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Providing step-by-step guidelines to relapse prevention with adult male child sex abusers, this guide is based on the author′s experience of piloting a unique cognitive-behavioural treatment approach in community-based, secure hospital and prison sex offender programmes. Hilary Eldridge presents the theoretical base for relapse prevention, and includes information on: the relapse process and its implications for assessment of perpetrator patterns; intervention in those patterns and maintenance of change; rationale for the exercises used in each phase; how to introduce the exercises; how to deal with client questions and resistance; and different ways of explaining the materials. The author also provides sample therapist//client dialogue.

· A Dutch language edition of Maintaining Change is available. For details, please contact: Dr Ruud Bullens,Ambulant Bureau Jeugdwelzijnszorg,Centraal Bureau Leiden,Postbus 216,2300 AE Leiden,Holland.

This chapter discusses the concepts of pedophilia and child molestation. It analyses the legal and social impact of pedophilia and child molestation. It also presents five interesting facts about pedophilia according to DSM‐5. An important distinction between a \"child sexual abuser\" and a \"pedophile\" is discussed. The clinician uses several assessment procedures to diagnose pedophilia. These include a record review, clinical interview, paper and pencil testing, collateral contacts, and sometimes even physiological testing called the penile plethysmograph. The chapter also discusses other important issues in assessment. The clinicians look at all the data from their review of records, clinical interview, paper and pencil testing, and from the specialized testing and arrive at some diagnostic conclusions as well as some treatment recommendations. The chapter reviews the most common model used, called relapse prevention, and also briefly reviews some of the best designed outcome research investigating this model's effectiveness.

After reviewing the literature on sex offenders-a literature largely devoted to behavioral, cognitive-behavioral, and relapse-prevention approaches to treatment-the author proposes that an object-relational group psychotherapy treatment has a great deal to offer in the treatment of incest offenders. The author describes the parameters that distinguish group treatment of incest offenders from other object-relational group treatments. These parameters are largely related to the legally mandated nature of the treatment. The reality of enforced treatment and the very real influence treaters have on the lives of their patients supports a particular and salient transferential experience of the therapist as an authority figure who is generally also seen as harsh and arbitrary. Clinical case material clarifies how both overidentification with, and avoidance of, this authority figure role can derail treatment. The author concludes that there is potential for exploiting the reality-based treatment parameters with this population to help develop a treatment alliance that can be a powerful and effective treatment tool.