Although pedophilia has yet no cure, various treatments are available that are aimed at reducing or preventing the expression of pedophilic behavior, reducing the prevalence of child sexual abuse. Treatment of pedophilia often requires collaboration between law enforcement and health care professionals. A number of proposed treatment techniques for pedophilia have been developed, though the success rate of these therapies has been very low.
Cognitive behavioral therapy
Cognitive behavioral therapy, also known as relapse prevention, has been shown to reduce recidivism in contact sex offenders.
According to Canadian sexologist Michael Seto, cognitive-behavioral treatments target attitudes, beliefs, and behaviors that are believed to increase the likelihood of sexual offenses against children, and "relapse prevention" is the most common type of cognitive behavioral treatment. The techniques of relapse prevention are based on principles used for treating addictions. Other scientists have also done some research that indicates that recidivism rates of pedophiles in therapy are lower than pedophiles who eschew therapy.
Behavioral interventions
Behavioral treatments target sexual arousal to children, using satiation and aversion techniques to suppress sexual arousal to children and covert sensitization (or masturbatory reconditioning) to increase sexual arousal to adults. Behavioral treatments appear to have an effect on sexual arousal patterns on phallometric testing, but it is not known whether the test changes represent changes in sexual interests or changes in the ability to control genital arousal during testing.
Applied behavior analysis has been applied with sex offenders with mental disabilities.
Pharmacological interventions
Medications are used to lower sex drive in pedophiles by interfering with the activity of testosterone, such as with Depo-Provera (medroxyprogesterone acetate), Androcur (cyproterone acetate), and Lupron (leuprolide acetate).
Gonadotropin-releasing hormone analogues, which last longer and have fewer side-effects, are also effective in reducing libido and may be used.
These treatments, commonly referred to as "chemical castration," are often used in conjunction with the non-medical approaches noted above. According the Association for the Treatment of Sexual Abusers, "Anti-androgen treatment should be coupled with appropriate monitoring and counseling within a comprehensive treatment plan."
Limitations of treatment
Although these results are relevant to the prevention of reoffending in contact child sex offenders, there is no empirical suggestion that such therapy is a cure for pedophilia. Dr. Fred Berlin, founder of the Johns Hopkins Sexual Disorders Clinic, believes that pedophilia could be successfully treated if the medical community would give it more attention. Castration, either physical or chemical, appears to be highly effective in removing such sexual impulses when offending is driven by the libido, but this method is not recommended when the drive is an expression of anger or the need for power and control (e.g., violent/sadistic offenders). Chemical and surgical castration has been used in several European countries since World War II, although not to the extent it was employed in Nazi Germany. The program in Hamburg was terminated after 2000, while Poland is now seeking to introduce chemical castration. The Council of Europe works to bring the practice to an end in Eastern European countries where it is still applied through the courts.