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Science has come up with tools to help them, but it's still a huge responsibility and a terrible burden." Challenges of treatment Adding to that burden are clients who may not disclose all of their crimes or sexually deviant thoughts.

Offenders who report crimes they have committed, other than those they were convicted of, face either additional prosecution or being held beyond their sentence under a civil commitment law.

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"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.

"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.

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?

But many psychologists and policy advocates, including law professor John Q.

La Fond, JD, of the University of Missouri-Kansas City, say that approach disregards key information on the nature of sex offenders--statistics show most are not likely to repeat their crimes--and on the increasing efficacy of offender treatment, largely due to a modern behavior modification model stressing relapse prevention through recognition and avoidance of criminal impulses.

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.

That's why the recent meta-analysis finding is a breakthrough of sorts--low recidivism rates among untreated sex offenders make finding a statistically significant treatment effect difficult, says psychologist Robert Prentky, Ph D, who is the director of research for Justice Resource Institute in Bridgewater, Mass.

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