Posted by Adm. on October 5, 2005, 5:36 am On the subject of treatment techniques, here is some additional information, excerpted from the Telling the Truth Project: _________________________ Adult exhibitionists have been successfully treated by a variety of conditioning techniques, including reciprocal inhibition (Bond & Hutchinson, 1960), partial-reinforcement schedule with imaginal stimuli (Kushner & Sandier, 1966), and by an anticipatory-avoidance technique (D.R. Evans, 1968). Several successful treatments of adolescents have also been reported in the behavior-modification literature. MacCulloch, Williams and Birtles (1971) described the treatment of a 12-year-old boy who had a compulsion to undress and expose his erect penis to older women. Not only was he shy and socially unskilled with girls his own age, but his exhibitionistic behavior was occurring so frequently that court action was likely. Therefore, a preliminary trial of conventional psychotherapy was abandoned in favor of a conditioning approach to achieve a more rapid resolution. The patient and his mother consented to a method of anticipatory-avoidance aversion therapy designed to reduce the age of the boy’s heterosexual approach-objects. The procedure included reinforced-, delayed-, and non-reinforced-avoidance trials and presentation of the CS[conditioned stimulus]2 on a partial schedule in order to reduce the generalization decrement to the real-life situation. The boy was given 18 twenty-minute sessions of therapy using six CS1 and six CS2 slides. At the completion of treatment, 25 percent of the boy’s masturbatory fantasy still concerned older women, but he was able to control the start of the cognitive chain which had previously led to the exhibitory behavior. At the six-week and five-month follow-ups, he reported that his masturbatory fantasy exclusively concerned girls his age and the compulsive ideas about exposing himself were absent. Callahan and Leitenberg (1973) treated a 15-year-old boy with a four-year history of exposure, which had resulted in police action, expulsion from high school, and two institutional commitments. By replicated, counterbalanced intrasubject presentations, two different aversion-therapy approaches were compared: (1) Four sets of six treatment sessions of covert sensitization in which an imagined aversive event was followed by the imagined exhibitionistic behavior, and (2) Three sets of six sessions in which shock was made contingent on erection to slides during exposure fantasy. The data did not reveal any difference in the relative effectiveness of one treatment over the other, but by the end of treatment and at the 18-month follow-up, overall improvement was found. Penile plethysmography indicated that the boy’s erectile response to slides of nude females under instructions to fantasize intercourse was 83 percent of maximum, while instructions to think of exposure resulted in only 14 percent erection. Mean daily urges to expose decreased from a baseline of four to five daily to less than one daily at follow-up, and incidents of reported exposure decreased to zero from a baseline of once every other day. Appropriate dating behavior was reported subsequent to treatment as well. There appears to be only one case in the literature in which an adolescent exhibitionist was treated by positive rather than aversive conditioning. Lowenstein (1973) proceeded on the assumption that fantasy plays a causal role in creating and perpetuating sexual deviations and that orgasm can be made contingent upon infrequent fantasies in order to reinforce acceptable social behavior. A 17-year-old boy was referred for treatment by a probation officer prior to his court appearance for exhibitionism. He exposed himself to adolescent girls several times weekly in a wooded area. He sought their surprised reaction, and he traced this behavior back to age 10. He rarely masturbated, considering it “dirty,” and he was judged to be essentially male identified. The boy was instructed to use a running diary to record a baseline of daily events, sexual stimulation, and drive to expose himself. After the one-week baseline, the boy was trained through counter-conditioning and reciprocal inhibition techniques to masturbate every day while fantasizing about sexual intercourse with a female. Competing behavior was encouraged by instructing him to associate with people in busy activity as much as possible, since exposure was less frequent under these conditions in his history. He continued to record his thoughts of exposure and rated the strength of the need to expose on a 1-10 scale. After the 20-day treatment period, the drive to expose himself reportedly decreased, to reappear only on occasions of experienced anxiety. Overt instances of exposure reportedly ceased entirely and no instances were reported by the boy at the 12-month follow-up. Lowenstein speculated that the increase in masturbation reduced sexual drive and its deviant expression. _________________________ This board does not make a practice of endorsing or propagating any religious or political viewpoints. The above is reproduced for its content, because of being relevant to the topic of this board. David Parker
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(Originally posted on May 1, 2001, 3:02 pm)
Exhibitionism
Telling the Truth Project is a religious organization centered around compiling writings representing the best of scholarship on various subjects. The above is an excerpt from one of their compilations. 
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