More research needed for medical and psychological treatments for people who commit sexual offences against children

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This systematic literature review, conducted by the Swedish Council on Health Technology Assessment, scrutinises the scientific evidence for preventive medical and psychological interventions directed at sex offenders.

The review found major weaknesses in the evidence base and concluded that:

In the absence of findings from reliable research, a reasonable treatment and follow-up strategy might be to reduce sex crime-specific risk factors, e.g. sexual preoccupation, in offenders having the highest risk of recidivism.

The summary of conclusions in full were:

  • Major deficiencies were found in the evidence concerning effective medical and psychological interventions for individuals that have committed sexual offences against children. This is serious, since the purpose of this treatment is to prevent new offences. Better research is necessary – primarily controlled studies that are sufficiently large and include several countries. Such research is particularly important in light of the Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse.
  • For adults that have committed sexual offences against children, the scientific evidence is insufficient for determining which treatments that could reduce sexual reoffending. The lack of evidence concerns both benefits and risks with pharmacotherapy and psychological treatment programmes. Sufficiently large studies of high methodological quality are essential to remedy this.
  • Concerning adolescents that have committed sexual offences against children, limited scientific evidence suggests that multi-systemic therapy prevents recidivism. This intervention is based on a combination of systemic family therapy, social learning theory, and social ecological theory. Possible effects of other treatment methods could not be appraised.
  • As regards children with sexual behavioural problems directed at other children, the scientific evidence is insufficient to draw conclusions about if cognitive behavioural could decrease the risk for future sexual offending. Likewise, the effects of other treatment methods could not be appraised.
  • For adults and adolescents that have not committed sexual offences against children, but are at higher risk (e.g. individuals with sexual attraction to children), there is a lack of research on possible effects of preventive methods. Hence, it is important to develop effective interventions.

Medical and Psychological Methods for Preventing Sexual Offences Against Children: A Systematic Review (PDF). Swedish Council on Health Technology Assessment, May 2011.

Council of Europe Convention on the Protection of Children against Sexual Exploitation and Sexual Abuse. Oct 2007.

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