Quality Improvement Initiative for Pedophilic Disorder-Nursing Paper Examples

Pedophilic Disorder-Nursing Paper Examples

Pedophilic disorders are associated with a recurrence of sexually arousing fantasies and urges, causing attraction to younger children. Kiper et al. (2021) observed that pedophiles force or coercion children, mostly under 13 years, into sexual activity and could even threaten them or their pets. Female children are at increased risk of victimization by pedophiles compared to male children. Pedophilic disorders are often diagnosed when the individual experiences increased distress and inability to function properly (Pedophilic Disorder-Nursing Paper Examples).

According to Seto (2022), DSM-5 guidelines dictate that individuals with pedophilic disorders must be over 16 years old and more than five years older than the child victim. Also, pedophiles should exhibit arousal patterns in children for more than six months to be diagnosed with a pedophilic disorder (Savard et al., 2021). Therefore, Cognitive Behavioral Therapy (CBT) offers the most suitable approach to treating and managing pedophilic disorders (Pedophilic Disorder-Nursing Paper Examples).

The paper will examine the need for a quality improvement initiative for pedophilic disorders and the expected outcomes of the initiative. It will also explore aligning previous research findings with the quality improvement initiative. The paper will also explore the steps to implement the quality improvement initiative program. The last part will evaluate the quality improvement initiative to determine its effectiveness in improving, preventing, and managing pedophilic disorders (Pedophilic Disorder-Nursing Paper Examples).

Significance of Quality Improvement in Practice or Organization

Pedophilic disorders affect the daily lives of pedophilias and their victims. For instance, the United States (US) has designated pedophilic disorders as a criminal offense, increasing the risk of damage to professional careers (Perrotta, 2020). Convicted offenders are less likely to rebuild professional careers, which may increase unemployment and the inability to fend for family needs (Seto, 2022). Similarly, pedophiles and victims often experience shame and discrimination, making it challenging to live harmoniously in society (Pedophilic Disorder-Nursing Paper Examples).

Discrimination and stigmatization could contribute to trauma among the offenders, forcing them into deviant behaviors like substance abuse (Merry et al., 2020). Moreover, pedophilic disorders affect individual functioning by compelling them to lead dual lives. The perpetrators strive to maintain the secrecy of the condition, which could hinder them from effectively performing their responsibilities, such as spousal needs or socializing (Pedophilic Disorder-Nursing Paper Examples).

Therefore, individuals with pedophilic disorders require immediate help managing their desires. Merry et al. (2020) assert that CBT provides a suitable treatment strategy for the disorder since it enhances reintegration and societal acceptance of such individuals, including reducing recidivism rates. CBT therapies reduce sexual hypersensitivity by influencing an individual’s cognitive processes before committing deviant behavior (Pedophilic Disorder-Nursing Paper Examples).

It helps individuals recognize pedophilic behavior as a problem and develop coping skills to prevent such urges (Hallberg et al., 2020). It also enhances their self-esteem, which is necessary for overcoming stigma and successful social reintegration. Thus, individuals exhibiting pedophilic disorders should be enrolled in CBT programs to reduce problems associated with the disorder and enhance their coping mechanisms (Pedophilic Disorder-Nursing Paper Examples).

Previous Research supporting the Quality Improvement Initiative

Previous studies have confirmed the effectiveness of CBT programs for pedophilic disorders. For instance, Merry et al. (2020) systematically reviewed previous studies examining pedophilic offender rehabilitation programs based on CBT programs. The authors reviewed scientific articles published between 2014 and 2019 and drawn from major databases like PubMed, ProQuest, and Science Direct. The 28 articles reviewed indicate that CBT administered to offenders effectively prevented recidivism, an outcome necessary for successful reintegration into the community (Pedophilic Disorder-Nursing Paper Examples).

The researchers found that pedophilic behavior was associated with emotional instability, availability of sexual stimuli and childhood sexual history, and use of illicit substances like alcohol. In this case, CBT programs equipped the offenders with skills to manage their sexual urges, effectively reducing recidivism rates (Merry et al., 2020). Therefore, the authors concluded that the CBT programs could be more effective when administered individually for privacy.

Another study by Heydari et al. (2023) comparing the efficacy of combined treatment packages with CBT among men with pedophilic disorder confirmed CBT’s effectiveness in managing sexual urges. The researchers employed a semi-experimental study design of pre-test-posttest-follow-up among 30 Afghan men (Pedophilic Disorder-Nursing Paper Examples).

