.
Following a summary of the research data, Chapter IV should be organized in
manner consistent with the research hypotheses: first, present data related to the
first hypotheses; and second, analyze those data to determine whether the first
hypothesis can be supported or rejected. Follow this sequence for each
hypothesis.
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Tables are an effective way to present quantitative data. Qualitative data should
be summarized, as opposed to verbatim transcriptions.
Chapter V: Discussion, Conclusions, and
Recommendations
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findings, interpretation of the results, and problems and/or limitations; (b) a
conclusion: what did we find out? what did we learn? and (c) recommendations
for changes in policy or practice, future research, or anything else that will
direct solutions to the problem(s) that were the focus of the research.
Endnotes
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sparingly: if the information is of central importance, it should be included in
the text; if the information is irrelevant or nonessential, it should be excluded;
however, if the information is tangential, and more fully develops an element of
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each chapter or at the end of all the text.
Appendix or Appendixes
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information that would be distracting if presented in the text. For example, a
survey instrument or questionnaire, a data collection form, or a list of variables
would be appropriate for placement in an appendix.
References
Only those works cited in the text appear in the Reference section and,
conversely, every work in the Reference section must appear in the text. It is
important to properly cite all references. References style should be according
to APA manual.
Examples:
Tokita, K., & Schmid, K. (1963).Variants of alpha1-acid glycoprotein. Nature,
200:266.
Johnson, A. M., Schmid, K., & Alper, C. A. (1969). Inheritance of human
alpha1-acid glycoprotein (orosomucoid) variants. J Clin Invest, 48:2293 *****“ 2299.
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Schmid, K. (1975). Alpha1-acid glycoprotein. In: Putnum FW, editor. The
plasma proteins. Vol. 1 (pp. 183 *****“ 228). New York: Academic Press.
Giblett, E. R. (1969). Genetic markers in human blood. Oxford and Edinburgh:
Blackwell.
Schmidtmann, U. (1999). PGM1 (phosphoglucomutase-1) polymorphism. Ph.D.
Thesis, National University, San Diego, California.
Pollanen, M.S. (2000). The forensic value of the diatom test for drowning.
Forensic Pathology Unit, Office of the Chief Coroner of Ontario, 26 Grenville
Street Toronto, Ontario, Canada, M7A 2G9. Retrieved June 20, 2003 from:
Http://erin.utronto.ca/academic/FSC/FSC239Y-Drowning.HTM
Note:
â No more than 3 web sites allowed.
â No News Papers are allowed.
Index
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including an index only if word processing software facilitates its creation.
11Section 2: Format for Text
Style
The Forensic Sciences Program follows the format guidelines established by the
American Psychological Association (APA). Please speak with your instructor
if you need additional help with the format.
Margins
Standardized margins are required on every page to ensure that no part of the
project is cut off when it is bound and trimmed. The left margin must be 11/2
inches from the edge; all other margins must be at least 1 inch from the edge.
Line Spacing
Double spacing is required for the entire thesis.
Punctuation
Many common manuscript problems involve punctuation. Selecting committee
members who are good *****s and who are familiar with APA style can
alleviate most problems.
Pagination
Every page must be counted in the numbering. With the exception of the title
page, a number must appear on every page. Placement of page numbers must be
consistent throughout and fit within the margins. Page numbers for preliminary
pages using Roman numerals appear centered at the bottom of the page; pages
using Arabic numerals appear in the upper right edge of the paper, one inch
from the right edge and one inch from the top.
Chapters
Each chapter must begin on a new page. Chapters should be numbered.
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Section 3: Illustrations
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plates, etc.) is to present information more clearly than can be done with words.
Legends or titles should be self-explanatory, concise, and consistent in form.
Refer to the APA Style Manual.
Tables
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horizontal alignment. Tables over half a page in length should be placed on a
separate page. Tables too wide to be accommodated on one page may be typed
on two or more pages, pasted together and either folded or reduced to page size
by a suitable photographic process. Lengthy tables should be placed in the
Appendix.
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letters (a, b, etc.). Do not use numbers for footnotes to tables. Footnotes are
placed at the bottom of the table, not the bottom of the page.
Figures
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photographs, and maps, but not statistical data presented in tables. Refer to the
APA Style Manual for the various styles.
Section 4: The Final Copy
Typing and Printing of the Manuscript
The Master*****s Thesis is expected to be the product of neat and careful work by
all concerned. The physical appearance must be immaculate and convey an
impression of pride and quality in behalf of the student, the advisory committee,
the program, and the university.
Your manuscript must be prepared on a type*****, word processor, personal
computer, or mainframe computer. However, al print in the project must meet
the following standards:
Any standard typeface is acceptable (although a font such as Courier is
recommended) as long as the same typeface is used throughout the manuscript,
with the exception of certain appendix material or legend on charts, which may
be put in a different type. Italics should be used only to highlight specific words
or phrases in the text, and only rarely.
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The type size should be 12-point for all material in the text (thisincludes
any reduced material which may be included in the Appendix).
The print should be letter quality (type***** or letter-quality printer, 300
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clear and dense. Dot matrix is unacceptable. If you are uncertain about the
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