Successful approaches to the treatment of exhibitionism, an important paraphilic disorder with respect to offense frequency, are limited in the recent literature. The use of individual cognitive-behavioral treatment with a long-term, incarcerated exhibitionist is presented. Emphasis was placed on the development of insight through informed decision making, as well as improvement in communication style and social network enhancement. Deviant sexual fantasies were targeted for change and more appropriate fantasies encouraged. Phallometric data showed a decrease in deviant responses over therapy and an increase in appropriate arousal.
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