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Treatment & Resources for People Who Have Sexually Abused a Child

FAQ Category:
Adult's Behaviors

Treatment for people who have sexually abused a child is different from other types of therapy for adults. Whether the person has been clinically diagnosed with Pedophilia, convicted as a sex offender, or has acted out unsafe sexual behaviors, treatment for people with these issues is an important and supportive process to ensuring safety. Typically, treatment therapies for those who have caused sexual harm focus on learning specialized strategies for managing unsafe thoughts and feelings, stopping abusive behavior, being accountable, and taking responsibility for any harm done. Other forms of treatment may also include housing assistance, community support groups, and resources for consistent work. For those who have sexually abused a child, treatment significantly reduces the future risk of reoffending for many adults and youth.
 
Treatment for people who have sexually abused a child does not excuse abusive behaviors. It is not intended to punish or humiliate participants, either. The main purpose of treatment for those who have sexually abused is to prevent further sexual harm [3] [6]. Treatment is offered by therapists who specialize in working with adults or youth with sexual behavior problems, typically called sex-specific therapists.

Here are the answers to frequently asked questions about treatment:

How does treatment benefit the person who has sexually abused?
What are the goals of  treatment for people with sexual behavior problems?
Who can attend treatment for unsafe sexual behaviors?
What happens in treatment for sexual behavior problems?
How long does treatment for unsafe sexual behaviors last?
How much does sex-specific treatment cost?
Is what is told to a therapist in sex-specific treatment confidential?
How could someone find a specialized therapist for unsafe sexual behaviors near them?
How can I learn more about treatment and the recovery process for adults or youth with sexual behavior problems?

How does treatment benefit the person who has sexually abused?

Research on treatment for people who have sexually abused a child and those who feel at-risk to abuse shows that treatment serves several important purposes: primarily to manage harmful sexual thoughts or impulses, as well as to help challenge distorted thinking patterns [6].

Additional benefits include:

  • The burden of keeping the secret of abuse occurring can be lifted.
  • The cycle of broken promises to oneself that “it will never happen again” can finally end.
  • The abusive behavior can stop, and the person abusing can get ongoing support to rebuild a safer life.
  • There can be support from peers in a therapy or community treatment  group to help the person abusing or at-risk adult stay safe.
  • The child who experienced abuse can be protected and/or begin the process of recovery.

What are the goals of treatment for people with sexual behavior problems?

Specialized treatment for people who have sexually offended or are at risk to do so concentrates on addressing personal accountability and managing behaviors to ensure safety for the individual and for the community. A focus of treatment like therapy to reduce and end sexual harm is to help an individual create a safer life for themselves by developing their strengths while managing risk. Many treatment programs take into account the existing strengths and resources of each participant, such as the Good Lives Model [6]. This may include other aspects of someone's life, like how they get their needs met such as consistent work and stable housing, as well as the social support they have in place.

Therapists who work with people struggling with harmful and unwanted sexual thoughts and behaviors may use a variety of clinical strategies, including cognitive behavioral therapy, group treatment, insight and empathy development, and relapse prevention [6]. Greater understanding and awareness gained during treatment may help those who have sexually abused a child develop the necessary skills to create safety plans and practice healthier behaviors.

The goals for the person in treatment may include how to:

  • Identify their own specific risk factors and develop a personalized plan for preventing abuse in the future.
  • Recognize and decrease the use of manipulative behavior patterns.
  • Address denial and accept full responsibility for their harmful behaviors, past and present.
  • Understand the impact of harmful behaviors on themselves and others.
  • Develop healthy sexual attitudes and behaviors.
  • Explore the impact of one’s own childhood trauma, if and when appropriate.

Who can attend treatment for unsafe sexual behaviors?

Someone can make an appointment for treatment if they have sexually abused a child or if they believe they are at risk to do so. While reaching out for help before a person has crossed the line is ideal, there is still support and hope if abuse has occurred.

Someone can also seek out treatment if they have questions or concerns about their sexual thoughts about children, even if they don’t feel at-risk to cross a line. There is a population of individuals who have not committed acts of harm towards children but do have a sexual interest in children. Some research(ers) describes this population as non-offending minor-attracted persons (MAPs), or “child-attracted” or “teen-attracted" for more specialized assessment and treatment. Treatment with these individuals can contribute to child abuse prevention efforts [5].

Treatment for unsafe sexual behaviors is available for adults, teens and children. Typically the approaches to treatment for adolescents and younger children differ from those used with adults. Often treatment providers or specialized therapists will first do an individual evaluation to help determine the usefulness of treatment and the most effective approaches to use. Then those seeking treatment can work together with care providers or therapists to navigate their treatment goals.

What happens in treatment for sexual behavior problems?

Programs are often in outpatient community-based mental health programs or agencies and generally require sessions on a weekly basis. Sometimes treatment may occur in a group setting facilitated by a trained professional. In treatment, individuals will learn strategies, develop skills, and get peer and professional support to manage thoughts, feelings, and behaviors that are harmful or potentially harmful.

