Preventing sexual abusers of children from reoffending: Systematic review of medical and psychological interventions
Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ: British Medical Journal
Abstract
Objective To evaluate the effectiveness of current medical and
psychological interventions for individuals at risk of sexually abusing
children, both in known abusers and those at risk of abusing.
Design Systematic review of interventions designed to prevent
reoffending among known abusers and prevention for individuals at risk
of sexually abusing children. Randomised controlled trials and
prospective observational studies were eligible.Primary outcomes were
arrests, convictions, breaches of conditions, and self reported sexual
abuse of children after one year or more.
Results After review of 1447 abstracts,we retrieved 167 full text studies,
and finally included eight studies with low to moderate risk of bias. We
found weak evidence for interventions aimed at reducing reoffending in
identified sexual abusers of children.For adults, evidence from five trials
was insufficient regarding both benefits and risks with psychological
treatment and pharmacotherapy.For adolescents, limited evidence from
one trial suggested that multisystemic therapy prevented reoffence
(relative risk0. 18,95%confidence interval 0.04to0.73);lack of adequate
research prevented conclusions about effects of other treatments.
Evidence was also inadequate regarding effectiveness of treatment for
children with sexual behavioural problems in the one trial identified.
Finally, we found no eligible research on preventive methods for adults
and adolescents who had not sexually abused children but were at higher
risk of doing so (such as those with paedophilic sexual preference).
Conclusion There are major weaknesses in the scientific evidence,
particularly regarding adult men, the main category of sexual abusers
of children.Better coordinated and funded high quality studies including
several countries are urgently needed. Until conclusive evidence is
available, realistic clinical strategies might involve reduction of specific
risk factors for sex crimes, such as sexual preoccupation, in abusers at
risk of reoffending.
Description
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Article
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Keywords
recidivism, offender, reoffend, child sexual abuse, intervention, risk
Citation
Långström, N., Enebrink, P., Laurén, E. M., Lindblom, J., Werkö, S., & Hanson, R. K. (2013). Preventing sexual abusers of children from reoffending: Systematic review of medical and psychological interventions. BMJ: British Medical Journal, 347.