Pedophiliac persons may receive treatment to decrease pedophiliac arousal or enhance arousal to adults but still be unable to interact with adults because of deficits in the skills necessary for such interaction (Hudson and Ward 1997) - for example, social skills (necessary to establish a caring relationship with other adults), assertive skills (necessary to express their wants and needs), and sexual skills (necessary to become more knowledgeable regarding the personal and cultural standards of specific sexual interactions). Pedophiles, like any group of individuals, exhibit considerable variance regarding the extent of prosocial skills deficits. Okami and Goldberg (1992), in reviewing evidence supporting prosocial skills deficits in pedophiliac individuals, found that although a number of treatment programs provide prosocial skills training, the evidence that pedophiles, as a group, have such deficits is limited. Empathy skills appear to be the exception, especially in pedophiliac individuals’ appreciation of the potential negative consequences of adult-child sexual interactions.
Most categories of prosocial behavior treatment generally follow a skills training model, outlined as follows. A patient lists examples of his or her attempts at social or assertive responses with individuals in his or her environment. The setting, who said what, and the responses of the participants are then discussed. The patient is next asked what alternative ways he or she might have dealt with these specific situations and then is asked to role-play alternative social or assertive responses. Feedback is then provided regarding his or her performance, with special attention to reinforcing the patient’s improved social or assertive skills. Different scenarios are practiced in the treatment setting. Finally, the patient is sent out to practice these new skills in vivo and to bring back information regarding the effectiveness of these attempts. This process is repeated until the patient reports or demonstrates having acquired effective social skills or assertive skills to deal with real-life situations. For further information about training in prosocial skills, the reader is referred to Abel et al. (1984), Marshall (1971), and Whitman and Quinsey (1981).
Revision date: June 21, 2011
Last revised: by Jorge P. Ribeiro, MD