The majority of convicted sex offenders are eventually released back into the community. Consequently, effective treatment interventions that can lower the recidivism rates of sexual offenders are needed. Cognitive behavioral interventions based on the principles of risk, needs, and responsivity are the most common form of treatment used with sex offenders. To date, there is preliminary evidence that suggests that treatment using cognitive behavioral techniques decreases subsequent sex offender recidivism. This article reviews the current research on cognitive behavioral techniques for the treatment of sex offenders and provides guidelines for treatment providers.
AbelG.G., & AnnonJ.S. (1982, April). Reducing deviant sexual arousal through satiationWorkshop presented at the 4th National Conference on Sexual Aggression, Denver, CO.
2.
AbelG.G., MittlemanM.S., & BeckerJ.V. (1985). Sex offenders: Results of assessment and recommendations for treatment. In M. H. Ben-Aron, S. J. Hucker, & C. D. Webster (Eds.), Clinical criminology: The assessment and treatment of criminal behavior (pp. 191-205). Toronto, Ontario, Canada: M & M Graphics.
3.
AndrewsD.A., & BontaJ. (1998). The psychology of criminal conduct (2nd ed.). Cincinnati, OH: Anderson.
4.
AndrewsD.A., BontaJ., & HogeR.D. (1990). Classification for effective rehabilitation: Rediscovering psychology. Criminal Justice and Behavior, 17, 19-52.
5.
BarbareeH.E. (1991). Denial and minimization among sex offenders: Assessment and treatment outcome. Forum on Corrections Research, 3, 30-33.
6.
BarbareeH.E., & SetoM.C. (1997). Pedophilia: Assessment and treatment. In D. R. Laws & W. T. O’Donoghue (Eds.), Sexual deviance: Theory, assessment, and treatment (pp. 175-193). New York: Guilford.
7.
BarlowD.H., & AbelG.G. (1976). Sexual deviation. In E. Craighead, H. E. Adams, & K. S. Calhoun (Eds.), Handbook of behavioral assessment. New York: Wiley.
8.
BarnardG., FullerA., RobbinsL., & ShawT. (1989). The child molester: An integrated approach to evaluation and treatment. Philadelphia: Brunner/Mazel.
9.
BeckJ. (1995). Cognitive therapy: Basics and beyond. New York: Guilford.
10.
BeckerJ.V., & MurphyW.D. (1998). What we know and do not know about assessing and treating sex offenders. Psychology, Public Policy, and Law, 4, 116-137.
11.
BeckettR., BeechA., FisherD., & FordhamA.S. (1994). Community-based treatment for sex offenders: An evaluation of seven treatment programmes. London: Home Office.
12.
BlanchetteK. (1996). Sex offender assessment, treatment and recidivism: A literature review. Ottawa, Ontario, Canada: Correctional Services of Canada.
13.
BlumenthalS., GudjonssonG., & BurnsJ. (1999). Cognitive distortions and blame attribution in sex offenders against adults and children. Child Abuse and Neglect, 23, 129-143.
14.
CarichM.S., MetzgerC.K., BaigM.S., & HarperJ.J. (2003). Enhancing victim empathy for sex offenders. Journal of Child Sexual Abuse, 12, 255-276.
15.
Center for Sex Offender Management. (2000). Myths and facts about sex offenders. Washington, DC: U.S. Department of Justice, Office of Justice Programs.
16.
Correctional Service of Canada. (1995). Sex offenders and programs in CSC. Ottawa, Ontario, Canada: Author.
17.
DavisonG.C. (1968). Elimination of a sadistic fantasy by an offender-controlled counter conditioning technique. Journal of Abnormal Psychology, 73, 84-90.
18.
DougherM.J. (1996). Behavioral techniques to alter sexual arousal. In B. K. Schwartz & H. R. Cellini (Eds.), The sex offender: Corrections, treatment and legal practice. Kingston, NJ: Civic Research Institute.
19.
EndlerN.S., & ParkerD.A. (1990). Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology, 58, 844-854.
20.
Freeman-LongoR.E., & KnoppH.F. (1992). State-of-the-art sex offender treatment: Outcome and issues. Annals of Sex Research, 5, 141-160.
