Incest perpetrators. Their assessment and treatment

The multitude of articles published in the last decade in the area of intrafamilial sexual abuse highlight the complexity of the issue--both its assessment and treatment. Although no unique profile of an incest perpetrator exists, a review of studies revealed problems in the areas of sexual satisfaction, psychological functioning, interpersonal relationships, and family of origin. As well, incest families have been reported to be dysfunctional, with power imbalances; control struggles; indirect, unclear communication; and inappropriate coalitions among family members. Based on these observations, a wide range of treatment interventions now exists, including offender-oriented cognitive/behavioral therapies and a family-focused multimodal systems approach. Although questions remain to be answered in regard to the effectiveness and process of treatment, efforts limited to the recognition of these problematic families are no longer adequate. The focus must move to prevention through the early identification of individuals at risk both for offending and being part of an incest family structure; the implementation of proven, cost-effective, proactive intervention strategies; and the continuing dissemination of information to the public.