MAINZ, Germany — A man menacingly eyes a young boy sitting opposite him in a subway car. Then the tagline for a new ad campaign appears: "Do you love children more than you want to?"
Meantime, a related poster asks, "You are not responsible for your sexual fantasies, but you are responsible for your sexual behavior."
This disturbing TV and print campaign has been launched in Germany by doctors at the Institute for Sexology and Sexual Medicine at Berlin's renowned Charité Hospital. Their pitch: to offer medical treatment to potential pedophiles before they become perpetrators.
The program is unique because it is directed at potential perpetrators, who feel the desire to abuse children, but, so far, have failed to seek help. Existing programs in Germany, as well as in most other countries, focus on men who have already sexually abused children.
The Berlin institute has launched the privately funded publicity campaign, to generate awareness of the program, and moreover, to address potential patients directly.
The ads offer a telephone number for the institute and a Web address, stressing that private information will be met with absolute discretion.
"Up to date, there has been no adequate medical attendance for this patient group in Germany," Christoph Ahlers, the project coordinator told NBC News. "We are hoping to provide a scientific foundation for a future nationwide scheme," explained Ahlers.
Program goals
So far, 70 men have registered for the free program, which is due to start in October. The Charité hospital has a total of 180 therapy slots available and is presently selecting candidates for the three-year study.
Only patients who are not under surveillance of the German justice system and who have not been prosecuted for child abuse will be allowed to participate in the program.
All participants are also required to sign an agreement in which they promise not to have sexual contact with children.
During the project, the male patients will engage in group therapy treatment, as well as one-on-one sessions. At the end of the treatment period, doctors will conclude their study with a "before and after assessment.”
Therapists in Berlin hope that the men will learn to control their desires by developing empathy for their potential victims. "There is never a 100 percent guarantee that patients will not have a relapse," Ahlers said.
The institute has been successfully testing its methods on individual patients since 1997, and now hopes to reach the large number of unidentified potential perpetrators with this therapeutic prevention, Ahlers said.
After the Berlin institute failed to win financial support from the government and public institutions, the private Volkswagen Foundation invested approximately $625,000 in the project, covering the basic costs for the study.
"The health ministry and others did not see any need for prevention," Ahlers said.
Fears of increased crime
In Germany alone, approximately 20,000 children become victims of sexual abuse every year, while Germany's Federal Police estimate that the actual number of sexual crimes against children is much higher. Experts believe that up to 550 German children are being abused each day.
Germany's annual crime statistics show that 15,255 cases of child abuse were recorded in 2004, four of which involved the killing of the child. That number was down 1.1 percent from 2003.
According to an internal study done by the Berlin Charité Hospital, approximately 1,800 men between the ages 40 and 79 in the capital alone have fantasies of sex with children. But, according to the study, less than half of the men have lived out their fantasies.
Recent cases like that of 31-year-old Marc H., who is on trial in the northern German city of Stade for the killing of the 8-year-old siblings Levke and Felix, have triggered strong media coverage and a fears that such crimes are on the rise.
Yet, overall numbers have been on the decline in the past 10 years. While 32 people became the victims of sexual killings in 1993, that number declined to 18 people in 2004. Based on those statistics, an average of three to five children per year were the victims of murder.
"We still believe that the number of undetected cases is much higher," Ahlers said.
Hope for project, but potential stumbling blocks
Despite the general praise for the Berlin institute's project, it faces some difficult challenges.
Under privacy laws in Germany and other European countries, patients are protected by so called "professional discretion rule,” which prevents therapists, doctors and psychologists from revealing any information obtained during treatment.
So, under those European laws, medical professionals are not permitted to report a crime — for example the abuse of a child — which their patient might admit to during therapy.
But, experts believe that anonymity and discretion are the main reasons the patients are willing to open up to their therapists.
“An essential precondition for the success of this therapy and prevention project is the absolute discretion of the researchers and therapists," said Professor Heinz Schoech, from the department of criminology at the Ludwig-Maximilian-University in Munich.
"It is a difficult situation, but we did not make the laws and have to abide by them," said Ahlers. "But, in the end it is about victims and the prevention of new victims," he added.