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Controversy Associated with Personality and Paraphilic Disorders

 

Kyong Power

Walden University

NRNP 6675: PMHNP Care Across the Lifespan II

Dr. Mihaela Fletcher

July 17. 2022

 

 

 

 

Assignment: Controversy Associated with Personality and Paraphilic Disorders

 

Paraphilic disorders are far more common in men than in women, and generally quite chronic, lasting at least two years. Treatment of these disorders usually involves both psychotherapeutic and pharmacologic treatments.

 You will 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.

To Prepare

Review this week’s Learning Resources and consider their insights on assessing, diagnosing, and treating personality and paraphilic disorders.
Select a specific personality or paraphilic disorder from the DSM-5-TR for this Assignment.
Use the Walden Library to investigate your chosen disorder further, including controversial aspects of the disorder, maintaining the therapeutic relationship, and ethical and legal considerations.

The Assignment

In two to three pages:

Explain the controversy that surrounds your selected disorder.
 
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.

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Introduction

A paraphilia can be centered on a particular object or a particular act. A paraphilia disorder (PD) is fixated with the thing or behavior to dependence on that object or behavior for sexual gratification. Most paraphilias are more common in men than women (Keister, 2019). This paper aims to address the controversy surrounding paraphilic disorders and describe my professional belief and the strategies to maintain a relationship with patients presenting with the condition. Clarify ethical and legal considerations related to the disorder and why they are essential in your practice.

Controversy Surrounding Paraphilic Disorders

There is much controversy surrounding Paraphilic disorders. Many argue that these disorders are not mental disorders but simply sexual preferences that should not be pathologized. Others say that Paraphilic disorders are mental disorders that should be treated. There is also controversy surrounding the treatment of these disorders, with some arguing that treatment should be involuntary and others arguing that treatment should be voluntary. According to the DSM 5, Paraphilias primarily concern the individual’s erotic activities, and others primarily affect the individual erotic target. An example of the former would include intense and persistent interests in spanking, whipping, cutting, binding, or strangulating another person. Interest in these activities equals or exceeds the individual’s interest in copulation or equivalent interaction with another person (American Psychiatric Association, 2013).

Professional beliefs about the disorder

Because many of the behaviors associated with these disorders are illegal, there is a risk of criminalizing people with them if they are not treated. There is also a risk of violating the person’s civil rights if they are involuntarily committed to treatment. Overall, there is much controversy surrounding Paraphilic disorders. These disorders are complex, and there is no easy answer as to whether or not they should be treated. The argument has pros and cons; ultimately, it is up to each individual to decide what they accept as the best course of action. I think that Paraphilic disorders are real mental disorders that should be treated. I believe this for a few reasons. First, many of the behaviors associated with these disorders can harm both the person engaging in them and others. As healthcare clinicians, we must constantly research this condition, keep up with current data, and collaborate with peers to ensure the proper management plan (Briken et al., 2019).

Strategies to Maintain a Therapeutic Relationship

According to Thibaut et al. (2020), the therapeutic relationship is the foundation of mental health practice. It is, in essence, the primary tool through which practitioners help elicit and sustain change in the lives of their patients. A few strategies can be used to maintain the therapeutic relationship with a patient who may present with a Paraphilic condition.  Being open-minded and nonjudgmental when working with these patients is essential. Remember that these disorders are real and that the patients are not choosing to engage in these behaviors.

It is crucial, to be honest with the patients about the potential risks and harms associated with their disorder. Many of these patients are unaware of the potential damage their condition can cause, which is essential to educate them.
Respecting the patient’s autonomy and allowing them to make their own decisions about treatment is essential. Many of these patients will be reluctant to seek treatment because of the stigma surrounding their disorder. Respect their decision and only provide treatment if they are willing to participate.
When working with these patients, it is crucial to be aware of the ethical and legal considerations.

Because many of the behaviors associated with these disorders are illegal, there is a risk of criminalizing the patients if they are not treated. 

Ethical and Legal Considerations Related to Paraphilic disorder.

A few ethical and legal considerations must be considered when working with patients that may present with a Paraphilic disorder. Many behaviors associated with these disorders are illegal; there is a risk of criminalizing the patients if they are not treated. There is a risk of violating the patient’s civil rights if they are involuntarily committed to treatment. Also, there is a risk of harming the patient if the wrong treatment is used. There is a risk of hurting other people if the patient is not treated. These considerations are essential when working with patients that may present with a Paraphilic disorder. However, I believe that the potential harm these disorders can cause justifies the need for treatment. I also think the treatment’s ethical and legal considerations are done respectfully and responsibly (Briken et al., 2019). A clinician is also needed to assess risk assessment, evaluation of violent sexual predators, and court-mandated treatments.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing

Briken, P., Boetticher, A., Krueger, R. B., Kismödi, E., & Reed, G. M. (2019). The current legal situation for patients with paraphilic disorders and implications of the ICD-11 for paraphilic disorders for Germany. The journal of sexual medicine, 16(10), 1615-1622. https://www.sciencedirect.com/science/article/pii/S174360951931313X

Keister, G. W. (2019). Paraphilias. Salem Press Encyclopedia of Health.

Thibaut, F., Cosyns, P., Fedoroff, J. P., Briken, P., Goethals, K., & Bradford, J. M. W. (2020). The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders. World Journal of Biological Psychiatry, 21(6), 412-490. https://doi.org/10.1080/15622975.2020.1744723

 

Please Revise underlined sections and proofread them for me. Thank you.

 

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