These groups provide weekly outpatient treatment to adult or adolescent patients with sexual or related disorders. Most patients are males, but there are also females in treatment. The primary goal of treatment is control of inappropriate sexual thoughts and behaviors, as well as enhancement of healthy relationships. Group therapy (1) confronts rationalizations and denial, (2) creates a supportive milieu conductive to frank discussion and treatment, (3) provides guidance regarding effective relapse prevention strategies, and (4) encourages empathy for others. It also encourages development of a support network.

          Other issues include awareness of stressors which can decrease one's ability to exercise needed self-control, awareness of stimuli that heighten unacceptable sexual cravings, and any other relevant matters the patient needs to discuss.

          The Clinic provides parole and probation officers with monthly compliance letters for those under legal obligation to be in treatment and also informs these authorities should the patient become noncompliant. If patients in outpatient treatment experience concerns about imminent loss of control, inpatient hospitalization is encouraged. Currently, outpatient groups meet on Tuesday or Thursday evenings.

          The mentally retarded group provides outpatient treatment to those persons with sexual disorders who suffer from borderline to moderate mental retardation, a major learning disability, or other handicaps that impair intellectual functioning. These individuals usually have some degree of educability and ability to communicate with others. Treatment goals include development of social skills, and development of a positive self-concept. The group sessions help assess current structure and stressors, try to facilitate productive activity, and there is weekly problem solving and crisis intervention. There is close liaison with other agencies involved in the care of these patients.

          Individual counseling, couples' counseling and family counseling are also available at the "National Institute." Depending on the patient's needs, these sessions may be the primary plan of treatment, or they may be arranged in conjunction with a group therapy regimen.

          Studies begun at Johns Hopkins in 1966 have shown that compulsive sex offenders treated with antiandrogenic (sex drive reducing) medication plus counseling have appeared to gain in self regulation of sexual behavior. The medication decreases the frequency of erections and ejaculation and also lessens the feeling of libido and the mental imagery of sexual arousal. The medication can be thought of as an appetite suppressant for the sex drive, intended to make self control easier. Such medication may be recommended in instances where improper sexual behaviors seem to have become compulsive or driven.

          Treatment with antiandrogens is voluntary, and patients are asked to give informed consent before beginning such treatment. The medicine is not feminizing. The treatment does not eliminate sexual drive. Instead, the patient will be maintained at a level intended to help him (or her) be better able to conform behavior to appropriate standards.

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