Current concepts in preventing sexual abuse.

Most efforts to prevent sexual abuse have focused on teaching school children to resist abuse after it starts and to report it promptly to trusted adults. These programs increase children's knowledge and skills and the likelihood that children will disclose sexual victimization but have not been shown to reduce the incidence of abuse. A recent, unique approach to prevention is a Vermont social marketing campaign that encouraged sexual offenders to seek treatment. During the campaign, 50 persons voluntarily sought treatment for sexual offending or sexual behavior problems, and eight offenders presented themselves voluntarily to state attorney offices. Recent evidence indicates that many sexual offenders were themselves molested and that lack of family support about that molestation is an important risk factor for sexual offending. However, the number of treatment programs for "sexually reactive" children and adolescent sexual offenders in the United States declined from more than one thousand in 1994 to 337 in 2000. In nine states, no adolescent treatment program is currently available. There is an urgent need for methodologically sound research aimed at delineating the causes of sexual deviance and at measuring and improving the efficacy of treatment for sexual offenders.