Paedophilia and online child exploitation materials: Ethical and practice issues in psychological treatment

With heightened community awareness of the legal consequences of accessing child exploitation materials online, there has been an increase in clients presenting for psychological treatment due to paedophilic sexual attraction and the desire to access online materials. Clients may present fonnellor treatment of their own volition, without being involved in any criminal proceedings. The mental health problems that develop secondary to paedophilia (e.g., depression, anxiety, substance abuse) are prominent in individuals presenting for treatment. This is often due to the fear of being publically ‘exposed’ as a paedophile, yet having difficulty finding an alternative way to manage sexual attraction to children other than viewing child exploitation materials online. It is noted that not all individuals who access this online content may be diagnosed with paedophilic disorder, however this article focuses on the treatment needs of individuals who identify as exclusively paedophilic in their sexual interests.

Internet-based child exploitation materials, according to Australian law, include all sexual depictions of children in online content, including simulations by adults that allude to the parties being underage. Illegal content in Australia includes fictional children as well as real children, computer-generated children, cartoons, drawings and writing about paedophilic sexual fantasy. Chat rooms or forums on which paedophilic sexual attraction is discussed are also classified as illegal content in Australia. Therefore, psychologists need to be equipped for the prospect of clients presenting for assistance with managing their sexual attraction to children and its associated illegality.

The issue of sexual attraction to children generates strong emotions, and psychologists may have their own personal views. However, it is imperative that clients presenting for assistance with such an attraction who are making efforts to reduce their risk of offending behaviour receive an informed, non-judgmental and supportive response from professionals engaged in their care. While not all psychologists may wish to provide treatment with respect to this presenting problem, they still have a responsibility to be well informed about how to respond to the initial disclosure of sexual attraction to children and to be able to follow through with appropriate referral processes.

The complex ethical and practice issues for psychologists working with clients with paedophilic sexual attraction who access online child exploitation materials are explored here from three perspectives: those of two experienced forensic and clinical psychologists working in the area, a postgraduate clinical psychology student new to the field, and a voluntary client presenting for assistance with managing paedophilia and the habit of accessing child exploitation materials online, who was invited to contribute to the article.

Clinical and forensic psychologists’ perspective

As private practitioners we work with both mandated and voluntary clients. Mandated clients have generally been convicted in a criminal court of child exploitation-related offences, and the details regarding the accessing of exploitation materials have been fully investigated and are a matter of record with the authorities. However, when a client presents voluntarily for help in the absence of an active police investigation or record of past offending behaviour, there are complex issues to overcome. The clinician must work within mandatory reporting requirements, and communicate these openly to the client at the outset of treatment.

When paedophilia is an exclusive sexual orientation, and the client has no alternative sexual interests that can be fostered towards a healthy sexual life and fulfilling intimate relationships, the focus of treatment is on helping the client to manage his or her sexuality without engaging in offending behaviour. Many of our clients with paedophilia (exclusive type) do not want to harm children. They express their understanding that engaging in sexual activity with a child is not only illegal, but is illegal because of the recognised harm that sexual abuse causes children. Many of the clients we work with are ashamed of their paedophilia, and some experience chronic self-destructive and suicidal tendencies due to their feelings of sexual attraction towards children. There are members of the community in Australia who need the assistance of psychologists to deal with the distress caused by their sexual attraction to children, and to learn skills to manage their sexual feelings. It is imperative for the mental health of this sector of the community, and for the protection of children, that evidence-based psychological interventions to assist clients with paedophilia and problems accessing child exploitation materials are well established, utilised and promoted within Australia.

There is much to be learnt from existing efforts such as the Prevention Project Dunkelfeld established in Germany in 2005. This project focuses on providing clinical and support services to individuals who are sexually attracted to children. The Project was initially funded by a corporate organisation, but transitioned to receiving government support in 2008. The project’s slogan is: ‘You are not guilty because of your sexual desire, but you are responsible for your sexual behaviour. There is help! Don’t become an offender’. It is reported that over 1,000 men sought services in the first five years of the Project. The therapy offered by the Project includes psychological work on sexuality acceptance and identity, inclusion of significant others in therapy and CBT targeting adaptive coping skills, as well as libido-reducing medications.

A provisional psychologist’s perspective

As a provisional psychologist on placement, my work with people who identify as paedophiles and access child exploitation materials necessitates close supervision. There is a dearth of literature to answer the many questions I have, for example, what are my legal and ethical obligations when I know a client is downloading abuse images? What is the likelihood of risk escalation and how do I assess this? What treatments are available and how strong is the evidence base? What is my personal reaction to the presenting issues?

For me, the conceptualisation of paedophilia as a distinct sexual preference was novel and surprising. It was not discussed in my studies and although it would be easy to criticise that my training in this area has been insufficient, I understand that it may not be a priority. Paedophilia is an uncommon referral and downloading sexual images of children is a relatively new crime.

When I turned to the literature to aid my learning, I found that there were very few articles that explored the aetiology of paedophilia. Opinions are divided and typically based on correlational and descriptive research. The psychological profile of Internet sex offenders is also largely unknown as the few published articles in this area have only studied incarcerated persons. Thus, due to methodological limitations, there is scant generalisability of findings that can assist a practitioner working with an un-incarcerated individual.

There are treatment manuals emerging in the literature, but more research is required to expand the evidence base and provide clarity for expected outcomes. Intensive supervision from an experienced practitioner is essential for provisional psychologists working in this field.

A voluntary client’s perspective

Paedophiles are in an impossible situation – we can do no right in society's eyes, and we have few if any avenues through which we can seek help. Unfortunately, paedophiles typically come into contact with mental health services after we have been convicted of a crime. This is unacceptable, from both the perspective of abused children, and that of paedophiles. We must be in contact with mental health services before we commit any crime. Unfortunately for some this is not possible in the prevailing culture of fear and hatred toward paedophiles. To address child sexual abuse, getting assistance to paedophiles is just as important as getting assistance to victims of child sexual abuse. The current systemic method of dealing with sexual abuse in Australia, which largely ignores paedophiles, does a great disservice to children.

Paedophiles are mostly men with normal levels of sex drive, and in treating paedophiles, it is naive, unrealistic and futile to expect us to remain chaste and refrain from masturbating. Nobody would ask this of a man who has normal sexual attractions. ‘Chemical castration’ drugs may be employed, but these often have undesirable short - and long-term side effects.

We have difficulty knowing what our rights are under the law and as clients seeking professional assistance. One of the most important factors in getting paedophiles to voluntarily seek help is informing us whether or not we are subject to mandatory reporting laws if we have accessed child exploitation materials.

What really is needed is something like a website, approved by the Australian Government so paedophiles can be entirely confident of its authority and veracity, which unambiguously spells out what rights paedophiles have, exactly what mandatory reporting entails, and exactly what is considered child exploitation material, so that we know how to stay within the law in managing our sexual attraction. The website would also need to be a resource to show where paedophiles can seek counselling and psychiatric assistance. The wider public needs a greater understanding of paedophilia, and there especially needs to be greater awareness amongst health professionals of what paedophilia is and how to deal with it.

The authors can be contacted at [email protected]