(PNM-47) The Psychotherapist’s experience in group psychotherapy with individuals with paraphilic disorders: reflections from clinical practice

Abstract Introduction Paraphilic disorders involve preferential and persistent sexual interests in atypical objects, situations, or individuals, often causing distress or impairment. Treatment combines pharmacotherapy and psychotherapy, including group therapy. This study reflects on the psychotherapist’s experience conducting group psychotherapy with paraphilic individuals voluntarily seeking treatment at a tertiary outpatient sexual health clinic. Methods This study reports the experience of three psychotherapists during an eight-month group therapy process. Sessions were weekly and based on cognitive-behavioral therapy. The group consisted of five male participants (ages 27-60) diagnosed with paraphilic disorders per DSM-5, all under pharmacological treatment. Two psychiatrists led the sessions under weekly supervision by a psychologist. Initial interviews were conducted for screening and rapport-building before group inclusion. Results Participants mainly experienced pedophilia and hebephilia; one had fetishism. Throughout the process, other paraphilic behaviors - sadism and exhibitionism - were identified. Early sessions were marked by participant dropouts and difficulties in emotional expression and interpersonal connection. Common issues included low self-esteem, impulsivity, and a restricted behavioral repertoire. A cohesive, supportive dynamic emerged, encouraging openness and emotional sharing. Participants felt relief in discussing paraphilic thoughts in a nonjudgmental environment. They reported reduced paraphilic behaviors, increased self-awareness, better insight, and broader emotional and relational experiences, contributing to improved quality of life. Conclusions Group psychotherapy, combined with pharmacological treatment, appears effective in managing paraphilic disorders. These observations stem from clinical experience, and further studies are needed to test the proposed hypotheses. Financing No conflict.