Forensic Psychotherapy for Sexual Offenders: Likely Factors Contributing to Its Apparent Ineffectiveness

Abstract

This chapter offers perspectives as to a variety of possible reasons why sexual offender treatment has yet to have empirically or scientifically demonstrated its efficacy. Various aspects of sexual offenders as client characteristics, characteristics of clinicians who provide therapeutic services to such offenders, the nature and delivery of psychotherapy for sexual offenders, and evidence that specific components of psychotherapeutic interventions that comprise the core of most forensic sexual offender treatment have demonstrated neither general effectiveness nor specific effects on sexual offenders all likely account for failure to demonstrate the effectiveness of sexual offender treatment to reduce sexual reoffending. First, the available psychotherapy literature generally and that for sexual offenders is briefly reviewed. From this, it is apparent that most psychotherapies appear to be generally effective interventions for persons with mood and anxiety problems but less effective for persons with more chronic, entrenched behavioral problems. Client variables are identified as accounting for the largest portion of variance in general psychotherapy outcome. Further, most recent systematic and meta-analytic reviews indicate that, to date, no or little scientific evidence exists that psychosocial interventions affect sexual reoffending among sexual offenders, let alone produce meaningful personal change in such offenders. Second, a historical perspective is considered on the largely non-theoretical and nonempirical nature by which sexual offender treatment developed in North America. This historical review provides an important context for understanding problematic aspects of the development of and implementation of almost all current programs of sex offender treatment. Finally, a critical analysis of the client, therapist, process, and intervention delivery elements as applied in sex offender treatment as well as the more specific treatment components of forensic sex offender treatment is provided. This review identifies the striking degree to which few aspects of conventional and contemporary programs of sex offender treatment have been demonstrated to have any relationship to enduring behavior change generally and reductions in sexual offense recidivism more specifically. It is concluded that the available evidence would suggest that, in particular, client characteristics and treatment components, both theoretically and empirically, have no effect on decreasing the likelihood of future sexual offending. Finally, the implications of the current state of affairs regarding the apparent failure to develop and demonstrate the efficacy of varied presumed “key” elements of general and specific intervention programs directed at reducing sexual offender recidivism are discussed and future directions for research and practice in the management of sexual offenders are identified.