21.
Freeman-LongoR.E., & PithersW.D. (1992). Clients manual: A structured approach to preventing relapse: A guide to sex offenders. Brandon, VT: Safer Society.
22.
GallagherC.A., WilsonD.B., HirschfieldP., CoggeshallM.B., & MacKenzieD.L. (1999). A quantitative review of the effects of sex offender treatment on sexual reoffending. Corrections Management Quarterly, 3, 19-29.
23.
GreenfieldL. (1997). Sex offenses and offenders: An analysis of data on rape and sexual assault. Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics.
24.
HallG.C. (1995). Sex offender recidivism revisited: A meta-analysis of recent treatment studies. Journal of Consulting and Clinical Psychology, 63, 802-809.
25.
HallG.C. (1996). Theory-based assessment, treatment, and prevention of sexual aggression. New York: Oxford University Press.
26.
HallG.C., & HirschmanR. (1991). Toward a theory of sexual aggression: A quadripartite model. Journal of Consulting and Clinical Psychology, 59, 662-669.
27.
HansonR.K. (2000). What is so special about relapse prevention? In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders (pp. 27-38). Thousand Oaks, CA: SAGE Publications.
28.
HansonR.K., GordonA., Harris, A.J.R., MarquesJ.K., MurphyW., QuinseyV.L., et al. (2002). First report of the Collaborative Outcome Project on the effectiveness of psychological treatment for sex offenders. Sexual Abuse: A Journal of Research and Treatment, 14, 159-194.
29.
HansonR.K., & Morton-BourgonK.E. (2005). The characteristics of persistent sexual offenders: A meta-analysis of recidivism studies. Journal of Consulting and Clinical Psychology, 73, 1154-1163.
30.
HappelR.M., & AuffreyJ.J. (1995). Sex offender assessment: Interrupting the dance of denial. American Journal of Forensic Psychology, 13, 5-22.
31.
HeimbergR.G. (2001). Current status of psychotherapeutic interventions for social phobia. Journal of Clinical Psychiatry, 62, 36-42.
32.
HowellsK., DayA., & WrightS. (2004). Affect, emotions and sex offending. Psychology, Crime & Law, 10, 179-195.
33.
HudsonS.M., MarshallW.L., WalesD.S., McDonaldE., BakerL.W., & McLeanA. (1993). Emotional recognition skills of sex offenders. Annals of Sex Research, 6, 199-211.
34.
HudsonS.M., & WardT. (2000). Interpersonal competency in sex offenders. Behavior Modification, 24, 494-527.
35.
JohnstonL., & WardT. (1996). Social cognition and sexual offending: A theoretical framework. Sexual Abuse: A Journal of Research and Treatment, 8, 55-80.
36.
KeenanT., & WardT. (2000). A theory of mind perspective on cognitive, affective, and intimacy deficits in child sexual offenders. Sexual Abuse: A Journal of Research and Treatment, 12, 49-58.
37.
KirschL.G., & BeckerJ.V. (2006). Sexual offending: Theory of problem, theory of change, and implications for treatment effectiveness. Aggression and Violent Behavior, 11, 208-224.
38.
KnoppF.H., Freeman-LongoR.E., & StevensonW. (1992). Nationwide survey of juvenile and adult sex-offender treatment programs. Orwell, VT: Safer Society.
39.
LawsD.R. (1989). Relapse prevention with sex offenders. New York: Guilford.
40.
LawsD.R., HudsonS.M., & WardT. (2000). The original model of relapse prevention with sex offenders: Promises unfulfilled. In D. R. Laws, S. M. Hudson, & T. Ward (Eds.), Remaking relapse prevention with sex offenders (pp. 2-26). Thousand Oaks, CA: SAGE Publications.
41.
LawsD.R., & OsbornC.A. (1982). A procedure to assess incest offendersProposal submitted to research committee, Atascadero State Hospital, Atascadero, CA.
42.
LinehanM.M. (1993a). Cognitive behavioral treatment of borderline personality disorder. New York: Guilford.
43.
LinehanM.M. (1993b). Skills training manual for treating borderline personality disorder. New York: Guilford.
