Treatment of Adult Male Sexual Offenders in a Psychiatric Setting

The Sexual Behaviours Clinic located in the Royal Ottawa Hospital is committed to providing specialized comprehensive assessments, consultations, management, and treatment to our community in general. Our service provides assistance not only to a population of sexual offenders but also to individuals with various sexual dysfunctions, paraphilias, and gender identity disorders. Over the past 16 years, the clinic has gained an international reputation as a center of academic excellence. Staff hold university appointments and provide education resources and opportunities to the two major university programs in the city. We also provide consultation to professional colleagues and as an information resource center to the community at large. The interface with the community has included consultation to other professionals and also the media via our public relations office. The research component of our Sexual Behaviours Clinic has produced ground-breaking scientific information to further delineate the boundaries of this area of expertise and dispel myths and misperceptions about sexual offenders. It also affords the clinic the opportunity to provide a vehicle for quality assurance and quality control. Although the clinic has opportunities for admission to psychiatric beds, its primary focus has been to manage offenders on a long-term basis in a community setting. This we feel provides a more effective long-term solution to these serious behaviors compared to merely gating penitentiary dispositions. Objective psychophysiological measures of sexual arousal and psycho-pharmacological interventions are often overlooked or underutilized by other programs, although there is an extensive body of research to substantiate the efficacy, reliability, and validity of these modalities. Effective treatment and management of individual sexual abusers may include psychopharmacological treatments while not excluding other treatment modalities. Our clinical practice of providing comprehensive, multidisciplinary, and multifocused interventions will be discussed in this chapter.