|| Sourcebook of Treatment Programs for Sexual Offenders
||William Lamont Marshall, Yolanda M. Fernandez, Stephen M. Hudson,
and Tony Ward
||Plenum Press, ©1998
233 Spring St.
New York, NY 10013
This 483-page book assembles 31 descriptions of ongoing sexual offender
treatment programs from around the world. This includes programs in prisons,
community settings, and psychiatric institutions and programs that deal
with differing populations, i.e., female, clergy, and ethnic populations.
It is clear that there is much worldwide effort and attention being devoted
to treating sexual offenders. Canada and the United States appear to be
leading the way while many other countries are actively developing treatment
programs in their own environments. Much of this activity can be traced
to the influence and work of William Marshall, one of the editors, whose
example and students have been seminal and guided the progress of sexual
Each chapter includes descriptions of administrative concerns, institutional
relationships and problems, funding problems, assessment procedures, treatment
content, staffing questions, and as much evaluative and outcome information
as is available. Any professional establishing a sexual offender treatment
program or working to improve one already in place has much to learn from
While there is not enough outcome information yet available to demonstrate
convincingly what works and what does not work for discriminable populations
or types of sexual offenders, there are several concepts that appear to
have consensual validation across the various reports. There is also modest
empirical support for these concepts in the outcome evidence reported.
Cognitive behavioral procedures are universally understood to be the most
desired and most likely efficacious approaches to sexual offender treatment.
Almost all programs also include a relapse prevention element that attends
to the process of the individual in committing crimes and reoffenses.
Confrontational, hostile, and controlling behaviors are understood to be
counterproductive, lead to early terminations, and have little positive
effect. Every program description in one way or another asserts that sexual
offenders ought be treated with respect and consideration while therapists
remain firm and aware of conning and manipulation. Treating sexual offenders
as if they were monsters is likely to confirm their own cognitive errors
and may increase the likelihood of recidivism. Allowing for development
of trust, a realistic basis for improving self-esteem, and modeling a rational
and nondestructive use of power and control is presented as essential to
a treatment program.
There is universal acknowledgment of the importance of therapist factors
and hence staffing becomes a crucial issue. Therapist style and therapist
actions toward the offenders must be observed and managed. Not everybody
can be a good sexual offender therapist. There are also a number of warnings
about negative effects on the therapists. In the present climate of budget
cuts and greater accountability for funds and effectiveness, staffing decisions
become even more significant. There must be ongoing and continuous training
and updating of staff skills, consciousness, and awareness.
Sexual offenders must take responsibility for their actions and behaviors.
All programs seek to insure as an initial step that the offenders accept
their individual responsibility for their criminal acts. Then they go beyond
this to support and enhance personal responsibility throughout the life
of the individual. Many also include training in social skills, intimate
relationships, and development of empathy. Denial is recognized as a major
issue, however, only one program description, that for clergy, even mentions
the possibility of false accusations and false or wrongful convictions.
The demonization of sexual offenders and their rejection by society is understood
to be problematical. This may well result in increasing numbers of old sexual
offenders filling up prison spaces at high costs and little discernible
increment in public safety.
This book represents the best thinking and practice currently being done
in the treatment of sexual offenders. The net result is cautious optimism
that there can be effective treatment programs that will reduce the likelihood
of recidivism. Whether the costs may be too high remains to be determined.
It is also necessary to continue to produce scientifically sound research
to identify the factors that lead to success and with which groups and/or
individuals. Every professional who has an interest in sexual offender treatments
can profit from reading this book carefully and referring to it often as
a resource for responding to basic issues about sexual offenders.
Reviewed by Ralph Underwager, Institute for Psychological Therapies.