Treatment of Adult Sex Offenders
Treatment of Adult Sex Offenders by Robert Prentky and Barbara Schwartz with contributions from Gail Burns-Smith (December 2006).
This article provides an overview of the current state of treatment of adult male sex offenders, with a focus on the effectiveness of treatment, which boils down to one question: Does it reduce victimization and, if so, by how much? Available data admittedly provide an imperfect answer. The term 're-offense' signifies a sex offender who as been caught, prosecuted, and convicted for a subsequent sex offense. Re-offenders represent only a small proportion of the total number of sex offenders.
Relapse prevention, a treatment model developed in the early 1980s that continues to be used today, is a self-control model that teaches the individual to identify and recognize a unique pattern of thoughts, feelings, and situations that precede and lead to relapses. It is sometimes used in conjunction with medications. Evaluating the effectiveness of therapy for sex offenders, however, proves to be complicated. All treatment outcome studies, including those targeting sex offenders, must control for individual differences among therapists, regardless of the technique used, establish adequate control groups, and address ethical issues, such as denying treatment to patients and measuring outcomes. Treatment often reduces re-offense rates but not enough to be statistically significant. This result is a mixed and often confusing message that has been trumpeted both by treatment advocates and treatment opponents to support their 'causes.'
The most reasonable conclusion at this point is that treatment can reduce sexual recidivism over a 5 year period by 5 - 8%. This estimate, although crude, is promising. Although we do not know from this estimate how many individual offenders were responsible for almost 210,000 reported sexual assaults in 2004, it is reasonable to surmise that the number is considerable. Of these offenders, a substantial proportion were undoubtedly already known to the criminal justice system and could have been required to participate in treatment. If we accept, as a general rule, that out of every 100,000 identified sex offenders, treatment can reduce sexual recidivism by 5% to 8%, the end result may be 5,000 to 8,000 fewer recidivists (individuals who commit further sexual assaults). Thus, relatively small reductions in sexual recidivism rates can have a notable impact on the number of victims.
Given the failure of more traditional correctional remedies for reducing the level of sexual violence in society, other interventions must be actively sought. One potentially effective intervention for some known offenders is treatment. Perhaps the more pressing question, certainly from a public policy standpoint, is "who" is most likely to be impacted by treatment and how best should they be treated. When resources are limited, optimal resource allocation becomes critically important. Treatment should be regarded as one potentially effective intervention for managing the risk of sexual offenders that have been returned to the community. Treatment should not be regarded as a cure for sexual offenders, or as a stand-alone intervention. Treatment is one element of a comprehensive release plan that may include medication, probation, GPS monitoring, polygraphy, random urine screens, and other interventions.
The most important point, however, is that the overarching goal of reducing sexual violence in society must rest squarely with the forces within society that promote and foster sexual violence. By merely reducing the risk of those who have already turned to sexual violence, we will never achieve the ultimate aim of making society a safer place by restoring the rights to sexual autonomy for women and children.
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