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"We are unlikely to find a large treatment effect as long as the re-offense rates for untreated sex offenders are relatively low, for example, around 15 percent." Assessing dangerousness Psychologists have gleaned a number of important treatment insights in their research--the most basic of which is one size does not fit all."A large part of the challenge to managing this group is educating the courts that sex offenders are a highly heterogeneous population and not all of them are at high-risk for re-offending," says psychologist Moss Aubrey, Ph D, who does private assessment of male sex offenders in New Mexico.

"Some are highly predatory, highly psychopathic and have repeated offenses, making them more likely to re-offend," he explains.Though that's not a large reduction, the large sample size and widely agreed-upon research methods make it statistically reliable and of practical significance, Hanson says.Misperceptions Even so, psychologists face challenges in convincing law enforcement authorities to take treatment seriously given the obvious public concern about sex offenses."In the 1980s, American states made the decision that sex offenders were not sick; they were bad," La Fond says."Some states decided to offer treatment, but there wasn't much hope that it would work. That analysis showed for the first time a significant difference between recidivism rates for sex offenders who were treated and those who were not, says psychologist R.You want to confront those ideas right away and make it clear that sex offenses are very serious crimes." If treatment methods are as effective as Hanson's meta-analysis indicates, they are likely to become more popular in U.

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Controversial questions swirl around the correctional system's management of sex offenders: How long should they be incarcerated for their crimes of forcing sex acts on adults or children? Does psychological treatment in prison actually affect the risk of committing further offenses?

And how can courts balance offenders' potential for rehabilitation with a community's need to protect its citizens?

Actuarial scales for determining an offender's risk of committing more sex crimes after treatment are available, but not always trusted by judges and many clinicians, Prentky says.

More often, courts base release decisions on progress reports from prison psychologists--relying heavily on their expertise.

It's crucial to start therapy as soon after incarceration as possible, La Fond says.