This article examines the complex metacognitions necessary for a sex offender to achieve other-oriented empathy. Sex offender treatment programs appear to be teaching empathy without having a clear understanding of the difference between self-oriented and other-oriented empathy and without tools to measure these deficits or change. Discussion of factors necessary for formation of affective emotions is undertaken. The impact of shame on the capacity to experience one's own emotions is examined in relationship to childhood trauma Recommendations are offered to enhance therapists' skills to foster empathy in sex offenders.
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