Sex-specific evaluation and treatment is appropriate for children and teenagers who have or are developing a sexual interest in younger children and for adults who have or are developing a sexual interest in children. Sex-specific specialists are also skilled at evaluating and treating men and women who may be sex addicts, having multiple affairs, voyeurs (window-peepers), exhibitionists (flashers), or who have sexual fetishes (a sexual obsession with a material object or a nonsexual part of the body).
If a teenager or adult is having sexual thoughts or fantasies that involve children, an evaluation with a sex-specific therapist is very appropriate. A sex-specific therapist can determine the seriousness of the problem and can teach the client skills to redirect his or her sexual interest toward age-appropriate partners. There is generally a period of time where a person is thinking about being sexual with children, but before the person acts on it. A sex-specific therapist can provide effective treatment during this “thinking” period, and before any actual acts of molestation have occurred. Many times individuals and families are unsure whether a true problem exists and hesitate to seek help. In these situations, we recommend seeking out an evaluation so that the sex-specific specialist can help you determine the answer to this important question.
A sex-specific evaluation is also appropriate for children or teenagers who are exhibiting persistent inappropriate sexual behaviors. A sex-specific therapist can determine whether the behaviors are related to normal childhood sexual experimentation and are not a cause for concern or whether the behaviors are something more problematic. If the behaviors are considered problematic, the sex-specific therapist can provide treatment. Seeking out evaluations at an early stage and being open to receiving treatment will protect many of our children.
Sex-specific treatment bears little resemblance to traditional, dynamically-oriented, talk therapy. Talk therapy is generally not effective for people who have or are developing a sexual interest in children. However, there are numerous therapists who may provide mostly talk therapy as treatment for this disorder. For this reason you must be sure you find a well-trained, experienced, sex-specific therapist for yourself, your family member, or friend, and not simply go to the best traditional therapist in your town. Please refer to the Checklists and Tools section of our website for information on “Contrast: Traditional vs. Sex-Specific Therapist” and “Six Questions to Ask When Selecting a Sex-Specific Therapist” to help you understand the differences between a traditional therapist and a sex-specific therapist and to know what questions to ask any therapist or treatment provider you are considering prior to making an appointment.
A Note About Reporting Laws
What individuals tell therapists is usually confidential. However, confidentiality between therapist and client only works if the things that are kept confidential are not dangerous to others. Therapists have always broken confidentiality, if the client is a danger to himself (a suicide risk) or to others (a murder risk). In addition, state laws add a third instance in which the therapist must break confidentiality: if the therapist suspects that a known child is being sexually abused. If the client says, “I’m going to murder John Smith,” then the therapist must break confidentiality to notify the authorities and to notify John Smith. It’s the same process in interviewing and treating people with a sexual interest in children. If the client says “I have continual sex fantasies of little girls, I have strong urges to do sexual things with little girls,” the therapist has nothing to report to Child Protective Services (CPS). However, if the client says, “I sexually touched my cousin Johnny Smith,” then the therapist must report.
At the beginning of the first appointment, a sex-specific therapist will ask you to read and sign a consent form that outlines your state’s reporting laws and clarifies that you understand the law that requires therapists to report child sexual abuse. Similar laws exist in all 50 states requiring therapists, physicians, schoolteachers, and other professionals, to report to Child Protective Services or the police, if they suspect that a known child is being sexually abused. Most sex-specific therapists not only have the client or guardian (if the client is a minor) sign a consent form acknowledging the law, they also explain the law again at the beginning of the session. The reporting laws are important and a client should never be surprised that they exist. Understanding these laws allows you to make informed decisions about your interactions with the therapist.