44.
LiptonD.N., McDonelE.C., & McFallR.M. (1987). Heterosocial perception in rapists. Journal of Consulting and Clinical Psychology, 55, 17-21.
45.
LoomanJ., AbracenJ., & NicholaichukT.P. (2000). Recidivism among treated sexual offenders and matched controls: Data from the Regional Treatment Centre (Ontario). Journal of Interpersonal Violence, 15, 279-290.
46.
MaletzkyB.M. (1991). Treating the sexual offender. Newbury Park, CA: SAGE Publications.
47.
Marlatt, G. A., & Gordon, J. R. (Eds.). (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York: Guilford.
48.
MarquesJ., & NelsonC. (1992). The relapse prevention model: Can it work with sex offenders? In R. D. Peters, R. J. McMahon, & V. L. Quinsey (Eds.), Aggression & violence throughout the life span (pp. 222-243). Newbury Park, CA: SAGE Publications.
49.
MarquisJ.N. (1970). Orgasmic reconditioning: Changing sexual object choice through controlling masturbation fantasies. Journal of Behavior Therapy and Experimental Psychiatry, 1, 263-270.
50.
MarshallW.L. (1971). A combined treatment method for certain sexual deviations. Behaviour Research and Therapy, 9, 292-294.
51.
MarshallW.L. (1989). Invited essay: Intimacy, loneliness and sexual offenders. Behaviour Research and Therapy, 27, 491-503.
52.
MarshallW.L. (1994). Treatment effects on denial and minimization in incarcerated sex offenders. Behaviour Research and Therapy, 32, 559-564.
53.
MarshallW.L. (1996). Assessment, treatment, and theorizing about sex offenders: Developments during the past twenty years and future directions. Criminal Justice and Behaviour, 23, 162-199.
54.
MarshallW.L., AndersonD., & FernandezY. (1999). Cognitive behavioural treatment of sexual offenders. Chichester, UK: Wiley.
55.
MarshallW.L., & BarbareeH.E. (1990). Outcome of comprehensive cognitive-behavioral treatment programs. In W. L. Marshall, D. R. Laws, & H. E. Barbaree (Eds.), Handbook of sexual assault: Issues, theories, and treatment of the offender (pp. 365-385). New York: Plenum.
56.
MarshallW.L., BarbareeH.E., & EcclesA. (1991). Early onset and deviant sexuality in child molesters. Journal of Interpersonal Violence, 6, 323-336.
57.
MarshallW.L., BryceP., HudsonS.M., WardT., & MothB. (1996). The enhancement of intimacy and the reduction of loneliness among child molesters. Journal of Family Violence, 11, 219-235.
58.
MarshallW.L., & FernandezY.M. (2001). Empathy training. In M. S. Carich & S. Mussack (Eds.), A handbook on the sexual abuser (pp. 141-148). Brandon, VT: Safer Society.
59.
MarshallW.L., HudsonS.M., JonesR., & FernandezY.M. (1995). Empathy in sex offenders. Clinical Psychology Review, 15, 99-113.
60.
MarshallW.L., & LawsD.R. (2003). A brief history of behavioral and cognitive behavioral approaches to sexual offenders: Part 2. The modern era. Sexual Abuse: A Journal of Research and Treatment, 15, 93-120.
61.
MarshallW.L., SerranG.A., & CortoniF.A. (2000). Childhood attachments, sexual abuse, and their relationship to adult coping in child molesters. Sexual Abuse: A Journal of Research and Treatment, 12, 17-26.
62.
McGrathR.J., CummingG., LivingstonJ.A., & HokeS.E. (2003). Outcome of a treatment program for adult sex offenders: From prison to community. Journal of Interpersonal Violence, 18, 3-17.
63.
McGrathR.J., HokeS.E., & VojtisekJ.E. (1998). Cognitive-behavioral treatment of sex offenders: A treatment comparison and long-term follow-up study. Criminal Justice and Behavior, 25, 203-225.
64.
McGuireR.J., CarlisleJ.M., & YoungB.G. (1965). Sexual deviations as conditioned behaviour: A hypothesis. Behaviour Research and Therapy, 3, 185-190.
