The authors contend that present approaches to treatment of the pedophile are not as effective as they should be. Recent developments in the application of attachment theory and the treatment of the “difficult client” may lead to improvements in the treatment for such individuals. Attention is drawn to some of the characteristics that pedophiles have in common with personality disordered individuals and with the difficult client. One conclusion is that confrontation during treatment could be countertherapeutic if not antitherapeutic with the pedophile and that other more empathic and supportive approaches are needed, at least at the beginning of the treatment process. Ideas presented in this article suggest the development of a therapeutic alliance that would provide a platform for the treatment of pedophilia and the associated behaviors.
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