Minnesota is one of 20 states that have passed civil commitment laws. This means that courts in these states are able to confine child molesters, rapists and other sex offenders who have finished their prison sentences but are deemed too dangerous to re-enter the community. For these offenders, therapy isn’t a complementary wellness add-on, it’s crucial to their overall wellbeing. Without the proof that therapy has made them safe to leave, the former inmates can stay in prison indefinitely.
According to David Prescott, a licensed therapist who has spent years sitting face to face with paedophiles trying to evaluate their progress, ‘So far, research shows that treatment very definitely can work.’ However, critics of the treatment argues that psychotherapy does nothing for the wellness of sex offenders – or, indeed, their potential victims – if the person drops out or is kicked out of therapy. Moreover, the treatment centres can cost tens of thousands of dollars each year – and that’s per person. In 2011, a government audit showed Minnesota spent $120,000 annually per person in civil commitment.
Researchers have been working with sex offenders for two decades now, but still we are without a cure for deviant urges. Therefore, the job of a therapist is to help paedophiles resist their urges. Dr. Fred Berlin, director of the Johns Hopkins Sexual Disorders Clinic in Baltimore, comments, ‘We don’t know how to change the fact that a person is sexually attracted to children, but that doesn’t mean there can’t be successful treatment.’ From the research, we know it is better to take an empathetic tone with paedophiles, rather than a harsh or confrontational one, which can be a challenge for therapists.
Prescott, a past president of the Association for the Treatment of Sexual Abusers who is now the clinical instructor of the Becket Family of Services Centre in Maine, clarifies, ‘Let me just be clear, you can be very challenging by being warm and empathic.’ If someone resists group therapy, for instance, Prescott notes he might respond by saying, ‘You don’t like the term sex offender, and yet your victim was willing to testify against you?’ Robin Wilson, an assistant professor of psychiatry at McMaster University in Hamilton, Ontario, points out that many paedophiles have issues with their personal boundaries and interpersonal violence, and treating these issues may keep them from abusing others.
However, Wilson continues, it is more important to have a support system of people around the sex offender who will hold him accountable for good behaviour once he re-enters the community. (Wilson estimates 5% or less of paedophiles are female, hence the use of “he”.) Wilson asserts, ‘There’s a common misperception that sex offenders are sex offenders all the time. That’s not necessarily true. Under certain circumstances they do have normal relationships.’ Dr. Richard Krueger, who is in the group working on updating the information about paedophilia in the Diagnostic and Statistical Manual of Mental Disorders, adds that the “pedohebephilic” type of paedophile, who is sexually attracted to both prepubescent and pubescent children (rather than the “hebephilic” type, who is sexually attracted solely to pubescent children) can sometimes be nudged into focusing on adults.
Still, Krueger, who is the medical director of the Sexual Behaviour Clinic at New York State Psychiatric Institute in New York, also points out that paedophiles who fall under the “classic type,” and are attracted only to prepubescent children, usually under the age of 11, often don’t change their focus. He argues, ‘With some paedophiles who are fixated, you can’t really make much of a dent; you may not be able to change their sexual interest pattern. In these situations pretty much you can only repress things, and you would use androgen [drug] therapy to do this.’