Forensic Psychotherapy for Sexual Offenders: Has Its Effectiveness Yet Been Demonstrated?

Abstract

It has long been debated as to whether psychotherapy is effective for sexual offenders. This chapter reviews the existing systematic reviews and meta-analyses regarding the scientific evaluation of psychosocial treatments as applied to such individuals; such interventions are almost all applied in “justice-related” settings and thus should be regarded as “forensic” treatments. This chapter is intended to provide a straightforward, reasoned, and accessible review of the existing research findings and issues regarding psychotherapy for sexual offenders. First, a brief synopsis of the research literature regarding psychotherapy in general is presented. Both the accepted methodological practices utilized in studying the effectiveness of psychosocial treatment and the results of the extant psychotherapy outcome literature are summarized. Such a review provides a context for viewing the parameters for the more specific research literature on sexual offender treatment outcome. In general, many psychotherapies appear effective for persons with negative affect, but they are markedly less effective for more entrenched or complex problems. Second, the primary systematic reviews and meta-analyses of sexual offender treatment are examined. The clear consensus of the most recent reviews would best be summarized as suggesting that, to date, the general efficacy of sexual offender treatment has not been scientifically demonstrated. Empirically, few or no claims can be made for the “success” of such interventions either at affecting changes in characteristics of sexual offenders or at reducing future sexual offending. Third, a critical analysis of select methodological issues and inadequacies related to results of existing treatment research will be presented that provides perspective on the inaccurate claims of certain studies that claimed to demonstrate that sexual offender treatment might reduce sexual offense recidivism. Fourth, evidence is reviewed of the particular failure of psychosocial treatments to demonstrate personal and/or systematic change among sexual offenders who participate in sexual offender treatment and to reduce sexual offense recidivism among those individuals deemed “higher risk.” Finally, implications of the lack of demonstrated effects of psychosocial interventions for sexual offenders are discussed relative to alternative forms of offender management.