Tackling child sexual abuse - a lesson from Germany?

I would like to echo the sentiments of Alex Hossack in a recent letter regarding social attitudes towards sexual offending ('Sex offenders – time to step outside the anger?', October 2014). 

I had been drafting a letter to The Psychologist along very similar lines and I was glad to see that Hossack's contribution was so well-reasoned and similar to my own. However, when Hossack asserts that 'the biggest inhibitor of change is media myths', I would argue for a slightly different conclusion.

The impact of media reporting stands alongside, and potentially obscures, similar ills inherent in our legislation. As I see it, the main stumbling block for unconvicted and would-be offenders seeking psychological support lies in our mandatory reporting laws. These laws bind social, medical and mental health professionals into compulsorily contacting police if they believe that a crime has been committed or is likely to be committed, superseding all confidentiality clauses. In this way, as Hossack pointed out, it becomes almost impossible to provide treatment to individuals of this nature, but no practical solutions were mooted.

It is clear that British society is currently failing the victims of child abuse as well as the adults who may prey on them. Following the arrests of 660 people for child pornography offences, Phil Gormley, deputy director general of the National Crime Agency, called for a proactive approach in developing 'a range of interventions to prevent people offending… [and] to enable people to seek help to prevent their offending from becoming even more serious'.

Convicted offenders make up only the tip of an iceberg, with vast numbers of those attracted to children remaining hidden throughout their lifetimes. Research from Michael Seto estimates that paedophilia affects around 1 per cent of the global population, a figure suggesting British society may currently contain 641,000 such individuals; more than seven times the total capacity of British prisons (87,879). These figures seem to be supported by Phil Gormley's assertion that we cannot 'simply arrest our way out of this problem'.

One country that I would suggest is not failing this sexual underclass is Germany. I was shocked to find a recent search of the BPS website returned no mention whatsoever of Prevention Project Dunkelfeld [although see p.70]. Prevention Project Dunkelfeld (PPD) is a free, confidential treatment programme for help-seeking paedophiles and hebephiles that has been operating across Germany since 2005. Named after the population segment not known to the authorities or the law, Prevention Project Dunkelfeld (German for 'dark field') aims to provide therapeutic and pharmacological support to the estimated thousands attracted to children, regardless of their offending history. Under the PPD model, treatment is open to those who have never committed a crime, those who have committed a crime and have not been caught, and those who have committed a crime and already been punished.

Structured treatment is provided weekly in an anonymous group setting, as well as in one-to one sessions where necessary. Interventions include CBT, as well as sexological and medical approaches, with the option of pharmacological support, employing SSRIs and androgen antagonists. In some contexts, therapy is also offered to the client's partner and relatives, in order to promote the repair of interpersonal relationships and continued support at home. The programme is designed to run for 50 sessions, or approximately one year.

Rather than perpetuating Britain's reactive and potentially wasteful method of forcing convicted sex offenders through psychosocial treatment, regardless of their desire to change, PPD is a voluntary service that accepts only help-seeking and committed individuals, those for whom psychological intervention is far more likely to make a difference. In times of increasing austerity, the German model maximises funding by working in partnership with universities. A UK programme could follow suit, with academic funds being provided in return for researchers gaining voluntary access to a notoriously inaccessible sample.

The goal of the treatment programme is to increase personal awareness and enable service users to control and transform their paedophilic desires into more positive thoughts and actions. The project hinges on the theoretical standpoint that users are not at fault for their sexual feelings, but that they are responsible for how they act upon them. PPD offers many potential benefits beyond psychotherapy, such as increased personal accountability and decreased isolation. In this way, learning to boost social and legal compliance can run parallel with improvements in mood and self-esteem. A network of 10 treatment centres has been established throughout Germany, with the hope of eventually providing a national system geared towards the primary prevention of child sexual abuse by accepting, training and reintegrating possible offenders into the functional fabric of society.

In this country the work of the Lucy Faithfull Foundation and their Stop It Now programme go some way towards bridging current neglect, but without more sustained funding even these limited services are being crushed by the weight of help-seeking paedophiles, with an average of 2000 calls per month going unanswered.

In sum, PPD is hailed as a robust attempt to proactively tackle the collective suffering caused by child sexual attraction, with positive results being documented since 2009. However, according to project leader, Dr Klaus Beier, this beneficial work is only made possible by the anonymity afforded under German law. Unlike the UK, Germany does not have a mandatory reporting policy and without a reassessment of our laws, this progressive project could never be realised here in Britain. Is it time to ask ourselves if mandatory reporting is doing more harm than good?

Ben Aaron MacLeod
Writer and author
Newcastle upon Tyne