A respected school coach is arrested after a student reports that he attempted to have sexual contact with him. Which issue would be the priority for assessment in the period immediately following the coach's arrest?
a. Determine the nature and extent of his sexual disorder.
b. Investigate whether other children were harmed.
c. Assess the potential for suicide or other self-harm.
d. Assess the patient's perception of his problem and needs.
C
Pedophiles and other persons with paraphilias can be at increased risk of self-harm associated with the guilt, shame, and anger they feel about their behavior and its effect on their families, victims, and victims' families. They also face considerable losses, such as the end of their careers or the loss of freedom to imprisonment. Thus safety is the priority issue for assessment. Determining the nature and extent of the patient's disorder and related patient perceptions would be appropriate but not the highest priority for assessment. Investigating whether other victims exist is a matter for law enforcement rather than health care personnel.
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