those factors that have a direct relevance to reducing re-
offending. Noncriminogenic factors include treatment
needs that do not directly relate to re-offense risk but
that may improve the overall adjustment or quality of
life of the offender, which may thereby indirectly reduce
sexual recidivism. Finally, the responsivity principle
maintains that treatment interventions should be deliv-
ered in a way that is compatible with the ability, treat-
ment readiness, or cognitive capacity of the offender.
The strength of this risk, need, and responsivity model
lies in its consideration of the heterogeneity of sexual
offending. Indeed, this model advocates for the use of
differential treatment strategies for offenders with varied
criminogenic and noncriminogenic needs, thus renounc-
ing a “one size fits all” approach to treatment.Does Treatment Work?
Despite the early notion in the sex offender academic
community that “nothing works,” recent research has
been more optimistic with regard to the value of sex
offender treatment. Indeed, recent evidence seems to
suggest that there are small but important differences
in the recidivism rates of offenders who do and do not
receive sex-offender-specific treatment interventions.
Indeed, researchers have found that sex offender treat-
ment is effective in reducing both sexual and general
recidivism.
A meta-analysis of sexual offender treatment out-
come studies found that, on average, sex offenders who
had completed treatment had a 12.3% sex offense
recidivism rate compared with the 16.8% recidivism
rate seen for offenders who did not complete treatment.
In support of more recent (typically CBT) interven-
tions, those who completed treatment demonstrated a
sexual recidivism rate of 9.9%, while those who did not
receive one of these newer interventions had a 17.4%
recidivism rate. While more research may shed light on
the particular strategies that work for particular types of
offenders, one can reasonably conclude from the exist-
ing research that treatment does indeed reduce recidi-
vism. Given this research evidence, some contend that
effective treatment programs should target offenders
who are deemed to be at highest risk to recidivate and,
moreover, that best practices suggest that such pro-
grams must target the offender’s criminogenic needs
and be based on a combined CBT and psychopharma-
cological model.
Critics charge, however, that the overwhelming
majority of sex offender treatment studies use too weaka methodology to draw any firm conclusions. As a result
of practical constraints and the many impediments to
implementing sound research methodologies in crimi-
nal justice or treatment settings, treatment outcome
studies typically fail to use rigorous research designs
that use, for example, random assignment or lengthy
follow-up periods. Sex offenders typically cannot be
randomly assigned to treatment or no-treatment groups
in these settings. Instead, researchers tend to examine
differences between treated and untreated groups where
assignment has been based on need, resulting in a selec-
tion bias. That is, offenders selected for treatment are
typically different in important respects—either being
viewed as amenable to treatment or more dangerous
and, therefore, more in need of treatment. Thus, the
groups being compared differ in risk level or motivation
or other important respects that affect conclusions.
Unfortunately, researchers are seldom able to use rigor-
ous, tightly controlled designs, because they must do
this research in real-world settings that allow for less
sophisticated methodologies.
Moreover, there is often divergence with regard to
what sort of outcome should be measured. While some
studies might consider outcome very narrowly to
include only sexual reconvictions, other studies consider
outcome much more broadly, including for example,
any arrests (even for nonsexual offenses), probation vio-
lations, and/or informal reports of re-offense. Some
attention has also been given to the measurement of in-
treatment change. Indeed, some research has examined
pre- and posttreatment scores on dynamic variables
related to sexual recidivism. Thus, treatment providers
or researchers might focus on changes in attitudes toler-
ant of sexual offending or intimacy deficits as a function
of treatment interventions. More research is needed to
establish the direct relationship between these within-
treatment gains and actual reductions in recidivism.
In sum, while meta-analytic research has generally
supported the value of treatment for sex offenders, the
research studies on which these meta-analyses were
based have typically employed suboptimal method-
ological designs. Despite this, the weight of the
research does show some support for cognitive-
behavioral and psychopharmacological interventions.
Thus, while there is room for optimism, especially
with regard to certain techniques, firm conclusions
about the utility of sex offender treatment await fur-
ther research.Cynthia Calkins Mercado732 ———Sex Offender TreatmentS-Cutler (Encyc)-45463.qxd 11/18/2007 12:44 PM Page 732