Managing Versus Successfully Treating Paraphilic Disorders

The Paradigm Is Changing

Authored by: J. Paul Fedoroff

Handbook of Clinical Sexuality for Mental Health Professionals

Print publication date:  February  2016
Online publication date:  January  2016

Print ISBN: 9781138860254
eBook ISBN: 9781315716596
Adobe ISBN: 9781317507468


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This chapter focuses on my recommendations for how to assess, manage, and treat individuals with paraphilic disorders. The emphasis is on criminal paraphilic disorders or those behaviors that may become criminal. The fifth edition of the Diagnostic and Statistical Manual (DSM-5) states that paraphilias, per se, do not necessarily cause harm and therefore are not diagnosed as disorders. This may be true, but people with paraphilias and their partners often are perplexed and concerned that they may become harmful without treatment. The most important factor that distinguishes healthy sexual interests from problematic ones is consent. While people do not choose their paraphilias, they do choose whether and in what way to act on their sexual interests. This chapter provides guidance about how to prevent future sex crimes by facilitating consensual sexual interests and voluntary behaviors in people with either unconventional sexual interests (paraphilias) or harmful paraphilic disorders.

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