Primary Health Professionals’ Beliefs, Experiences, and Willingness to Treat Minor-Attracted Persons

Abstract

There is a desire and need among minor-attracted persons (MAPs) to access support within the community, and this often begins with an approach to healthcare providers working in general medical/mental health settings. However, little is known about the experiences of these non-specialist professionals in relation to their beliefs, knowledge, and decision-making processes when working with patients who disclose sexual attractions to children. Using an online survey, this study explored the knowledge, comfort, competence, and treatment willingness of 220 non-specialist healthcare providers when faced with patients who disclose sexual attractions to children. We investigated how often such disclosures were made, clinician stigma, treatment priorities, and professionals’ willingness to report MAPs to external agencies because of their sexual attractions. Some key differences were found when comparing primary medical vs. mental health professionals, including increased likelihood to view MAPs as dangerous, unable to control behaviors and that sexual attractions are an avoidable choice, in the former group. Both groups prioritized mental health treatment targets above controlling attractions and living with stigmatized attractions, although controlling or changing attractions were still relatively high priorities. Results indicated a need for further training, focusing on increasing comfort around working with MAPs, as this was associated with a greater willingness to work with this group. We identify current gaps in service provision for MAPs seeking professional support and discuss recommendations for professional training.

Outpatient Therapists’ Perspectives on Working With Persons Who Are Sexually Interested in Minors

“…3 In this way, we aimed to describe the attitudes, expectations, and experiences of a population who, in principle, should be most sympathetic and accustomed to people with mental health problems because dealing with psychological distress is an inherent part of their job profile and plays a central role in their professional training. This notion is corroborated by higher stigmatization of MAPs among general medical practitioners than mental health specialists (Lievesley et al, 2022). Notably, prior studies have included less stringently selected samples of healthcare practitioners and as a result included a much more heterogeneous and potentially more stigmatizing group of healthcare-related occupations and-in cases in which multivariate analyses have been conducted-focused on only a few, select dependent variables in multiple regression analyses.…”

“…Published studies have largely focused on professionals working in specific sexual abuse prevention settings (Beggs Christofferson, 2019;Goodier & Lievesley, 2018;Levenson & Grady, 2019b;Parr & Pearson, 2019) or students about to graduate as social workers or counselors (Walker et al, 2022). Three studies by Lievesley et al (2022), Stephens et al (2021), and Roche and Stephens (2022) that took approaches most similar to that in the present study have focused on varying healthcare practitioner groups, however, consisting of sizeable subsamples of practitioners not (yet) specialized for psychotherapeutic treatment. In Lievesley et al, (2022;N = 220) roughly half of the sample (46%) classified themselves as primary medical healthcare specialists (e.g., physicians), and 19% of the participants in Roche and Stephens (2022;N = 101) were students, social workers (24%), or psychologists or psychotherapists (roughly 50%).…”

“…Three studies by Lievesley et al (2022), Stephens et al (2021), and Roche and Stephens (2022) that took approaches most similar to that in the present study have focused on varying healthcare practitioner groups, however, consisting of sizeable subsamples of practitioners not (yet) specialized for psychotherapeutic treatment. In Lievesley et al, (2022;N = 220) roughly half of the sample (46%) classified themselves as primary medical healthcare specialists (e.g., physicians), and 19% of the participants in Roche and Stephens (2022;N = 101) were students, social workers (24%), or psychologists or psychotherapists (roughly 50%). The hitherto largest mental health clinician sample so far (Stephens et al, 2021; N = 309) consisted of roughly a third of practitioners who identified as social workers or professionals other than registered clinicians, psychologists, or psychiatrists, who made up the remaining sample.…”

“…In terms of therapist competency, only between roughly a quarter and 43% of practitioners answered correctly that pedophilia is a sexual attraction to children below the age of 11 and such general knowledge deficiencies about aspects related to minor attraction were associated with stigmatizing attitudes (Lievesley et al, 2022 ). Therapists’ stigmatization of MAPs, in turn, was negatively related to their willingness to accept MAPs for treatment (Roche & Stephens, 2022 ).…”

“…Therapists’ perceived competence was associated with willingness to treat MAPs on a zero-order level but had to be removed due to collinearity in a multivariate model controlling for stigmatizing attitudes. In this multivariate model, it was revealed that treatment willingness was statistically linked to therapists’ anticipated comfort and therapists’ regard of mental health issues as an important treatment focus, whereas focally controlling sexual attractions was negatively related to therapists’ willingness to treat MAPs (Lievesley et al, 2022 ).…”