Treatment programs for incest offenders traditionally do not differentiate between pedophilic and nonpedophilic perpetrators. This oversight has failed to meet the specialized needs of pedophilic incest offenders, who differ from other incest as well as nonfamilial sex offenders in significant ways. The combined cognitive-behavioral therapy and pharmacotherapy used in the treatment of pedophilic incest offenders was successful both in reducing deviant sexual fantasies and urges and in increasing awareness of risk factors and behavioral controls. This combined treatment approach addresses the specific needs of this type of sexual problem which poses unique clinical and legal issues. 46 references. A case report is reviewed to illustrate the methodology discussed. 46 references. (Author abstract modified)