Prevention Through Treatment
Child sexual abuse (CSA) is a highly neglected serious public health problem in our community. Mindful of this gap, KEMHRC, Pune has taken up an ambitious project to nip the problem in its bud. The project proposes an intervention to prevent CSA by helping and treating persons with sexual attraction towards children. This prevention strategy stated above is adopted from a pioneer project in Germany.
In 2005, the Institute of Sexology and Sexual Medicine, Berlin, started the “Prevention Project Dunkelfeld” which has now developed into a nationwide network of outpatient clinics in Germany providing treatment for self-identifying paedophiles/hebephiles outside of the legal system who are motivated to not offend. The team from Germany has been helping the KEMHRC, Pune team for the service arm which is to be established as an expanded service of the ‘sexual health clinic’ at KEM Hospital, Pune.
We are hopeful and ambitious in envisaging this movement to grow all over India. Primary prevention would make it so that there will be no offenders and no victims. Our mission is to make a safe environment for our children.
Phase 1 – Feasibility Study
A feasibility study was conducted by KEMHRC, Pune, involving secondary stakeholders (SS) of child sexual abuse (CSA). We considered cultural context, acceptability, and adaptability of the concept of primary prevention in terms of providing treatment for people at risk to sexually offend against children. The study was conducted between 1 st January 2016 to 31 st March 2017. The target group comprised of NGOs, school representatives, and mental health professionals. A specially designed survey questionnaire based on clinical experience and review of literature was the methodology used. Key informant interviews with resource persons and focus group discussions with members of local project advisory committees were also conducted.
Conclusions
- People with a sexual preference for pre- and/or early-pubescent children should be treated before they happen to commit an act, and the public should become aware of paedophilia and hebephilia and its treatment.
- Sincere and truthful reporting is at the heart of the “Protection of Children from Sexual Offenses Act” (POCSO). The reporting must be safe for all the stakeholders. It was suggested that in the upcoming review of POCSO, KEMHRC, Pune should make recommendations for mandatory therapeutic intervention for the perpetrator after reporting.
- Better awareness and tolerance of healthy sexuality would enable freedom of expression, which in turn can reduce the incidence of CSA.
Phase 2: Treating Persons with Sexual Preference for pre- and/or early-pubescent Children
Based on the findings and conclusions of the feasibility study conducted the next phase proposes the following:
- Develop and provide more effective treatment of persons with sexual preference for pre- and/or early-pubescent children
- Develop awareness in the public and among stakeholders about paedophilia and hebephilia, its relationship to CSA, and prospects for treatment and prevention
- Get deeper insight into the cultural dimensions of CSA – occurrence, disclosure, perceived causes, preferred help and wider family, and socio-political and economic contexts
- Clarify relevant aspects of the psychopathology relevant for effective treatment
The following sources are envisaged for recruitment of persons with a sexual preference for pre- and/or early-pubescent children:
- Referrals from various NGOs and networking schools
- Psychiatrists, clinical psychologists, sexual health clinics, and psychiatry units
- Through awareness sessions in the community
- Through social media awareness campaign
- Routine attendees of the sexual health clinic or the psychiatry clinic at KEMH, Pune