Advances in sex offender treatment and challenges for the future

This paper describes what the authors believe to be the major advances, the areas of debate, and the future direction of sexual offender treatment as we leave the 20th century and enter the new millennium. In the area of sex offender treatment, the modification of relapse prevention for use with sex offenders has had a profound effect on the way that therapy is done. Additionally, the development of the selective serotonin reuptake inhibitors and other pharmacotherapies has moved the field more toward a bio-psycho-social model of etiology and treatment, and focused more attention on co-morbid psychiatric disorders in the treatment of sexual offenders. The late 1990s saw major advances in the development of actuarial prediction tools for recidivism, and a concerning move toward phallometric stimuli with unclear reliability and validity. Additionally, the development of the Abel Screen for Sexual Interest has provided a promising, but as yet unvalidated, alternative to phallometry. The 1990s were also a period of considerable growth in the application of sexual offender treatment to special populations, such as adolescents, the developmentally disabled, women and children. The major challenge for the future is to develop methodologically sound re-search on which to base our decisions about the treatments to apply, the unique needs of special populations, and the assessment of dangerousness.