Adolescent exhibitionists: theory and therapy

In the absence of an agreed etiology or preferred treatment for exhibitionism the author reviews his clinical experience in working with adolescent boys who have indecently exposed themselves. A retrospective analysis indicates that the implicit theories that informed clinical practice construed exhibitionism as social behaviour rather than psychological symptom and placed it in a clear development context. It is argued that adolescent exhibitionism can be viewed as a "strategic interaction" that is characteristically adolescent. Using the individual adolescent's account of his misconduct it may be possible to determine the particular "game" in which he is engaged. This formulation can lead to clinical interventions which will best foster a future change of strategy and reduce the prospects of re-offending. Three clinical vignettes illustrate this model in action. Finally the theoretical limitations and practical difficulties associated with this way of understanding adolescent exhibitionists are discussed.