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Wednesday, September 4, 2013

Are we making progress with sexual abusers of children?

There is likely no topic that can stir a highly charged debate like the one around sexual abusers of children. I am careful to not use the word pedophile as the broad descriptor as they are a subset of the sexual abusers of children. A pedophile has a sexual orientation to children whereas not all sexual abusers have that.

None the less, there is a major abhorrence of sexual abusers in our society. There is a strong sentiment against them that might be summed up as, "Throw them in jail and toss the key away." The research, however, offers a somewhat different view.

There is not doubt that sexual abuse is prevalent. It is estimated that up to 20% of women and around 8% of men report that they have been abused prior to age 18. There are some highly visible examples such as with the Catholic Church, Jerry Sandusky, the former UPenn coach, the Boy Scouts of America, Jimmy Savile in the UK, all coming to mind.

As well, the long term consequences of sexual abuse are significant in both physical and mental health. Some victims of sexual abuse will also go on to become perpetrators.

With all that in mind, I was fascinated to see research published by Langstrom et al., in The British Medical Journal. It looked at the data on preventing sexual abusers of children from reoffending. Overall, they did not find that there was significant research to conclude that many interventions have an evidence base to support that they are effective. There is simply a significant need for well designed research to help answer the question. This was a rather disappointing conclusion.

There were a few points in the article that merit specific mention:

1. The observed rate of re-offence for sexual abusers of children is low. One study with a sample size of 9,603 found only 12.7% re-offended after 5 years. Yearly hazard rates are less than 3%;
2. Treating all sex offenders alike is dangerous. By low risk offenders with high risk offenders we create a significant concern of increasing the risk level of the low risk offender - a contamination effect;
3. Even keeping low risk offenders in long term therapy may increase their risk;
4. The Risk, Needs and Responsivity principle is important - offenders should be matched with treatment that matches their level of risk; the specific treatment needs of the client and their responsivity to intervention.

To be as effective as we can be with sexual abusers of children, we need to understand more, but also be sure to apply what we do know. Policy should be driven by the research. There is no taking away the pain of sexual abuse. Effective intervention with offenders is one of the tools we need. We have yet to develop effective prevention tools that reduce the frequency of sexual abuse. As the authors note, rates of abuse have not differed substantially in recent decades (although regional variations exist).


Langstrom, N., Enebrink, P., Laure, E., Lindblom, J., Werko, S. & Hanson, K. (2013). Preventing sexual abusers of children from reoffending: Systemic review of medical and psychological interventions. The British Medical Journal, 347, f4630.

1 comment:

  1. There are different types of child abuses. Somewhere down the line, parents are responsible for it. Had they been careful enough, nobody could tough their children in anyway. Thank you for this informative article.

    Vijay Shree
    Surrogacy In Uttar Pradesh