Therapy for sexual misconduct? There’s no evidence to back it up

UNITED STATES
New York Times

November 28, 2017

By Benedict Carey

The recent surge in accusations of sexual harassment and assault has prompted some admitted offenders to seek professional help for the emotional or personality distortions that underlie their behavior.

“My journey now will be to learn about myself and conquer my demons,” the producer Harvey Weinstein said in a statement in October. The actor Kevin Spacey announced that he would be “taking the time necessary to seek evaluation and treatment.”

Whatever mix of damage control and contrition they represent, pledges like these suggest that there are standard treatments for perpetrators of sexual offenses. In fact, no such standard treatments exist, experts say. Even the notion of “sexual addiction” as a stand-alone diagnosis is in dispute.

“There are no evidence-based programs I know of for the sort of men who have been in the news recently,” said Vaile Wright, director of research and special projects at the American Psychological Association.

That doesn’t mean that these men cannot change their ways with professional help.

The evidence that talk therapy and medication can curb sexual misconduct is modest at best, and virtually all of it comes from treating severe disorders, like pedophilia and exhibitionism, experts said — powerful urges that cannot be turned off.

Still, there is reason to think that these therapeutic approaches can be adapted to treatment of the men accused of offenses ranging from unwanted attention to rape.

“You’re really looking at two categories of people,” said Rory Reid, an assistant professor of psychiatry at UCLA, who has a clinical practice focusing on sexual problems.

“One is what I call sexually compulsive behavior. The other is reserved for people committing nonconsensual acts — sex offenders.”

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