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Treatment of incarcerated sex offenders 

Treatment of incarcerated sex offenders
Chapter:
Treatment of incarcerated sex offenders
Author(s):

Fabian M. Saleh

, Albert J. Grudzinskas

, and H. Martin Malin

DOI:
10.1093/med/9780199360574.003.0059
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date: 17 January 2020

Sex offenders are incarcerated in substantial numbers for a variety of non-violent and violent crimes, with or without diagnoses of paraphilias. The treatment of sex offenders in correctional contexts is arguably one of the most challenging undertakings for psychiatrists. Sex offenders comprise a highly stigmatized population that typically engenders intense negative feelings in both the professional and lay communities. The growing number of sex offenses in recent years has had a profound impact on public perception. In 2012, the latest year for which comprehensive data have been compiled, there were 73,080 incidents of sex ‘crimes against persons’ in the United States involving 79,625 individual victims and individual 76,927 offenders. The potential contributions of psychiatry to sex offender management span a considerable segment of the patient’s life: from post-arrest evaluation and emergent care, through adjudication in the courts, incarceration, possible civil commitment, and supervised release. Nevertheless, psychiatrists, as physicians and healers, bring much needed medical expertise to the discussion. Foremost is the ability of psychiatry to demonstrate that sex offenders are a heterogeneous population. Further, a rational, effective, and humane approach to the social problem of sex offending depends upon accurate assessment, diagnosis, and treatment approaches to the offender. Psychiatrists can also inform the ongoing debate about competency, dangerousness, the appropriateness of civil commitment, life-long sex offender registration, compulsory medication and other medically relevant issues in sex offender management. This chapter reviews the nosology, assessment, diagnosis, best and evidence-based practice issues relevant to the care of convicted sex offenders in correctional settings.

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