They assessed the effectiveness of combined therapy programs based on commitment and acceptance, mindfulness, and schema therapy using a multifaceted sexual self-concept questionnaire. The study results indicated that CBT (schema therapy) and combined therapy produced positive self-concept scores, with the combined therapy being more effective. In this case, an extensive focus on an individual’s real values was integral in identifying the pedophilic problems increasing the individual’s sexual urges towards children (Pedophilic Disorder-Nursing Paper Examples).

The final study investigated the impacts of internet-administered CBT (ICBT) on hypersexual disorders (HD) among people with paraphilic and without paraphilic disorders. HD disorders that occur concomitantly with paraphilia cause a loss of control of sexual urges, which could contribute to sexual offenses against children. Hallberg et al. (2020) conducted the study at the ANOVA clinic at the Karolinska University Hospital, Stockholm, Sweden, where they administered a 12-week ICBT protocol for HD among patients with and without paraphilia (Pedophilic Disorder-Nursing Paper Examples).

They also administered a follow-up intervention within three months after the end of the 12-week treatment program. The study findings showed a significant reduction in HD symptoms and sexual compulsivity, confirming that CBT programs can reduce HD, paraphilic disorders, and psychiatric distress. Henceforth, the three studies confirm that CBT efficiently reduced pedophilic and HD symptoms among patients in different settings; hence should form the basis of the quality improvement initiative (Pedophilic Disorder-Nursing Paper Examples) (Pedophilic Disorder-Nursing Paper Examples).

 Steps Necessary to Implement Quality Improvement Initiative

The CBT program should be implemented carefully to enhance its effectiveness and acceptance among pedophilic disorder patients. In this case, Bannink and Geschwind (2021) explained that psychologists should first employ four steps: understand the patient’s values, mental conditions, and personality. Understanding the patient’s medical and mental health, including the level of aggression, is integral in formulating the therapy goals. Second, the therapist should investigate the patient’s awareness and perceptions about the pedophilic problems they are experiencing. Engaging the patient in an open discussion and observing their reactions is essential to help identify the problem’s root cause (Fortuna et al., 2020) (Pedophilic Disorder-Nursing Paper Examples).

Third, the therapist should identify the patient’s negative and inaccurate perceptions and thoughts to facilitate recognition of the thinking patterns and beliefs influencing the pedophilic disorder (Bannink & Geschwind, 2021). The step can include an assessment of the patient’s behavior in varying situations. Lastly, Fortuna et al. (2020) illustrate that the therapist will assist the patient in reshaping the harmful or inaccurate thoughts by adopting an accurate viewpoint in assessing their thoughts.

For example, it is crucial to encourage the patient to take a positive attitude in overcoming societal beliefs about pedophilia, such as that it is caused by poor self-confidence and inability to control social anxiety. The patient may need therapy for longer durations to adequately perceive and adopt positive attitudes and emotional responses toward the pedophilic disorder (Pedophilic Disorder-Nursing Paper Examples).

Evaluation

The interpersonal, affective, cognitive, and behavioral variables will be evaluated to determine the effectiveness of the CBT program in pedophilic disorder treatment. T-tests will be conducted on the data collected to test the hypothesis and determine the CBT treatment. The hypothesis for the evaluation will be: CBT intervention contributes to low outcome questionnaire 45 (OQ 45) scores among individuals with pedophilic disorders. The OQ 45 will be administered to the patient to assess their impression of the treatment process (Pedophilic Disorder-Nursing Paper Examples).

Cordova (2021) illustrated that the questionnaire consists of 45 items and three subscales for symptom distress (SD), interpersonal relations (IR), and social role (SR) assessing psychotherapy progress in adults. SD scores above 37 indicate subjective discomfort due to anxiety and depression, IR scores above 16 indicate problems with interpersonal relationships, and SR scores above 13 indicate dissatisfaction and distress. In this case, total scores above 83 are highly distressful, while average scores range between 64 and 82, and low scores below 64 (Cordova, 2021) (Pedophilic Disorder-Nursing Paper Examples).

