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