65.
MooreB.S. (1990). The origins and development of empathy. Motivation and Emotion, 14, 75-79.
66.
MurphyW.D. (1990). Assessment and modification of cognitive distortions in sex offenders. In W. L. Marshall, D. R. Laws, & H. E. Barbaree (Eds.), Handbook of sexual assault: Issues, theories, and treatment of the offender (pp. 331-342). New York: Plenum.
67.
NelsonC., & JacksonP. (1989). High-risk recognition: The cognitive-behavioral chain. In D. R. Laws (Ed.), Relapse prevention with sex offenders. New York: Guilford.
68.
NicholaichukT., GordonA., DeqiangG., & WongS. (2000). Outcome of an institutional sexual offender treatment program: A comparison between treated and matched untreated offenders. Sexual Abuse: A Journal of Research and Treatment, 12, 139-154.
69.
PithersW.D. (1994). Process evaluation of a group therapy component designed to enhance sex offenders empathy for sexual abuse survivors. Behaviour Research and Therapy, 32, 565-570.
70.
PithersW.D. (1999). Empathy: Definition, enhancement, and relevance to the treatment of sexual abusers. Journal of Interpersonal Violence, 14, 257-284.
71.
PithersW.D., MarquesJ.K., GibatC.C., & MarlattG.A. (1983). Relapse prevention with sexual aggressives: A self-control model of treatment and the maintenance of change. In J. G. Greer & I. R. Stuart (Eds.), The sexual aggressor: Current perspectives on treatment (pp. 214-234). New York: Van Nostrand Reinhold.
72.
PorporinoF.J., & MotiukL.L. (1991). Preliminary results of the National Sex Offender Census. Ottawa, Ontario, Canada: Correctional Service of Canada.
73.
ScaloraM.J., & GarbinC. (2003). A multivariate analysis of sex offender recidivism. International Journal of Offender Therapy and Comparative Criminology, 47, 309-323.
74.
SchlankA.M., & ShawT. (1996). Treating sex offenders who deny their guilt: A pilot study. Sexual Abuse: A Journal of Research and Treatment, 8, 17-23.
75.
SchneiderS.L., & WrightR.C. (2004). Understanding denial in sexual offenders: A review of cognitive and motivational processes to avoid responsibility. Trauma, Violence, & Abuse, 5, 3-20.
76.
SmallboneS.W., & DaddsM.R. (2000). Attachment and coercive sexual behavior. Sexual Abuse: A Journal of Research and Treatment, 12, 3-15.
77.
StermacL.E., & SegalZ.V. (1989). Adult sexual contact with children: An examination of cognitive factors. Behavior Therapy, 20, 573-584.
78.
Van Dam-BaggenR., & KraaimaatF. (2000). Group social skills training for cognitive group therapy as the clinical treatment of choice for generalized social phobia ? Journal of Anxiety Disorders, 14, 437-451.
79.
WardT., HudsonS.M., MarshallW.L., & SiegertR. (1995). Attachment style and intimacy deficits in sexual offenders: A theoretical framework. Sexual Abuse: A Journal of Research and Treatment, 7, 317-335.
80.
WardT., KeenanT., & HudsonS.M. (1999). Understanding cognitive, affective, and intimacy deficits in sexual offenders: A developmental perspective. Aggression and Violent Behavior, 5, 41-62.
81.
WardT., LoudenK., HudsonS.M., & Marshall W.L. (1995). A descriptive model of the offence chain for child molesters. Journal of Interpersonal Violence, 10, 452-472.
82.
WardT., VessJ., & CollieR.M. (2006). Risk management or goods promotion: The relationship between approach and avoidance goals in treatment of sex offenders. Aggression and Violent Behavior, 11, 378-393.
83.
WilliamsS.M., & KhannaA. (1990, June). Empathy training for sex offendersPaper presented at the Third Symposium on Violence and Aggression, Saskatoon, Canada.
84.
YatesP.M. (2003). Treatment of adult sexual offenders: A therapeutic cognitive-behavioral model of intervention. Journal of Child Sexual Abuse, 12, 195-232.
