An International Randomized Waitlist-Controlled Trial of Internet-Delivered Cognitive Behavioral Therapy for Sexual Urges Toward Children.

Objective: Test whether Prevent It 2.0, a 9-week, anonymous internet-delivered cognitive behavioral therapy (iCBT) program, reduces the severity of sexual urges and behaviors toward children to prevent acts of child sexual exploitation and abuse. Method: In a randomized 1:1 waitlist-controlled trial...

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Publicado en:Journal of Consulting & Clinical Psychology Vol. 94; no. 7; pp. 425 - 437
Autores principales: McMahan, Allison, Joleby, Malin, Andersson, Gerhard, Letourneau, Elizabeth J., Seto, Michael C., Luke, Timothy J., Rahm, Christoffer
Formato: Artículo
Publicado: American Psychological Association Jul2026
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul2026
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      pub: American Psychological Association
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        10.1037/ccp0001019
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        atl: An International Randomized Waitlist-Controlled Trial of Internet-Delivered Cognitive Behavioral Therapy for Sexual Urges Toward Children.
      aug:
        au:
          McMahan, Allison
          Joleby, Malin
          Andersson, Gerhard
          Letourneau, Elizabeth J.
          Seto, Michael C.
          Luke, Timothy J.
          Rahm, Christoffer
        affil:
          Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services
          Department of Behavioural Sciences and Learning, Linköping University
          Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University
          Forensic Research Unit, University of Ottawa Institute for Mental Health Research
          Department of Psychology, University of Gothenburg
      su:
        Child sexual abuse
        Cognitive therapy
        Behavior therapy
        Sexual attraction
        Health policy
        Randomized controlled trials
      sug:
        subj:
          Child sexual abuse
          Cognitive therapy
          Behavior therapy
          Sexual attraction
          Health policy
          Randomized controlled trials
          Administration of Public Health Programs
      keyword:
        child sexual abuse
        internet-based intervention
        pedophilic disorder
        preventive psychiatry
        randomized controlled trial
        child sexual abuse
        internet-based intervention
        pedophilic disorder
        preventive psychiatry
        randomized controlled trial
      ab: Objective: Test whether Prevent It 2.0, a 9-week, anonymous internet-delivered cognitive behavioral therapy (iCBT) program, reduces the severity of sexual urges and behaviors toward children to prevent acts of child sexual exploitation and abuse. Method: In a randomized 1:1 waitlist-controlled trial with crossover at Karolinska Institutet, Sweden, N = 203 adults (≥18 years; 92.1% men, 0.5% women, 7.4% other; age 18–70, 66.6% aged 21–40; 49.8% Europe, 38.9% North America) were allocated to iCBT (n = 100) or waitlist (n = 103). The preregistered primary outcome was severity of sexual urges toward children (adapted Sexual Symptoms Assessment Scale). Secondary outcomes included weekly time spent observing children for sexual purposes, including use of child sexual abuse material, and severity of accessed material. The study was preregistered on https://ClinicalTrials.gov (ID: NCT05663047; Karolinska Institutet, 2022) and the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/Y2DC4; Rahm et al., 2022). Results: iCBT participants reported a significantly greater reduction in sexual urges toward children (−6.41 scale points, 95% confidence interval, CI [−8.26, −4.56]; d = −1.01, 95% CI [−1.30, −0.72]), as well as a significant decrease in time spent observing children for sexual purposes (including use of child sexual abuse material; −1.87 hr weekly, 95% CI [−2.91, −0.82], d = −0.517, 95% CI [−0.806, −0.228]) after 9 weeks compared to the attention-controlled waitlist. Conclusions: Prevent It 2.0 demonstrated efficacy in reducing sexual urges and offending related behaviors toward children, producing clinically significant reductions over 9 weeks, in an anonymous online sample. What is the public health significance of this article?: Prevent It 2.0 demonstrated that a brief, anonymous online cognitive behavioral therapy program can reduce sexual urges and behaviors toward children within 9 weeks. These findings support internet-delivered cognitive behavioral therapy as an effective component of a broader public health strategy to prevent child sexual abuse, complementing legal, clinical, and community-based prevention efforts.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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