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About the Sexual Abuse Clinic
A Letter from Barry Maletzky, M.D.
Most patients come to the Sexual Abuse Clinic at a difficult time
in their lives. While some patients seek help voluntarily, the majority
of our patients receive some pressure to participate in treatment,
either from the judicial system or from concerned others.
The label of "sexual offender" puts most people on the defensive.
Many people are scornful of men (and women) who have transgressed
the rights of the vulnerable. Nevertheless, we consider ourselves
to be fortunate in treating over 8,000 sexual offenders within the
past 25 years;
this experience has led us to conclude that there is no typical
offender type or personality. Our patients come from all walks of
life, including ministers, attorneys, teachers, drifters, businessmen,
and doctors. For most of these individuals, their sexual offense
was one small facet of their lives, something that didn't make them
"bad people," but rather, people with a problem that they can learn
to manage.
Most professionals believe that a combination of traumatic events,
social skills deficits, personality characteristics, and abnormal
patterns of learning predispose people to offend sexually. Nevertheless,
no one can identify all of the factors leading to abnormal sexual
development. We can say, however, that most patients do not offend
for lack of an age-appropriate sexual partner; that many offenders
are not at risk of committing nonsexual crimes; and most importantly,
that their condition is treatable. At the Sexual Abuse Clinic, we
are fortunate to have had a success rate of over 90%; many of these
figures come from follow-up periods as long as 25 years. Indeed,
our treatment techniques and outcomes have been published in prominent
professional journals and in several books.
The treatment methods we use come from the science of cognitive-behavioral
psychology. These methods are designed to modify existing patterns
of thinking and to change harmful patterns of behavior. For example,
we teach clients to recognize and challenge cognitive distortions
or "thinking errors" that lead to unwanted behavior. We also use
behavior modification or "aversive conditioning" to reduce the physiological
arousal that patients have associated with inappropriate sexual
stimuli.
We begin treatment by measuring the patient's arousal to a variety
of sexually suggestive stimuli with a machine known as the penile
plethysmograph. This allows us to determine a client's pattern of
arousal. Data from this test help us develop an individualized treatment
plan that will produce the best results. In individual therapy,
slides, movies and stories are used for arousal reconditioning.
Foul odors, tastes, aversive scenes, and biofeedback techniques
are used to suppress deviant sexual arousal. A number of positive
conditioning techniques are used as well, including pleasant imagery,
pleasant odors, relaxation, desensitization to age-appropriate sexual
stimuli, and social skills training. Since no two people are alike,
each patient is treated on an individual basis. However, we recommend
group therapy in the Clinic for patients who would benefit from
peer support. In either format, each patient is encouraged to participate
in designing his or her own treatment program.
Often, treatment effectiveness is a concern for both the therapist
and the patient. We encourage your feedback and that of the people
who live with you and know you. Therapists within the Sexual Abuse
Clinic will work with
you to provide proof of improvement and to ease the inevitable difficulties
arising from your sexual behavior problems. Many patients find that
their problems cause strain between them, their families, and the
agencies involved in their supervision. Although communications
with family members and agencies are governed by confidentiality
laws you should know of several exceptions: (1) If we learn that
you will be dangerous to another person we are mandated by law to
tell the appropriate people and agencies of this danger; (2) if
we learn that you have committed a crime or a parole or probation
violation, we must report this to the corrections division or a
law enforcement agency; (3) if we learn that you have a communicable
sexually transmitted disease, we are obligated by law to report
this to health authorities; and (4) if we learn of a new instance
of child (or adult) sexual or physical abuse, we are required by
statute to report this to the appropriate Children's Services Division
or law enforcement agency. Fortunately, these situations have been
rare.
A financial disclosure form is available. Please read it as part
of your introduction to The Sexual Abuse Clinic. We understand that
the financial burden of treatment can often be heavy. Therefore,
we are happy to arrange financing, often with no interest charged.
We look forward to serving you and the community. Please feel free
to contact us if you have any questions or concerns.
Barry M. Maletzky, M.D.
Founder and Advisor, The Sexual Abuse Clinic
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