Pedophilia
Conditions
Keywords
Child Sexual Abuse Material, Paraphilic Disorders, Waitlist, Child sexual abuse, Cognitive behavioural therapy, Self-help intervention, Internet based intervention, Prevention, Pedophilic disorder
Brief summary
The creation and distribution of child sexual abuse material (CSAM) is a large-scale global problem. CSAM is sometimes referred to as child pornography. It includes images, videos, live-streaming, and any other material that depicts sexual acts with a child or adolescent (i.e., a person under the age of 18). It also includes material that shows a child or adolescent in a sexually suggestive or explicit manner partially clothed, or nude, and can include material that does or does not illustrate sexual activity. CSAM use is a problem that continues to drastically increase in size despite the numerous political, police, and technological initiatives that have been put forth as solutions. Previous research also suggests that many active CSAM users desire help to stop their use, but have experienced difficulties finding support that is anonymous. Thus, there is a great need for anonymous intervention programs that assist active and at-risk CSAM users in developing skills to manage their thoughts, feelings, and behaviours related to CSAM. ReDirection is a free, anonymous, online, self-guided, cognitive behavioural therapy (CBT)-based program for individuals concerned about their use or risk to use CSAM. The treatment program is based on many years of clinical experience working with patients who have committed sexual offences, and the results of several previous research projects. This study will implement a scientifically rigorous design (a three-armed randomized waitlist-controlled trial) to evaluate two versions of this intervention (ReDirection 1.0 and ReDirection 2.0). The primary difference between the two versions of ReDirection is the length of the program and whether it includes the option for asynchronous messaging with a ReDirection specialist. The study design compares ReDirection 1.0 and ReDirection 2.0 with a waitlist control group. Participants in the waitlist control will wait six weeks before starting active treatment. While on the waitlist, participants will respond to questions about ongoing about sexual urges and behaviours. Participants will be recruited directly from the ReDirection website, where they will be directed to a secure platform designed specifically for clinical trials of internet-mediated CBT. This platform is called Iterapi. Potential participants learn about the ReDirection program through advertisements on both the Clearnet and Darknet. All trial activities, including participant registration, random assignment, intervention, and evaluation will be conducted via Iterapi. Treatment includes five-to-six modules over five-to-six weeks and the content includes CBT-based psychoeducation and exercises that aim to help participants gain greater understanding of, and skills to manage risky sexual thoughts, feelings, and behaviours.
Interventions
OTHERReDirection 1.0
A free, anonymous, online, self-guided cognitive behavioral therapy (CBT) intervention. Consists of 6 modules.
OTHERReDirection 2.0
A free, anonymous, online, self-guided, cognitive behavioural therapy (CBT) intervention. Consists of 5 modules and the option for asynchronous messaging with a ReDirection specialist.
OTHERWaitlist
Participants in the waitlist control will wait six weeks before starting active treatment. While on the waitlist, participants will respond to questions about ongoing sexual urges and behaviour.
Sponsors
Johns Hopkins Bloomberg School of Public Health
Protect Children Organisation, Finland
The Royal Ottawa Mental Health Centre
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
A three-arm randomized controlled trial where two treatment arms (ReDirection 1.0 and ReDirection 2.0) are compared to a waitlist control.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* 18 years of age or older * Able to read and understand English or Spanish * Have used or experienced urges to use CSAM within the last six months
Exclusion criteria
* Younger than 18 years of age * Unable to read and understand English or Spanish * Have not used or experienced urges to use CSAM within the last six months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Do ReDirection 1.0 and ReDirection 2.0 reduce participants' urges to use CSAM? | Up to 8 weeks | Urges to use CSAM is measured using a modified version of the SSAS (Sexual Symptom Assessment Scale), which is a self-rated measure originally developed to assess general sexual compulsive behaviour. This measure was adapted to include language specific to CSAM use, and response options were altered to permit more precise measurement. There's no scoring system at the moment. It's all item-by-item. But for all items, higher values indicated a greater frequency, intensity, and/or duration of urges. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Do ReDirection 1.0 and ReDirection 2.0 reduce participants' proclivity to offend? | Up to 8 weeks | Proclivity to offend is defined as likelihood to engage in offending behaviour if no one were to ever find out and the individual could not be punished. This is assessed using two separate items created for this study: one for likelihood of CSAM use and one for likelihood of sexual contact with a person 15 years of age or younger. These are each measured as a likelihood from 0 \[minimum\] to 100 \[maximum\]. A 0 indicates 'no chance' whereas 100 indicates 'guaranteed' |
Countries
Canada, Finland
Contacts
Primary ContactCarissa Augustyn, PhD
Backup ContactMichael Seto, PhD
Outcome results
None listed