Treatment for Adult Sexual Abusers of Children

Adult perpetrators of children sexual abuse rarely seek treatment voluntarily because they are afraid of the consequences. Not only do they fear social disgrace, loss of jobs, and loss of families, but they also fear prison terms and the prospects of being labeled as sex offenders for the rest of their lives. These are the consequences of sexually abusing children.

Therapists often prefer that sex offenders be court-ordered into treatment and that they serve prison time if they do not cooperate with treatment. They have found that many cannot motivate themselves to do the hard work that is required in treatment unless they have serious consequences hanging over their heads.

Accountability

Perpetrators are more likely to avoid prison time if they take responsibility for their sexually abusive behaviors. Judges and prosecuting attorneys see this as indicators of remorse and wishes to reform. Some perpetrators turn themselves in, with full knowledge of the consequences. Others, upon arrest, admit their crimes and plead guilty. When perpetrators take responsibility for their behaviors, the result can be suspended sentences, probation, and court-ordered sex offender treatment. If they fail treatment, they serve time in prison for what had been probation time.

Some sentences combine jail time, community-based treatment, and probation. Offenders may spend six months to a year in jail before they enter community treatment programs. Sometimes the “jail” time is time in a workhouse where perpetrators are on work release. They therefore can send support payments to their families.

A few community programs are in-patient, meaning that the offenders are under twenty-four hour supervision and have intensive treatment for several hours a day. These offenders live together, eat together, and have various treatment sessions and educational programs together. These are therapeutic environments in which participants may live for up to two years.

These programs may offer family sessions, marriage counseling, and encourage apology letters, and reconciliation sessions, again carefully done with close attention to the wishes and well-being of child survivors. These sessions are done for the benefit of survivors first and foremost and their safety is paramount. If there is little possibility of benefit to survivors, none of these activities take place.

Activities such as these may promote offender awareness of the impact of what they did. After Juice had been in community-based sex offender treatment for a year, he had an impact session with his stepdaughter and wife. He said

I told myself I was just going to listen and not respond unless they asked for a response. It was hard sitting in that session listening.

What made it hard for Juice was “feeling the shame and guilt for doing it to her.” Juice said the session made a big impression on him:

A lot of the stuff she said still sticks with me right now, today. That's where I get my motivation from, to, to try to change some of the behaviors that I engaged in.

For Juice, however, the impact was not immediate. He failed the community-based treatment program for drinking alcohol, breaking curfew, and having a hunting knife for a weapon. He made his statement about the impact statement two years after the session, when he was in a prison-based incest treatment program. Whether he really meant what he said is hard to know. If it is possibly true, this could be therapeutic to his stepdaughter.

Other Programs

Other community treatment programs are not in-patient and the offenders live in the community on their own. They may have therapy for a few hours a week or more and are able to go to work every day. Judges order the offenders not to live with their families, but most often the families do not want the offenders living with them anyway.

Sentences to community-based treatment are conditional. If these individuals fail treatment, they go to prison for the length of their probation. Owen, mentioned earlier, failed a community-based program and had to serve what had been a ten-year probation as a ten-year prison sentence.

Judges sentence offenders to community-based programs when they think offenders are at low risk to re-offend or to commit other anti-social acts. Typically, this means that they have no criminal record, a stable work history, and ties to family and community.

Prison Treatment Programs

When judges have evidence that offenders are at high risk to re-offend because of criminal records and instability in work and family, offenders typically are sentenced to prison.

Treatment may be available in prison-based programs. Often prison officials give incentives for participation in treatment, such as earlier release time and housing in units where offenders do not have to worry about their physical safety. Other inmates may detest men convicted of sex offenses against children, whom they consider “baby rapists.”

Both prison-based and community-based treatment use group treatment models that includes psychoeducation about emotions, grief and loss, and critical thinking. Sex offender group treatment typically is based on cognitive-behavioral approaches, where participants learn to identity the thoughts and emotions connected with their sexually abusive behaviors and then learn how to manage their thoughts and emotions before they get to the point where they act out sexually. Many programs work with perpetrators on their beliefs that enable them to perpetrate against children and with any childhood traumas that may be factors in their sex offending behaviors.

Like other treatment models, prison-based sex offender treatment programs sometimes offer sessions with spouses and child survivors, typically with great attention be paid to the preparation of all parties involved in order to avoid further harm to children and their families.

There is debate whether or not treatment works for perpetrators of child sexual abuse. Studies show that persons who complete sex abuse treatment are far less likely to abuse children sexually than those who do not complete treatment or do not participate in treatment at all.

In general, treatment is effective for most perpetrators. Since most perpetrators live in families and communities, safety for children is more likely if these individuals have gone through treatment.

Other Policies and Programs

Treatment professionals believe that a small percentage of perpetrators of child sexual abuse are unable to respond to treatment and are such high risk to sexually abuse in the future that they must be committed to locked mental health hospitals as sexually dangerous and psychopathic.

Thousands of men and a few women are now so confined in the United States, England, and other countries. The condition of their release is completion of treatment. Few individuals who are committed under mental health laws have been released.

There are other strategies meant to keep children safe, such as community notification, sex offender registries, and laws that prevent convicted sex offenders from living near schools, daycare centers, and playgrounds.

Community notification involves public meetings where officials from departments of corrections provide information about on offenders classified at highest risk and who is moving into the neighborhood. Not all sex offenders are subject to community notification, but only those at highest risk.

Sex offender registries are a means of keeping track of where sex offenders live. In addition to adults, some states require adolescents and even children under the age of twelve and who are adjudicated as sex offenders are required to register. Adult sex offender registries can be helpful to law enforcement, but they also are available to the general public.

Many states in the United States forbid registered sex offenders from living anywhere from 500 to 2500 hundred feet away from where children congregate, such as daycare centers, schools, and playgrounds.

There is concern about the fairness and wisdom of labeling children and adolescents as sex offenders. Although it is true that most adult perpetrators of child sexual abuse began their abusive behaviors in childhood and adolescence, many more young people stop their sexually abusive behaviors for any number of reasons and are no longer a threat.

Many teenagers may abuse children once or a few times and then quit. These are not chronic offenders, but young people who can be considered “naïve experimenters,” a term used for persons whose behaviors that cross the line but are unlikely to ever act this way again.

Responsible social policy and practice take into consideration the many risk and protective factors that perpetrators of child sexual abuse show over their lifetimes. Decisions about treatment, prison time, reconciliation, registries, community notification must be based on accurate, reliable information about risks and factors that suggest that those who have perpetrated are capable of changing their behaviors.

 Summary

Perpetrators cannot manage their behaviors without professional help and long-term support from close family members and other confidants. Persons who commit sexual abuse may be children, teenagers, or adults. Their behaviors not only affect survivors but family members and friends who care about survivors and perpetrators. Treatment and education programs at their best involve abusers and other family members.

Family members do not require treatment because they are crazy or because they did something wrong, but because child sexual abuse is such a shock and so hard to deal with that family members need professional help to cope with, adapt to, and overcome the effects of knowing someone they love and respect has abuse children sexually.

When perpetrators take responsibility for their behaviors and apologize in ways that have no hint of excuses or blame, this not only can help abusers, but it is helpful to child survivors, to parents and other family members, and to friends. Survivors can and do thrive without abuser accountability, but accountability does enhance quality of life of all who are involved.

Public policy regarding sex offenses sometimes has unintended negative consequences. Policy makers must take the time and make the effort to consider possible negative and positive consequences of the laws they pass. So-called solutions should not be part of the problem.