Effectiveness of sex offender treatment

There is as yet no evidence that sexual attraction of any sort can be altered.

• Throughout its history, studies of the effectiveness of aversion therapy, covert sensitization, and other behavioral methods on homosexuals, transvestites, exhibitionists, pedophiles, and others have reported success rates ranging from 30% and 57%.⁴⁰
• However, almost all studies have been, and continue to be, small, uncontrolled case studies. Few use comparison groups, baseline data, and adequate follow-up -- all necessary to determine that effects are genuine, long lasting, and due to treatment.⁴¹
• There is evidence that the methods result in only temporary suppression of deviant arousal.⁴²
• A meta-analysis of three well-designed studies that did use comparison groups found behavioral methods ineffective.⁴³
• The Council on Scientific Affairs of the American Medical Association writes that studies of the effectiveness of aversion therapy and covert sensitization with pedophiles parallel those with homosexuality: they are inconsistent and suffer from significant methodological problems, so that firm conclusions cannot be drawn.⁴⁴
• After reviewing the literature, Australian psychiatrist Nathaniel McConaghy similarly concluded that the methodological flaws and inconsistent findings of studies regarding attempts to change pedophilic attraction were identical to those of homosexual attraction. He found no evidence to support the basic beliefs on which behavioral methods are based, and his own studies found that the methods were no more effective than a placebo treatment.⁴⁵
• Treatment specialist Ron Langevin of the Clarke Institute of Psychiatry in Toronto writes that current methods for treating the pedophile must be recognized as "experimental because there is no satisfactorily proven method to change him to date." He argues that the reader should be skeptical of claims of their effectiveness:

  They mislead us all. We embark on ventures that are doomed to failure because they are improperly investigated. They offer a taste of plausibility and of cure, too often leaving the patient angry and disillusioned. If a treatment is to be used experimentally, the patient should know this and know that we do not have the answers.⁴⁶

• Kurt Freund, developer of the plethysmograph, writes,

  Among practitioners in the field, the opinion seems to prevail that there exist procedures capable of curing pedophilia, or which at least have a substantial beneficial effect on this disturbance. However, in therapeutic experiments, often either the definition of pedophilia or of therapeutic success, or both, are not well enough specified to warrant such a conclusion.

  Even reduced plethysmograph measurements are not conclusive, he writes, pointing to studies which find that penile response does not always accurately reflect true sexual attraction:
  • Behavioral methods can recondition penile erections without changing feelings of attraction.
  • Offenders are motivated to fake results.⁴⁷
• However, treatment specialist Gordon Hall writes that even if aversion therapy is ineffective at reducing deviant arousal, it may help eliminate cognitive distortions as well as have other (unspecified) benefits.⁴⁸