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The use of a self-administered noxious agent to suppress deviant sexual arousal is the focus of this paper. A recommended procedure for the use of olfactory aversion is described. Data from two publications by the author, wherein different noxious agents had been used, are presented and discussed. Several explanations for the mechanism of effect in olfactory aversion have been offered. Two of these, one using a nausea-producing agent and one using a pain-producing agent are described. The procedure using the pain-producing agent is the simplest to implement, the least ambiguous, and offers the least cumbersome explanation for the behavioral effect observed in olfactory aversion. However, a conditioning explanation is probably too simple. Several examples of cognitive mediation in conditioning procedures are presented and discussed.

The concept of harm reduction applied to sexual offending is very upsetting to some clinicians. This paper attempts to anchor harm reduction within the larger framework of relapse prevention. It is argued that reducing harm more accurately represents what clinicians do with sexual offenders rather than preventing or eliminating relapses. There are numerous common misconceptions about harm reduction with sexual offenders and explanations are provided for each of these. Finally, it is argued that harm reduction acknowledges that sexual abuse and all forms of interpersonal violence are actually public health issues. Adoption of this viewpoint, however, requires acceptance of a more humanistic perspective rather than a medical, psychological, legal, or political solution to a grievous social problem.

This paper argues that the notion of harm reduction can provide a more useful framework for the management of sex offenders. In this model, any reduction in the frequency or intensity of sexual offending is construed as positive. The zero-tolerance position, implicit in the relapse prevention model, has been a conspicuous failure in areas such as drug addiction and alcoholism. One of the major limitations is the equating of relapse with treatment failure. Moreover, managing sex offenders, in the sense of striving to limit socially undesirable behaviors, is a perfectly legitimate aim within the goal of making society safer.

The use of repetitive verbalization of deviant sexual fantasies to reduce deviant sexual arousal is the focus of this article. The similarity of the described procedure to other techniques designed to suppress or eliminate a wide range of undesirable behaviors is noted. Verbal satiation is quite similar to masturbatory satiation and the differences are compared. The verbal satiation technique is described, along with suggestions for improving its efficacy. The mechanism of effect is discussed, with emphasis on conditioned inhibition as the best explanation. Verbal satiation is compared to three types of aversive conditioning procedures to show that its operation and effects more closely resemble traditional satiation techniques. Maintenance of treatment effects in behavior therapy are discussed It is concluded that, given its simplicity and the strong support for satiation techniques in the behavior therapy literature, verbal satiation to reduce deviant sexual arousal should be given a more extensive empirical evaluation.

This is the first of two papers which briefly outline the development of behavioral and cognitive behavioral treatment of sexual offenders from the mid-1800s to 1969. We first consider the historic role of Sigmund Freud and note that a broad scientific interest in deviant sexual behavior was well established by 1900. In the early to mid-20th century, two psychologies were prominent in the development of behavioral approaches, those of John B. Watson and Alfred Kinsey. Behavior therapy for a variety of problems emerged in the 1950s and soon found application to deviant sexuality. The development of penile plethysmography helped to focus interest on deviant sexual preference and behavior. While nonbehavioral approaches to sexual offenders paralleled these developments, a combination of behavioral and cognitive behavioral treatments began to emerge in the late 1960s which ultimately developed into the approaches more commonly seen today.

This paper is the second in our attempt to highlight the major influences, trends, and emerging issues in cognitive behavioral approaches to treating sexual offenders. In this paper the developments from 1970 until the present are covered.

Thirty sex offenders were assessed for age and gender preference with a set of standardized erotic slides and an assessment protocol which specified each step in the procedure. This procedure was intended to be a normative study to be carried out at multiple sites in the United States and Canada. It was hypothesized that (1) the procedure would discriminate child molesters as heterosexual, homosexual, or bisexual, (2) the procedure would differentiate child molesters from normal subjects, and (3) both of these hypotheses would be confirmed at all sites. Data are reported here for 20 of the 30 subjects tested in groups labeled heterosexual pedophilia, homosexual pedophilia, heterosexual incest, and rape. Although the groups were quite small and measured response levels were low, good discriminations were obtained between groups and stimulus categories. It was concluded that the obtained data confirmed Hypothesis 1 and partially confirmed Hypothesis 2. Although the assessment protocol had to be altered to suit local conditions, it proved adequate and could serve as a guide in future standardization studies. Of particular interest was the finding that a 30-sec slide exposure was effective in producing discriminations in the critical categories related to the tested hypotheses.