We are testing a therapist-assisted online therapy program, designed to help individuals have more control over their behavior and make wiser decisions. The psychological treatment method we are evaluating is cognitive behavioral therapy.
Who are we looking for to join our study?
Individuals who currently look at Child Sexual Abuse Material (CSAM)* and who want to reduce this use.
We also require you to be over 18 years old and be able to read and write English. The participation is free of charge and anonymous and 2 months long.
*What we mean by "Child Sexual Abuse Material" - Within this study we’re focusing on the visual material showing sexual acts with children who have not entered puberty through pictures, streaming shows or videos. It is also referred to as “child pornography”.
Prevent it is a study initiated by Dr. Christoffer Rahm at ANOVA, Karolinska Institutet, Stockholm, Sweden.
This is a unique opportunity to participate in a cost-free program for unwanted sexual behavior with personal support from an experienced therapist.
When joining this study, you get access to resources and tools to help you develop yourself and make the changes you want to make.
This is therapy ON YOUR TERMS! which means that you have the ability not only to do everything at your own pace, but you can also quit at any time if you are unable to continue.
What happens when I register for the study?
You can register with or without an email address:
Registration with email: you will receive an email with a link to the treatment platform and a participant information sheet.
Registration without email: you will be redirected to the participant information sheet immediately to create a username and password. Make sure to save your information for later use, as it will be your only way to log into your account and cannot be retrieved if you lose it.
Please read the information sheet carefully, you will be asked to confirm you’ve read this form through.
You will then be redirected to a website where you can make an appointment for an interview with a therapist from the project. There you can select a day and a time (according to the time zone of your choice). Setting this appointment is necessary before you proceed to the next step of the recruitment process.
You will need to log into the platform (with your email or code) on the day and time you chose for the appointment. You will be interviewed on the platform by a live therapist who will answer any question you have about your potential participation. The therapist will double check that you meet the criteria for participation (inclusion criteria), and you will be asked questions about your approximate age, what continent you live on and a longer assessment about your mental health. Expect the interview to last around 60 minutes.
During the interview you will be notified whether or not you can join the study.
If you can join the study, you will be asked to fill out some additional forms. The forms include questions about your sexuality, your relationship to alcohol and drugs, and your social life. This is your baseline assessment that we can use to compare your treatment effects.
Shortly after filling out the forms you will get access to the first module of the treatment. There are 8 total modules over 8 weeks. You are encouraged to work with them for about 1 hour per week.
Each treatment module consists of a short video (plain text format of what is said in the video is also available). Each video is about 2-10 minutes long and includes exercises for you to work on when it fits your schedule throughout the week. During the treatment you will have ongoing personal contact with your therapist who will give you feedback on your completed worksheets and answer any question you might have.
We look forward to your participation!
Q1. What is the target group?
Adults who look at pictures or films of prepubertal children for sexual purposes, who see this behavior as a problem, and who would like to take steps to make a change.
From our clinical experience at our sexual medicine clinic in Stockholm, and previous research we know that having a sexual interest in children can lead to difficulties in different aspects of life, for example anxiety and shame, stressful family situations, fear of being exposed, as well as other potential consequences. We also believe it is beneficial for preventing child sexual abuse and exploitation both on- and offline.
Q2. What is the program like that is being evaluated?
We are evaluating a cognitive behavioral therapy (CBT) program. CBT is a very established and scientifically well validated form of psychotherapy. Research shows that for many conditions, CBT is as effective face to face, as when delivered over the internet. This specific CBT program consists of eight short weekly modules. They are in video format or text, with associated worksheets, and weekly individual feedback from a therapist. The program is 8 weeks long, with a follow-up after four more weeks. Most conversation is done via online chat or email within the platform. To go through initial assessments, we hold a live interview over a chat forum within the platform. The aim of the treatment is not to modify a sexual attraction pattern, but to identify ways to help reduce these anxiety provoking behavior patterns and increase quality of life. For research purposes the Prevent it CBT program is compared to a similar program without CBT ingredients that we call psychological placebo.
Q4. Do I need an email address?
After weighing both the risks and the benefits of having an email attached to the platform, we decided to make it optional for the participants to choose whether they would like to use an email or not.
The benefits of using an email include us being able to reach participants by email to remind them to take the next step in the treatment. Another benefit is to be able to help participants with password resets, should they lose their password to the platform. This means that the person who choose not to leave an email is responsible for keeping their log in information safe, as there would be no way to recover the password without an email attached.
The risks, however, include the identification of participants found through exposure from the use of email. It's relatively hard to obtain an email address anonymously. Using one single email address for more than one purpose, say for Prevent it and other email communication, is risky because it makes identification easier if your information is exposed. This is why we encourage participants to create an email just for platform use.
Q5. How is my information stored?
One of the most important and central aspects to us is to keep all information about our participants secure. All potentially person-identifiable data, such as email address (if one is being used), conversations, chats and answers to assignments, is stored in encrypted form. The risk of identification based on stored data, even for someone with access to the data in a decrypted form, is under the participants control -- by avoiding typing in identifying data (for example in conversations and chats), or by avoiding using an email address that can be linked to an individual, there is very little information stored that could make linking possible. The only information being stored that could potentially help with a confirmation attack to link a participant to other stored data is timestamps in the database indicating the date and time of a certain action being taken, such as when a message was sent, or an assignment was answered. These timestamps would then have to be correlated with other data somehow obtained outside of the platform, pointing at a person. We consider this risk to be low.
Q6. How is my data handled outside of the platform?
The platform has functionality for exporting data from the study to Excel files, to be stored on the computer of the therapist performing the export. Only two therapists (the pilot investigator and the lead researcher) can do this and will do so at the end of the study.
Q7. How is my data handled after the study?
The way sensitive data is handled once the study is finished affects the long-term privacy for participants. Data is going to be exported from the platform and stored on systems under control of ANOVA, sexual medicine clinic at Karolinska Institutet in Stockholm. The data being exported includes nominal entries such as reported increases and decreases in measurable behaviors. No text entries are exported. This will be stored on a private computer without internet connection for the use of the study. Only the project leader and lead investigator will have access to this computer, and they will use this to do statistical analyses which will be published and used to see the efficacy of the treatment.
Q8. What are the benefits of using a Tor browser?
Using Tor Browser to connect to the platform protects from being tracked on the network layer by hindering the IP address from being linked to the web site of the platform. Tor Browser also stops several methods of tracking on the application layer.
Q9. What other measures have you taken for my safety?
Therapists and administrators of the platform use two-factor authentication (2FA) when logging in to the platform. The second factor is the ability to read incoming text messages to a certain phone number, one per therapist or administrator.
Q10. I have other questions not found on this website
Feel free to email us at preventit [at] protonmail.com or karolinska [at] torbox3uiot6wchz.onion
Dr. Christoffer Rahm
Dr. Katarina Görts Öberg
Licensed Psychologist Charlotte Sparre
For questions about the study, please contact Christoffer Rahm at email@example.com or our TorBox at firstname.lastname@example.org.
You may now start your registration to the study.
By checking "I consent" you consent to your email address being stored on the platform, if you choose to use one.
Your personal data is stored encrypted and will only be handled within the study and viewed by the people in the project team.