Sample Questionnaire

Q1 What is your age or age group?
29 years

Q2 What kinds of sexual activities have you decided to stop doing but still struggle with?
Masturbating with younger boys

Q3 What kinds of sexual reactions of your body do you want to reduce or eliminate?
Getting an erection when alone with younger boys

Q4 What sexual reactions do you want to experience instead?
Getting sexually excited when alone with a nice girl

Q5 What kinds of feelings do you want to stop feeling?
Feeling attracted to younger boys and wanting them to talk to me.

Q6 What kinds of feelings do you want to feel instead of the unwanted feelings?
Feeling attracted to nice women.

Q7 Have you been sexually abused? If so you may qualify for state sponsorship (New Zealand Citizens only).
An older guy showed me how to masturbate but not sure if that’s abuse.

Q8 Why do you want to change the way you feel and behave?
I nearly got caught with one boy and realise it will eventually happen.

Q9 Assuming you are satisfied with the program supplied, how long are you prepared to work at it?
I would first like to try it out for a few months.

Q10 What treatment have you tried before?
I often tried using pornography instead but it’s not as good as the real thing.

Q11 What treatment are you currently receiving if any?
A few years ago my parents sent me to a Christian minister for the pornography thing.

Q12 Do you have any conditions or limitations that prevent you from doing physical exercise?
I occasionally suffer from asthma

Q13 If you are currently involved in a sexual relationship, describe the person without giving any names?
I sometimes have sex with a divorced woman I know. She’s rather pushy and I just go along with it.