Many people who have sexually abused a child are court ordered to attend sex specific treatment, but others may choose to go on their own. Treatment plans may include group or individual therapy, couples therapy, family therapy, polygraph (lie detector test) if mandated by the courts, specialized testing, and/or prescribed medications.

Cognitive-behavioral therapy (CBT) has been found to be most effective in reducing recidivism for adults who have sexually abused a child and is the most common form of treatment utilized for individuals who have sexually abused a child [4] [6] [7]. CBT helps individuals identify troubling emotions, thoughts, and actions that affect their daily life [8]. CBT can be beneficial for adults who have sexually abused children to learn how to change how they think, behave, and not engage in abusive sexual behavior [4] [6].

The individual in treatment learns to be aware of their reactions to situations and, through CBT, they develop new coping skills that help them better handle risky or unsafe situations. CBT treatment programs may also address other issues which can impact abusive behaviors, such as substance misuse, other mental health concerns, interpersonal issues, and general knowledge about sex and communication [6].

How long does treatment for unsafe sexual behaviors last?

There is no standard in terms of the length of treatment, and the duration of the program can depend on the person’s individual needs and risk level [2]. This is often determined by the therapist facilitating treatment. For those who are mandated to attend treatment, a timeline for treatment may be set as part of that requirement. For some, treatment may be a lifelong part of their safety plan.

How much does sex-specific treatment cost?

The cost of sex-specific treatment can vary. Some programs accept public or private insurance. Sometimes grants or other assistance are available to help pay for treatment. Other times participants must pay cash. Individuals can speak directly with a provider about payment options when setting up their initial or “intake” appointment.

Is what is told to a therapist in sex-specific treatment confidential?

What an individual tells their therapist is confidential; however, there are certain circumstances when a therapist must break that promise of confidentiality. Laws in every state require a therapist to contact authorities if a patient is a danger to themselves or others, shares a concrete plan to sexually abuse a child, and/or if the therapist suspects that a known child has been abused. These mandated reporting laws in each state are explained by the individual therapist to all adults and to guardians of children who seek professional counseling [1]. Understanding this limitation to the confidentiality offered in sex specific treatment is important, and applies to anyone seeking medical care or mental health services. If a person has questions about the limits of a therapist’s confidentiality, they can always ask, “If someone told you [X], would you need to report?” to learn more.

How could someone find a specialized therapist for unsafe sexual behaviors near them?

Treatment for sexual behavior problems is highly specialized which means that the professionals who do this work have received specific training in this area. Some mental health professionals know and understand more generally about these issues, but many do not have the specialized knowledge and background. The following organizations offer resources and referrals for adults and youth with sexually boundary-crossing, unsafe or abusive behaviors. No identifying information is required in order for you to obtain the names and numbers of therapists.

For assistance in locating a provider you may also call the Stop It Now! helpline at 1.888.PREVENT or 1.888.773.8368 or email the helpline.

How can I learn more about treatment and the recovery process for adults or youth with sexual behavior problems?

The following organizations offer free online (or print) catalogs of reading resources and recovery materials for clinicians, individuals and families.

References
[1] American Psychological Association. (2017). APA Ethical principles of psychologists and code of conduct. American Psychological Association. https://www.apa.org/science/programs/research/codes  

[2] Day, A., Ross, S., Casey, S., Vess, J., Johns, D., & Hobbs, G. (2019). The intensity and timing of sex offender treatment. Sexual Abuse, 31(4), 397-409. https://doi.org/10.1177/1079063217745069

[3] Hanson, R. K., & Yates, P. M. (2013). Psychological treatment of sex offenders. Current psychiatry reports, 15, 1-8. https://doi.org/10.1007/s11920-012-0348-x

[4] Harrison, J. L., O’Toole, S. K., Ammen, S., Ahlmeyer, S., Harrell, S. N., & Hernandez, J. L. (2020). Sexual offender treatment effectiveness within cognitive-behavioral programs: A meta-analytic investigation of general, sexual, and violent recidivism. Psychiatry, Psychology and Law, 27(1), 1-25. https://doi.org/10.1080/13218719.2018.1485526
 
[5] Levenson, J. S., Grady, M. D., & Morin, J. W. (2020). Beyond the “ick factor”: Counseling non-offending persons with pedophilia. Clinical Social Work Journal, 48, 380-388.  https://doi.org/10.1007/s10615-019-00712-4
 
[6] Losel, F., & Schmucker, M. (2017). Treatment of sex offenders: Concepts and empirical evaluations. The Oxford Handbook of Sex Offences and Sex Offenders, 392–414. https://doi.org/10.1093/oxfordhb/9780190213633.013.23

[7] Sousa, M., Andrade, J., de Castro-Rodrigues, A., & Gonçalves, R. A. (2023). The effectiveness of psychological treatment in adult male convicted for sexual offenses against children: A systematic review. Trauma, Violence, & Abuse, 24(3), 1867-1881. https://doi.org/10.1177/15248380221082080

[8] Tolin, D. F. (2023). Doing CBT: A comprehensive guide to working with behaviors, thoughts, and emotions. Guilford Publications. https://doi.org/10.1007/s10879-017-9377-4