Cognitive-Behavioral Therapy with an Incarcerated

Abstract: Successful approaches to the treatment of exhibitionism, an important paraphilic disorder with respect to offense frequency, are limited in the recent literature. The use of individual cognitive-behavioral treatment with a long-term, incarcerated exhibitionist is presented. Emphasis was placed on the development of insight through informed decision making, as well as improvement in communication style and social network enhancement. Deviant sexual fantasies were targeted for change and more appropriate fantasies encouraged. Phallometric data showed a decrease in deviant responses over therapy and an increase in appropriate arousal. Exhibitionism, the paraphilic disorder that involves the public exposure of one’s genitalia for sexual gratification, appears to be viewed most often as a &dquo;nuisance&dquo; sexual offense. Setting aside the question concerning the severity of trauma for victims of exhibitionists (see Cox & Maletzky, 1980), the sheer frequency of the offense demands attention. Cox (1980) noted that roughly one-third of all sexual offenses reported in Canada, Great Britain, and the United States involve exhibitionism. He also pointed out tha