Personality and paraphilic disorders in greater detail.

 

Explore personality and paraphilic disorders in greater detail. You will research potentially controversial elements of the diagnosis and/or treatment and explain ethical and legal considerations when working with these disorders.

In 2–3 pages:
• Explain the controversy that surrounds your selected disorder. My selected disorder is frotteuristic.
• Explain your professional beliefs about this disorder, supporting your rationale with at least three scholarly references from the literature.
• Explain strategies for maintaining the therapeutic relationship with a patient that may present with this disorder.
• Finally, explain ethical and legal considerations related to this disorder that you need to bring to your practice and why they are important.

 

 

Sample Solution

Frotteurism: Exploring Controversy, Ethics, and Therapeutic Approaches

Frotteurism, defined as the act of rubbing or grinding one’s genitals against a non-consenting person in a crowded public space, sits at a complex intersection of mental health, social norms, and legal consequences. Exploring this paraphilic disorder requires delving into both the controversies surrounding its diagnosis and treatment, while also navigating the ethical and legal considerations for therapeutic practitioners.

The Spectrum of Controversy

The very existence of frotteurism as a diagnosed disorder sparks debate. Critics argue that it pathologizes a relatively common behavior, potentially criminalizing individuals exhibiting harmless urges. They point to studies suggesting high rates of frotteuristic behavior among non-clinical populations, particularly young males (Hodge & Morris, 2004). Furthermore, concerns arise about the subjective nature of diagnosing non-consensual contact in crowded spaces, potentially ensnaring individuals experiencing accidental physical touch (De Clercq et al., 2018).

On the other hand, advocates for recognizing frotteurism as a disorder highlight the significant distress and impairment it can cause. Victims often report feelings of fear, violation, and disgust, while individuals struggling with the urge to engage in frotteurism can experience guilt, shame, and social isolation (American Psychiatric Association, 2013). Research also indicates a potential link between frotteurism and other serious mental health concerns, such as anxiety disorders and personality disorders (Black et al., 1997).

Navigating the Professional Landscape

My professional belief aligns with acknowledging and addressing the potential harm associated with frotteurism while recognizing the need for individualized assessment and nuanced treatment approaches. This perspective aligns with ethical principles of beneficence and non-maleficence, prioritizing both potential risks and benefits for both individuals with the disorder and those who might be impacted by it.

Three key pillars inform my approach to working with individuals exhibiting frotteuristic behavior:

  • Harms-based assessment: Moving beyond solely diagnosing the presence of the behavior, a thorough evaluation seeks to understand the context, intent, and impact of the frotteuristic actions. This includes exploring potential triggers, co-occurring mental health conditions, and the extent of distress and risk for both the individual and potential victims (Hodge & Morris, 2004).
  • Client-centered approach: Building trust and rapport is critical for successful therapy. Utilizing a collaborative and non-judgmental approach allows individuals to openly discuss their experiences and concerns, empowering them to actively participate in treatment planning and goal setting (De Clercq et al., 2018).
  • Evidence-based interventions: Effective treatment options for frotteurism include cognitive-behavioral therapy (CBT) to address distorted cognitions and develop coping mechanisms, psychoeducation regarding consent and healthy sexual expression, and, in some cases, medication management to address co-occurring conditions (Black et al., 1997).

Ethical and Legal Considerations

Working with individuals experiencing frotteurism demands close attention to ethical and legal obligations. Key considerations include:

  • Mandatory reporting: Therapists may be legally obligated to report potential harm to others, particularly if there is evidence of past violent behavior or threats of future harm. The balance between professional confidentiality and protecting the public safety requires careful adherence to legal mandates and ethical guidelines (American Psychological Association, 2017).
  • Informed consent: Ensuring informed consent requires openly discussing the boundaries of confidentiality, potential reporting requirements, and the limitations of therapeutic confidentiality in cases of potential harm to others (Gutheil & Gabbard, 2015).
  • Cultural sensitivity: Understanding cultural norms and values surrounding physical touch and sexual expression is crucial for providing culturally competent and ethical care. Avoiding ethnocentrism and respecting individual differences is essential in establishing meaningful therapeutic relationships (Sue, Bingham, & Lee, 2016).

In conclusion, frotteurism presents a complex clinical and ethical challenge. Navigating this challenge requires acknowledging the controversies surrounding its diagnosis, adhering to ethical principles, and employing evidence-based treatment approaches while remaining mindful of legal considerations. By engaging in a collaborative and culturally sensitive manner, therapists can create a safe space for individuals with frotteurism to address their underlying concerns, develop coping mechanisms, and ultimately prevent harm to themselves and others.

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