Target population

People who feel sexually attracted to, or sexually aroused by, children and early adolescents. Troubled Desire is targeted at individuals who have not had the chance to engage directly with therapists, however it could also be used by individuals who have engaged in therapeutic services.

Delivery organisation

Troubled Desire was developed at the Berlin-based site of the Prevention Network “Kein Täter werden”, which means ‘Don’t Offend’. The web preference of Troubled Desire is overseen by the Institute of Sexology and Sexual Medicine at the Charité at the Universitätsmedizin Berlin.

Mode and context of delivery

Troubled Desire is an online self-help tool available at www.troubled-desire.com. The self-help tool is designed to be completed by individuals who are concerned by their sexual attractions or arousals towards children. The self-help tool will be available in 10 languages from January 2020.

Level/Nature of staff expertise required (e.g. professional background)

No staff are required for use of the online treatment.

Intensity/extent of engagement with target group(s)

Users can complete the self-help tool in their own time and return to it as and when they wish to by entering their webpage-generated personal user ID. It is the responsibility of the user to remain engaged with the self-help modules and to implement any recommended advice. As with all self-help tools, the more time and effort a user spends engaging with the material, the more they will achieve. If available, users are advised to contact a local therapeutic service, however they should be mindful of professional confidentiality policies if they are unknown by the authorities.

Description of intervention 

Prior to engaging with the self-help resources, users are required to answer a number of anonymous questions about themselves in order to customise the websites approach and to provide constructive, immediate, personal feedback. The feedback identifies a user’s sexual preference and problematic sexual behaviour. These questions are broken down into three categories:

1. I am -    Questions about their education, family, profession and contact situations with children
2. I feel - Questions about sexual fantasies
3. I do -     Questions abut sexual and non-sexual behaviours

There are 16 subsequent self-help modules that the user can work through in whichever order they choose. The modules are as follows:

• Sexual preference structure

To explore the building blocks of sexual preference structure and to gain insight into the colourful world of sexual desires, including your own.

• Problematic sexual behaviours

To discuss the matter of informed consent in terms of problematic sexual activities.

• Myth buster

To examine myths (false assumptions) and facts (true findings) about love, sexuality and children experiencing assaults with the aim of dispelling false assumptions.

• Rose-tinted glasses

If someone looks at something through rose-tinted glasses, they see only the pleasant parts of it. This module goes through the situation in order to discover how our thoughts are able to manipulate the experience of reality.

• Genesis of sexual attractions

Those searching for the cause will discover that there are, in fact, multiple causes… This module discusses the causes for having one sexual preference or another, and to gain insight into how to make sense of each one.

• Acceptance

Acceptance is not for granted. It’s granted by knowledge. This module conveys an understanding of the importance of acceptance and tries to apply this knowledge to our sexual preference.

• Take a break

Time management issues, recurring headaches, work stress or persistent fantasies about children can easily engross us or throw us off track. This module looks at a relaxation technique that will enable us to more easily master daily challenges.

• Fantasy and behaviour

We will explain the importance of differentiating between fantasy and behaviour. By gaining a deeper understanding of our own sexual fantasies and behaviours the module will be able to improve impulse control pertaining to these sexual desires.

• Self-perception

The module takes a look at the individual and their own inner processes. The goal is to identify unfavourable sexual behaviour and potential adverse situations, and to learn how to intervene at an early stage by disciplining thoughts and feelings.

• Personal triggers

The risk to commit a sexual assault or to use child sexual abuse images is not always the same, but rather is dependent on certain conditions. The module helps users to learn how to identify those ‘triggers, i.e. factors that increase the risk of fantasies becoming behaviour.

• Situation analysis

The module examines what happens before, during and after the use of child abuse images or a child sexual assault in order to establish behavioural control mechanisms at the earliest stage.

• Impulse control

One… two… three pieces of chocolate… while dieting? It can sometimes be difficult to control our impulses. This module looks at the importance of impulse control and tries to find ways to improve it during our daily life.

• Empathy

Whether we see joy or grief, humans are capable of taking the perspective of others. This module takes a closer look at the ability to take another’s perspective and discover how this ability helps individuals to navigate social surroundings.

• Letter of a victim

Child sexual offending dramatically affects the emotional and physical health of the victims. In the module users go through the letter of a victim of childhood sexual abuse in order to address the consequences of that experience.

• Medical treatment options

Some people experience sexual desires or fantasies that are too intense, not manageable and cause marked distress. For those people, the module gives an overview of taking medication as an additional valuable option.

• The secret of well-being

In order to live a good life and maintain our well-being we must respect and care for our individual needs. Therefore, the module provides a brief guide and read the story of a young man who was able to do this by understanding and overcoming his negative behaviours.

The intervention is based on the Berlin Dissexuality Therapy (BEDIT) manual, which is the foundation of the prevention network “Kein Täter werden”.

Evaluation

To date, Troubled Desire has not been evaluated. However, a randomized control trial is currently in development. The initial findings suggest that Troubled Desire is proving successful as an increasing number of users are returning to use it frequently.

References

No references available to date.

Contact details

Hannes Gieseler; Managing Director

Email:                 hannes.gieseler@charite.de

Address:            Zentrum für Human- und Gesundheitswissenschaften, Universitätsklinikum Charité Campus Mitte, Freie und Humboldt-Universität zu Berlin, Luisenstraße 57, D-10117 Berlin-Mitte

Website: https://www.troubled-desire.com/

INFORMATION CORRECT AT JUNE 2021

RATING: Pioneering