Besides, the CBT effectiveness will also be evaluated based on the therapist’s impression. The therapist can utilize the OQ 45 scores to make conclusions regarding the patient’s treatment outcomes. Thus, the OQ 45 will provide accurate and reliable assessment results on the effectiveness of the CBT intervention (Pedophilic Disorder-Nursing Paper Examples).

Conclusion

Pedophilic disorders can effectively be treated using CBT interventions. The CBT programs are necessary to reduce stigma and recidivism and boost the self-esteem of individuals with pedophilic disorders, including helping them manage sexual hypersensitivity. Previous studies confirm the effectiveness of CBT therapies in reducing and managing pedophilic disorders. Researchers like Merry et al. (2020), Heydari et al. (2023), and Hallberg et al. (2020) concur that CBT is efficient in controlling sexual urges and should be prioritized in treating individuals with pedophilic disorders (Pedophilic Disorder-Nursing Paper Examples).

In this case, it is essential to take appropriate steps in administering the CBT interventions, such as understanding the patient’s personality, awareness, and perceptions about the pedophilic behavior. They should also recognize the patient’s thinking patterns and assist them in developing positive attitudes and accurate perceptions to counter negative thoughts. OQ 45 assessment tools will evaluate the effectiveness of the CBT, and results will be analyzed through a t-test. Henceforth, therapists should consider CBT as the initial approach to treating and managing pedophilic disorders among patients (Pedophilic Disorder-Nursing Paper Examples).

References

Bannink, F., & Geschwind, N. (2021). Positive CBT: Individual and group treatment protocols for positive cognitive behavioral therapy. Germany: Hogrefe Publishing GmbH.

Cordova, S. J. (2021). The enhancement of treatment outcomes through using Oq-45 in the routine evaluation of therapeutic services in psychodynamic treatment (Doctoral dissertation, Biola University). https://www.proquest.com/openview/d0b70751833f5ddba3ae734f9d6097ee/1?pq-origsite=gscholar&cbl=18750&diss=y

Fortuna, L. R., Falgas-Bague, I., Ramos, Z., Porche, M. V., & Alegría, M. (2020). Development of cognitive behavioral therapy with integrated mindfulness for Latinx immigrants with co-occurring disorders: Analysis of intermediary outcomes. Psychological Trauma: Theory, Research, Practice, and Policy, 12(8), 825. https://psycnet.apa.org/doi/10.1037/tra0000949

Hallberg, J., Kaldo, V., Arver, S., Dhejne, C., Piwowar, M., Jokinen, J., & Öberg, K. G. (2020). Internet-administered cognitive behavioral therapy for hypersexual disorder, with or without paraphilia (s) or paraphilic disorder (s) in men: a pilot study. The Journal of Sexual Medicine, 17(10), 2039-2054.https://doi.org/10.1016/j.jsxm.2020.07.018

Heydari, B., Kajbaf, M. B., & Ghamarani, A. (2023). Comparison of the efficacy of the combined treatment package with cognitive behavioral therapy on the sexual self-concept of men with a pedophilia disorder. Journal of Psychological Science, 22(122), 343-359.https://psychologicalscience.ir/article-1-1912-fa.html

Kiper, V., Gary, A., & Geist, R. (2021). The facts about the pedophilic disorder. Nursing Made Incredibly Easy, 19(1), 42-47. doi:10.1097/01.NME.0000723384.14908.d4

Merry, P., Muslihah, N., & Wihastuti, T. A. (2020). Cognitive-Behavioral Therapy in Preventing Residivitism in Pedophilia: A Systematic Review. International Journal of Science and Society, 2(3), 86-99. https://doi.org/10.54783/ijsoc.v2i3.129

Perrotta, G. (2020). Pedophilia: definition, classifications, criminological and neurobiological profiles, and clinical treatments. A complete review. Open J Pediatr Child Health, 5(1), 019-026. https://dx.doi.org/10.17352/ojpch

Savard, J., Hirvikoski, T., Görts Öberg, K., Dhejne, C., Rahm, C., & Jokinen, J. (2021). Impulsivity in compulsive sexual behavior disorder and pedophilic disorder. Journal of Behavioral Addictions, 10(3), 839-847. https://doi.org/10.1556/2006.2021.00044

Seto, M. C. (2022). Clinical and conceptual problems with Pedophilic Disorder in the DSM-5-TR. Archives of Sexual Behavior, 51(4), 1833-1837. https://doi.org/10.1007/s10508-022-02336-1