Evidence That Sexual Abusers of Children Who Receive Therapy Are Less Likely to Reoffend Is Weak

By Mike Mitka
News@jama
August 9, 2013

http://newsatjama.jama.com/2013/08/09/evidence-that-sexual-abusers-of-children-who-receive-therapy-are-less-likely-to-reoffend-is-weak/

Researchers are calling for rigorous studies to assess whether treatment by mental health professionals reduces the risk that men convicted of sexually abusing children or those at risk for engaging in such abuse will do so in the future.

Men convicted of sexually abusing children or those at risk of performing such abuse may be treated by mental health professionals in an attempt to prevent future episodes. But whether such treatment actually works remains an open question, say researchers whose findings appear today in BMJ.

The researchers, from Sweden and Canada, performed a systematic review of interventions intended to prevent reoffending among known abusers or to prevent those at risk of sexually abusing children from initiating such behavior. Of the 1447 abstracts reviewed, the authors selected 167 full-text studies. Ultimately, only 8 studies, 5 involving adult men and 3 involving adolescents or children, were considered as they had low to moderate risk of bias.

The researchers found that the research on the effectiveness of interventions for preventing sexual offending and reoffending against children remains inconclusive. They concluded that there is insufficient evidence about the benefits and risks of cognitive behavioral treatment for individuals who sexually abuse children or for children with sexual behavior problems (who are considered at risk of engaging in such abuse). No studies with minimal quality standards were found for pharmacological treatments or for interventions directed towards those who had not sexually abused children but were at a higher risk of doing so.

A small study found weak evidence that multisystemic therapy (family and community-based therapy focused on environmental factors affecting offenders) prevents reoffending among adolescent sexual offenders.

“Based on the meagre results from our extensive systematic review, we conclude that there is an urgent need for well designed and well executed trials of treatment for adults who commit sexual offences against children,” wrote the authors.

Sexual abuse of children remains a global problem; an estimated 18% to 20% of women and 7% to 8% of men in the general population report being abused before the age of 18 years. Those who sustain such abuse are at increased risk for risky sexual behavior, chronic pain syndromes, anxiety, and depressive disorders, including posttraumatic stress disorder, substance misuse, suicide attempts, and sexually aggressive behavior.