The purpose of treating people with paraphilias is to control or eliminate the inappropriate sexual thoughts or behavior. However, the effectiveness of treatment is questionable. Paraphilias tend to be chronic and recur throughout a person’s life, especially during times of stress. For example, as many as 25 percent of people convicted of pedophilia resume the behavior within a few years of release from prison, according to the American Psychiatric Association (APA). People with pedophilia who victimize boys are twice as likely to repeat their behavior as people who victimize girls. 

Treatment is generally long-term. Success is complicated by the fact it requires the patient’s compliance and many patients with paraphilias receive treatment only because it is mandated by the court system.

Mental health therapy may be used to treat paraphilias. It can be accomplished one-on-one with a mental health professional or in a group setting with a professional facilitator. Common types of mental health therapy used to treat paraphilias include:

• Cognitive behavior therapy (CBT). Helps patients recognize the relationship between their thoughts and actions, and replace distorted thoughts with realistic ones. This type of therapy may help patients with paraphilias recognize and control the inappropriate thoughts preceding their sexual arousal.
  
  
• Interpersonal Psychotherapy. Communication with a mental health professional about thoughts, feelings and behaviors. This type of therapy may help people with paraphilias identify underlying motives or issues that may be associated with their sexual attraction to inappropriate objects, people or activities.
  
  
• Group therapy. Some people with paraphilias may benefit from groups that discuss sexual addictions. Some of these are self-help groups based on the 12-step model first used by Alcoholics Anonymous.
  
  
• Behavior therapy. Focuses on changing negative behavior. Using various learning techniques, patients with paraphilias may be able to reduce or stop their abnormal sexual behavior. For example, aversive conditioning trains a patient to associate negative consequences (e.g., smelling a repulsive odor) with their behavior.  

Medication may also be used to treat paraphilias. These include:

• Antiandrogens. Drugs that inhibit the action of androgens (substances that produce male hormones, such as testosterone and androsterone, responsible for sexual drive and attraction). Antiandrogens are used in patients with paraphilias to suppress their sexual urges.
  
  
• Antidepressants. Drugs that relieve depression and anxiety by affecting neurotransmitters in the brain. Antidepressants may be used to reduce the anxiety and depression that can occur in patients with paraphilias. Decreased sexual urges, a common side effect of certain antidepressants (selective serotonin reuptake inhibitors), may offer additional benefit to patients with paraphilias.
  
  

  

• Other medications may be considered if other mental health disorders are also present. These include antipsychotics, anti-anxiety medications or mood stabilizers.