Rehabilitating Criminal Sexual Psychopaths: Legislative Mandates, Clinical Quandaries

More than half the states in the United States have legislation on sex offenders that distinguishes between those whose offense is incidental to other offenses (“felony” sexual offenders) and those who engage in “repetitive, habitual, or compulsive” sex offenses (“criminal sexual psychopaths”). The legislation specifies that criminal sexual psychopaths must be treated, not punished. But treatment is problematic; the literature on various approaches finds uncertainty about the effectiveness of treatment.

Nathaniel J. Pallone asks whether there is a right to effective treatment and notes the political and ethical questions involved in potentially more effective Clockwork Orange-like approaches. Despite the fact that the category “sexual psychopath” is essentially a legal, not a psychiatric, category, judges tend to follow professional recommendations for categorization. Pallone emerges with some surprising, but convincing, conclusions. If the distinction between felony and psychopathic sexual offender is essentially empty, as the profession feels it is, it should be abandoned. All criminal sexual offenders should be punished, except those who opt for treatment and who are certified by mental health professionals as likely to benefit from psychological treatment. And for the few so identified, society should be prepared to commit significant resources to their treatment.

Combining a broad-ranging overview of the legal, criminological, and psychiatric literature on these questions, Rehabilitating Criminal Sexual Psychopaths raises questions of continuing importance. Legal experts, criminologists, mental health professionals, and all those concerned with public policy will find it significant.