The goal of this prospective multicentred, stratified, parallel-group superiority study is to prevent and reduce the usage of Child Sexual Abuse Material (CSAM) by a Therapist Chat Service (TCS) and Selfhelp Platform for Self-Referred Patients, mostly men with a sexual interest in children. The interventions are based on Cognitive Behavioral Therapy (CBT) principles and designed to treat the sexual behavioral disorder related with CSAM consumption.
1. Participants in the Selfhelp modules group will show a statistically significantly higher proportion of reduction in CSAM behaviours four weeks after baseline, as compared to participants in the waitlist control group. 2. Participants in the Selfhelp modules followed by TCS group will show a statistically significantly higher reduction of CSAM behaviours compared to participants in the Selfhelp-only and TCS-only groups, post-intervention.
Researchers will compare TCS-only-, Selfhelp-only-, Selfhelp + TCS- and Waiting group to see if if the interventions decrease CSAM use and improve mental well-being.
Participants will get web based selfhelp-modules and/or text-based chat intervention operated by trained therapists.
Adult participant (≥18 years);
recent (last 2 weeks) CSAM use or past CSAM use and self-reported risk;
proficiency in English, German or Spanish;
voluntary participation and agreement to the terms of the study.
Severe neuropsychiatric comorbidities (unstable psychotic disorder, organic brain damage, diminished intellectual functioning, untreated drug or alcohol addiction);
history of contact CSA perpetration (past or present);
ongoing criminal investigation, trial, punishment, or probation status for online or offline CSA or CSAM use;
current inpatient psychiatric treatment or other concurrent treatment targeting CSAM behaviours
Parallel
Selfhelp modules
Behavioral16 web-based structured selfhelp modules, based on CBT techniques from the Berlin Dissexuality Therapy (Beier, K. M. (2021). Pedophilia, hebephilia and sexual offending against children. The Berlin Dissexuality Therapy (BEDIT). Springer)
Therapist Chat Service
BehavioralOnline Therapy Chat Service (TCS) based on CBT techniques from the Berlin Dissexuality Therapy (Beier, K. M. (2021). Pedophilia, hebephilia and sexual offending against children. The Berlin Dissexuality Therapy (BEDIT). Springer)
Reduction in Child Sexual Abuse Material (RCSAM) severity
A) Reduction in Child Sexual Abuse Material severity (RCSAM severity): A reduction in CSAM severity in the last 2 weeks, defined as the pre-post difference in highest "Combating Paedophile Information Networks in Europe" (COPINE) scale scores, with a reduction from severity levels 4 or higher to levels 3 or lower after the intervention.
Reduction in Child Sexual Abuse Material (RCSAM) time
B) Reduction in Child Sexual Abuse Material time (RCSAM time): A 50% or greater decrease in CSAM consumption time (minutes) over the past 2 weeks. CSAM time is measured as the time (in minutes) spent consuming CSAM materials over the past 2 weeks.
Reduction in Child Sexual Abuse Material (RCSAM) risk
C) Reduction in self-reported risk of Child Sexual Abuse Material use (RCSAM risk): A reduction in self-reported risk of CSAM use (RCSAM risk): A decrease in the risk of CSAM consumption over the last 2 weeks, defined as a pre-post decrease in self-reported risk, as measured using an adapted version of the "Sexual Child Molestation Risk Assessment" (SChiMRA+) Part A.
Risk of Child Sexual Abuse Material (CSAM) consumption
Risk of CSAM consumption: Sexual Child Molestation Risk Assessment (SchiMRA+ part A) at baseline and follow-up.
Frequency of Child Sexual Abuse Material (CSAM) consumption
Frequency of Child Sexual Abuse Material (CSAM) consumption: Self-reported every two weeks, at baseline and follow-up.
Mental Wellbeing
Mental wellbeing: The Warwick-Edinburgh Mental Wellbeing Scale (WEMBWS; Tennant et al., 2007). The total score is obtained by summing the score for each of the 14 items. The scoring range for each item is from 1 - 5 and the total score is from 14-70. Higher scores mean a better outcome. Mental wellbeing is measured over the past 2 weeks.
Total Sexual Outlet
1. Self-reported number of orgasms achieved from masturbation using Child Sexual Abuse Material (CSAM) in the past week 2. Self-reported number of orgasms achieved from masturbation not using CSAM in the past week 3. Self-reported number of orgasms achieved from sexual interaction in the past week 4. Total sexual outlet: sum of self-reported number of orgasms from masturbation (with and without using CSAM) + self-reported number of orgasms from sexual interaction. This outcome is measured at baseline and follow-up.
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Charite University, Berlin, Germany
Lead sponsor
Universitat Internacional de Catalunya
Collaborator
