Treatment of Sex Offenders

Pref ace
It can be wise for a field to take stock from time to time. What do we, as a field,
know? What do we not know? What are our challenges? What is controversial and
what is not controversial in the field? To what extent are we meeting our stakeholders’
expectations (and indeed what exactly are these)? How effective are our treatments?
How well do we understand the etiology of the problems we treat? How
accurate are our clinical predictions? How valid are our assessment devices? Are
our diagnostic criteria clear and accurate? Do we have the right balance between
prevention, treatment, and a public health perspective? Are the laws and policies
involved in our field reasonable or do these need improvement? These sorts of questions
can guide critically important decisions regarding funding priorities, research
priorities, the reactions of others to our field, as well as public policy. Of course any
field has problems but a key issue are these problems clearly recognized and is
progress being made on these? All these questions deserve honest, direct, and
detailed responses.
The field of the assessment and treatment of sexual offenders is certainly an
important one. A number of diverse stakeholders are deeply concerned that this
work is done well. Our failures can have devastating personal consequences. There
can be a lot of emotions around these phenomena—one can see this around civil
commitment, relapse rates in treatment, and even in the definition and diagnosis of
a paraphilia. Practitioners and researchers work in a difficult context. There are a
number of value issues that can generate considerable heat. And it is fair to say that
what we want to accomplish, i.e., to prevent sexual offending, to measure a number
of important dimensions regarding sexuality, to treat it with 100 % effectiveness,
etc. has proven to be difficult tasks.
Clearly the field has made progress. For example, Laws ( 2016 ) provided a brief
description of current best practice interventions:
While there are some minor variations in the specifics of treatment programs across the
world, any credible program will typically have the following structure, orientation, and
elements. Following a comprehensive assessment period where static and dynamic risk factors
are assessed and overall level of risk determined, offenders are allocated into a treatment
stream. The default ecological assumption appears to be that sexual offending is a
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