Outcome data are presented, grouped into 5-year cohorts, for 7,275 sexual offenders entering a cognitive/behavioral treatment program. Assessment variables included treatment completion, self-admission of covert and/or overt deviant behaviors, the presence of deviant sexual arousal, or being recharged for any sexual crime (regardless of plea or conviction). It proved possible to follow 62% for the cohort at 5 years after initiating treatment, but follow-up completion rates decreased with time. Outcomes were significantly different based on offender subtype, with child molesters and exhibitionists achieving better overall success than pedophiles or rapists. Prematurely terminating treatment was a strong indicator of committing a new sexual offense. Of interest was the general improvement of success rates over each successive 5-year period for many types of offenders. Unfortunately, failure rates remained comparatively high for rapists (20%) and homosexual pedophiles (16%), regardless of when they were treated over the 25-year period. Implications for clinical practice and future research are drawn.

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A retrospective review of 4381 heterosexual and homosexual pedophiles treated in a community-based program produced preliminary evidence of factors associated with success or failure in treatment. Records of these offenders revealed a number of factors of importance in predicting treatment outcome, including victim and offender characteristics, offending behavior characteristics, and penile plethysmographic findings of deviant and normal sexual arousal. Results indicated that success in treatment was often associated with a minimum number of victims, familiarity and cohabitation with victims, an absence of force or threats employed in the crimes, admission of some responsibility for the offending incidents, and a stable history of employment and relationships with others. Plethysmograph findings confirmed the general impression that low pre-treatment deviant arousal was correlated with improvement. Surprisingly, duration and frequency of offending behaviors were not consistent predictors of treatment response. Limitations of the present study are noted and caution is advised in accepting these findings until corroborated by controlled research.Maletzky, M.B. (1993). Factors associated with success and failure in the behavioral and cognitive treatment of sexual offenders. Annals of Sex Research, 6, 241-258..

In 1999, the Oregon State Legislature, concerned about the risk certain sexual offenders might pose to their communities upon release from prison, enacted House Bill 2500. This bill required selected offenders to be evaluated prior to their release to determine whether medical treatment with medroxyprogesterone acetate (MPA), also known by its trade name of depo-Provera, was indicated to reduce their risk. The present study reviewed the first 275 men to be evaluated under this program from the years 2000 through 2004. Data were collected on diagnoses and outcome on three groups: men judged to need MPA who eventually went on to actually receive it; men recommended to receive MPA who, for a variety of reasons, did not receive the medication; and men deemed not to need MPA. Outcome measures included recidivism data, including reoffenses, parole violations, and reincarcerations, and whether these were sexual in nature. Data were also collected on employment and whether supervising officers believed the men in each group were doing well. Significant differences emerged among these three groups, with men actually receiving depo-Provera committing no new sexual offenses and also committing fewer overall offenses and violations compared to the other two groups. In addition, almost one third of men judged to need medication but who did not receive it committed a new offense and almost 60% of these were sexual in nature. While generalizations from these types of retrospective and partially subjective findings are inherently limited, the present study lends credence to the belief that, in selected offenders, anti-androgenic medication can be a valuable, if time-limited, addition to a cognitive and behavioral treatment program. Suggestions for more practical and far-reaching implementation of this adjunctive approach are offered.