Therapeutic Alliance as a Mediator in the Absence of Post-Treatment Recidivism: A Study of Men Who Have Committed a Sexual Offense Against a Child.

The impact of motivation for change, group therapy climate, and therapeutic alliance on treatment success in men who have committed sexual offenses (MCSOs) has produced mixed results in previous studies, often studied independently or limited to treatment progression. Thus, the way these factors interact and influence post-treatment recidivism remains unclear. The present study addressed this gap by examining the interplay of these factors in a sample of 140 men who had committed sexual offenses against children, followed for a potential recidivism period of 5-8 years, using both repeated measures ANOVA and structural equation modeling (SEM). Results from the ANOVA showed a decrease in cognitive distortions supporting child sexual offenses before and after treatment, associated to a stronger therapeutic alliance. SEM analysis revealed that the therapeutic alliance mediated the relationship between motivation, group climate, and the absence of post-treatment recidivism. These findings highlight the central role of the therapist in treatment effectiveness with MCSOs.