Abstract
As many as 25 % of youth diagnosed with obsessive-compulsive disorder (OCD) experience sexual obsessions. These youth have repetitive intrusive unwanted thoughts that can include sexual, possibly aggressive, acts with children, family members, the opposite sex, and strangers. Recurrent fears of being homosexual and/or a pedophile are also considered to be sexual obsessions. These thoughts are distressing to the youth who experience them and often lead to reassurance-seeking behaviors, avoidant behaviors, and anxiety or depressive symptoms. This chapter describes the nature and phenomenology of sexual obsessions, the impact of having sexual obsessions, and effective treatments for these obsessions. A case study of treating sexual obsession with exposure and response prevention (ERP) is presented to demonstrate individualized assessment and treatment. The chapter concludes with key points for clinicians working with youth with sexual obsessions.
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