Issues in Clinical Practice With Sex Offenders

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Abstract
Various issues are considered in terms of their empirical support and practical utility. DSM-III-R diagnostic criteria seem inappropriate and are largely ignored by researchers; revisions are clearly needed. Assessments of sex offenders characteristically cover cognitions, social difficulties, life-style problems, and sexual deviances. The first three of these areas have generated limited research to date and there is need to expand and refine efforts here. Erectile measures of sexual preferences appear to reveal little about rapists, exhibitionists, and incest offenders, but they have value with nonfamilial child molesters although there are limits to the value of these measures. Outcome evaluations offer encouraging, though not conclusive, support for the value of treatment. Antiandrogens have a valuable role to play as adjunctive components in a comprehensive approach, with cognitive-behavioral programs having the clearest empirical support.

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