Perspective: Clinical care of pedophilic individuals in Zurich, Switzerland

Abstract

Individuals with pedophilia are considered to have an elevated risk for child sexual abuse (CSA). Nevertheless, it is assumed that pedophilic sexual impulses can be controlled from acting out. To prevent CSA an outpatient treatment facility for people with pedophilia was founded in Zurich, Switzerland in 2021. The program focuses on the prevention of CSA and improvement of quality of life, incorporating empirically validated treatment principles, such as the Risk-Need-Responsivity (RNR) model and the Good Lives Model (GLM). Within the initial 24-month 142 individuals sought help, 46 individuals (mean age 36.0 ± 12.4 years) completed the assessment phase, two-thirds suffered from psychiatric comorbidities, and 67.4% reported sexual delinquency. The high drop-out rate was predominantly due to ongoing criminal proceedings, or other mental health conditions. Overall patients at this facility generally sought treatment voluntarily, leading to good treatment adherence, with severe self-harm being more prevalent than acute danger to others. A treatment approach focused solely on pedophilia is considered insufficient; psychiatric and psychosocial factors must also be addressed.