Publication Date: 
Sunday, July 12, 2009

The Problem: Sexual abuse is a big public health problem. Every year, there are about 90,000 rapes. U.S. Department of Justice, Federal Bureau of Investigation. Victims of sexual abuse suffer extensive physical and emotional harms; the long term sequelae of sexual abuse are associated with a number of health risk factors later in life.Beitchman et al, A Review of the Long-term Effects of Child Sexual Abuse, Child Abuse & Neglect 1992; 16(1): 101-118. A significant portion of sexual crimes are committed by juveniles; research indicates that as much as 80% of adult sexual offenders committed sexual crimes as juveniles. Groth et al, Undetected recidivism among rapists, and child molesters. Crime and Delinquency, 1982; 128: 450-458.  This suggests that treatment and rehabilitation of juvenile sexual offenders (JSOs) is important to reducing sexual violence. In 2008, 14,500 children were arrested for sexual offenses not including rape; 3340 children were arrested for rape. U.S. Department of Justice, Office of Juvenile Justice0. Rehabilitation is the primary aim of juvenile criminal justice systems in the United States. However, high rates of recidivism in sexual crimes and the high proportion of sexual crimes committed between juvenile family members challenge policies that otherwise seek to minimize the time that juvenile offenders spend in correctional custody. In this context, JSOs often fail to receive treatment addressing the bio-psychosocial causes of offending.

The Law: Mandatory treatment is often required as a condition of adjudications or plea bargains for juveniles charged with sexual crimes. The court system presents, in this respect, an important source of leverage for forcing sexual offenders into treatment. Probation and sentencing contingencies may be used to increase compliance with mandated treatment. All judges have discretionary authority to order participation in treatment programs for minors in adjudications involving sexual crimes. Some states mandate treatment in specialized programs for juvenile sexual offenders (Kentucky, KRS 635.515 (1)Alabama, Ala. Code 15-20-27).

The Evidence: Reiztel and Carbonell conducted a systematic review and meta-analysis of studies evaluating the effectiveness of juvenile sexual offender treatment programs. Lorraine R. Reitzel and Joyce L. Carbonell, The Effectiveness of Sexual Offender Treatment for Juveniles as Measured by Recidivism: A Meta-analysis, Sex Abuse (2006) 18:401–421. Only studies comparing recidivism among groups receiving and not receiving treatment were included; random placement into treatment and control groups was not required. Nine studies satisfied the inclusion criteria. Using a fixed effects meta-analysis of odds ratios across the studies, the reviewers found a statistically significant 0.43 effect size suggesting a sizable protective relationship between treatment and recidivism: for every 43 offenders in the treatment group that recidivate, 100 in the control group do so. Simple un-weighted average recidivism rates between the treatment group (7.37%) and the control group (18.93%) were substantially different. Though cautioning that the treated and untreated groups may have varied in systematic ways, the authors viewed the nine studies as sufficient evidence to conclude that treatment is effective in reducing recidivism.

The Bottom Line: According to the authors of a peer-reviewed meta-analysis, there is sufficient evidence to support the effectiveness of laws requiring treatment for juvenile sexual offenders in reducing recidivism.

Impact: Effective