Reducing Sexual Abuse Through Treatment and Intervention with Abusers

Adopted by the ATSA Executive Board of Directors on November 6, 1996

The serious harm caused by sex offenders under scores the significant need to develop methods of reducing the risks those offenders pose to society. The membership of the Association for the Treatment of Sexual Abusers (ATSA) is committed to developing strategies to eradicate sexual abuse while increasing the protection of the public. The following statement defines the role of treatment in society's management of sex offenders.

Who Is Included In The Category Of Sex Offenders?

It is important to understand that sex offenders are not all the same and, in fact, this heterogeneous group of individuals includes a tremendous variety in age, psychological profile, and history of offending. The vast majority of offenders are male. Studies indicate approximately eighty percent of sex offenses against children are committed by males and approximately twenty percent are committed by females.

Many people's awareness of sex offenders has been formed by media descriptions of the most serious offenders, frequently offenders who also murdered their victims. Certainly these offenders have committed very heinous acts and merit society's attention and censure; however, it is important to realize that this type of offender does not represent the typical sex offender.

Based on surveys from the general population, the offender is known to the victim or family in eighty to ninety-five percent of the cases. The offenders are family members in less than fifty percent of all occurrences and are identified as acquaintances (neighbors, coaches, teachers, religious leaders) in the remaining cases. Adults are the identified abusers in two-thirds of the assaults, the remaining one-third of abusers are under the age of eighteen years.

Sex offenders differ greatly in terms of their level of impulsiveness, persistence, the risks they pose to the public and their desire to change their behavior. Most people recognize the significant differences between a violent rapist with four identified victims and a teenager who has sexually abused a neighborhood child. Effective public policy needs to be cognizant of the differences among offenders rather than applying a "one size fits all" approach.

How Frequently Do Sex Offenders Re-offend?

Many people ask this question with the expectation that there is a typical re-offense rate for sex offenders and, based on many media reports, expect the answer to be somewhere between eighty and ninety percent. Because sex offenders are not a homogeneous group, generalizing a single re-offense rate is misleading and inaccurate. Rather, it is more accurate to examine re-offense patterns for the different categories of sex offenders. At present, the research literature indicates that re-offense rates for untreated sex offenders, who choose victims from within the family unit, range from four to ten percent. Re-offense rates for untreated sex offenders, who primarily target children, range from ten to forty percent and rates for untreated sex offenders who target adult women range from seven to thirty-five percent.

What Role Does Treatment Play In The Management Of Sex Offenders?

Often, the anger and hostility the public feels about sex offenders decreases the possibility of supporting treatment for sex offenders. Most often sex offender treatment is viewed as a "soft" response that minimizes the harm the offender has caused.

The Association for the Treatment of Sexual Abusers supports the position that treatment of sex offenders does not replace a criminal justice response, but rather is one of several tools society can use in designing effective sentences for offenders. Treatment can be combined with other criminal justice responses such as probation, jail, incarceration, as well as community monitoring and supervision. The purpose of treatment and the manner in which treatment is instituted can vary. When treatment is an option, prosecutors have more alternatives when convictions may be difficult to obtain.

Treatment is a powerful component in the prevention of future sex offenses. Prevention can be better addressed as offenders identify the means of accessing victims and the behaviors antecedent to their sexual acting out. As this information is provided to the treatment personnel, the offender's risk level to potentially re-offend can be closely monitored. Also, treatment providers garner a growing body of knowledge regarding the cognitive and behavior patterns exhibited by sex offenders, which can then be incorporated into education and prevention programs.

What Kind Of Treatment Is Effective With Sex Offenders?

Treatment for sex offending is still a developing field. Because sex offenses were kept hidden for so many years, the topic did not receive priority attention for funding. However, sufficient progress has been made allowing for the identification of strong indicators about the treatment approaches most likely to be successful.

The core approach used in many programs is cognitive-behavioral, which utilizes a relapse prevention model. The goal of this approach is to enable the offenders to understand their behavior, take responsibility for the behavior, increase motivation to change their harmful behavior and learn the skills necessary to control their deviancy. With training in relapse prevention techniques, offenders learn to identify the chain of thoughts and behaviors that, if uninterrupted, could culminate in the commission of a sex offense. In addition to learning to identify the chain, the offender masters alternative non-harmful techniques to intervene and stop the progression of behaviors.

Where Should Treatment Occur?

Treatment can occur in a variety of settings and at various stages in the criminal justice system. Some states have sentencing options combining a probation sentence, which may or may not include confinement, with community based outpatient treatment. The offender is supervised by corrections' personnel during the mandated treatment and if the offender does not make satisfactory progress, or is not adhering to the treatment plan, the case may be returned to court, reviewed by the Judge and a prison sentence imposed. Thus, treatment is offered to the offender and if sufficient progress is not attained, incarceration remains an option. In some states, treatment programs are offered to prison inmates. Following the prison term, a correctional officer supervises and monitors the individual in the community. This post-prison monitoring is an important part of the total treatment program.

What Are The Costs Of Treatment?

Treatment costs vary greatly depending on the treatment setting, intensity and duration. In most cases, the offender is required to cover the cost of the court mandated treatment program, but the government pays for correctional supervision and court time. The costs of prison sentences, even though they include a treatment program, are covered by the state. One study estimated that providing treatment to incarcerated sex offenders increased the cost of the sentence by twenty percent. To the extent that treatment can reduce recidivism and prevent new offenses, this is a wise investment of public resources--especially when considering the tremendous price paid by each victim of sexual abuse.

Is Treatment Sufficient To Reduce A Sex Offender's Risk To The Community?

Because offenders represent a heterogeneous group, some offenders will respond well to treatment intervention and others will not take advantage of the treatment concepts presented. A formal risk assessment conducted by a qualified professional offers the best method of estimating the risk posed by a particular sex offender. An appropriate assessment incorporates a review of the offender's history, clinical impressions, as well as risk prediction testing utilizing tests that have research validity.

Risk reduction can be objectively measured by conducting longitudinal studies of offenders and identifying their rates of re-offending. An effective treatment program should be able to reduce the recidivism of its participants, compared to similiar offenders who did not receive treatment. One review of studies published primarily before the 1980's raised questions about the effectiveness of treatment. Studies conducted since that time have examined programs using more "state-of-the-art" treatment techniques and results are indicative of some reduction in recidivism for the groups of offenders receiving treatment.

Where Do We Go From Here?

The Association for the Treatment of Sexual Abusers is committed to decreasing sexual abuse and increasing public safety. Sex offender treatment is seen as a valuable tool to use in addressing that commitment. Our knowledge about sex offenders, as well as how to best decrease the occurance of sexual offending has progressed greatly in recent years. Unfortunately the definitive answers are still out of reach. It is only through continued research and treatment of sex offenders that we can understand the etiology of sexual offending and eliminate sexual abuse of children and adults.