(615) Understanding Help-Seeking Among Individuals with Paraphilic Sexual Interests: A Qualitative Study of Calls to an Anonymous Helpline

Introduction Individuals at risk of problematic sexual behavior represent a highly stigmatised population facing notable barriers to help-seeking. Key tools for motivating these individuals to enter healthcare and to prevent potential sexually motivated offences are low-threshold services, especially helplines that often represent the first contact with professional help and a referral point to follow-up sexological or psychological care. The first service of this kind in the Central European region is represented by a helpline PARAFILIK launched in the Czech Republic in 2021, targeting self-identified individuals aged 18 and older who experience distress or concerns related to their own or close others' paraphilic preferences or problematic sexual behaviors. Data from other specialized European helplines show that helplines are highly utilised. However, to our knowledge, there are still insufficient studies using qualitative analysis to enable an in-depth understanding of problems and motives from a client-centred perspective that contribute to a decision to seek help. Objective This study aimed to characterise individuals contacting a national anonymous helpline regarding paraphilic sexual interests or problematic sexual behavior, and to explore their psychological state, perceived triggers, and situational circumstances that prompted them to seek help, as well as the needs and barriers they reported at the time of contact. Methods From January 2021 to August 2023, a total of 230 calls were registered and recorded in call logs that summarized the content of each call. The data were analysed using qualitative content analysis in Atlas.ti software. Four independent coders conducted the initial coding, assessed interrater reliability, and, collaboratively in pairs, developed broader categories that led to the identification of overarching thematic structures. Results Six main thematic areas emerging from the call data were identified: (1) the type of caller; (2) reasons for contacting the helpline; (3) negative impacts of problematic sexual behavior; (4) risk and protective factors; (5) help-seeking behavior; and (6) barriers to seeking help. The majority of callers discussed their paraphilic interest or compulsive sexual behavior and called regarding risky sexual or dissexual behavior or pornography consumption. The most salient negative impacts were increased negative emotions and attitudes, such as negative self-image and loneliness, as well as disruptions in interpersonal relationships and daily functioning. Ongoing criminal proceedings were also a theme. Clients were often interested in follow-up treatment, but sometimes reported negative experiences with past professional help. A number of barriers to help-seeking emerged, including stigma, therefore a preference for anonymity, fear of judgment, concerns about medication or examinations, and, in some cases, a negative perception of available help. Conclusions These findings highlight the complex psychological and interpersonal challenges faced by individuals at risk of problematic sexual behavior, particularly emotional distress, problems in interpersonal relationships, and the stigma often linked to feelings of loneliness. The study provides a unique insight into the client’s perspective at the moment of seeking help. The results further underline the importance of low-threshold services such as anonymous helplines, not only for providing short-term psychological support but also for mitigating perceived barriers to follow-up professional help. Disclosure No