The Roman Catholic Church is getting tough in dealing with priests who abuse minors, with an increasing number of bishops adopting zero-tolerance polices that defrock offenders, forcing them to forfeit the clerical life. It is a no-nonsense policy demanded by victims and their advocates and insisted upon by church lawyers and fiscal officers.
But the church's tougher stance is stirring debate among mental health professionals who treat clerical sex offenders. Some argue that firing priests who abuse children doesn't help the priest or the community where he'll have to start a new life.
"If you defrock them and kick them out, who's going to be watching them?" asked Thomas G. Plante, a California psychologist who treats priests who have abused minors.
The policies have been embraced by major Catholic dioceses such as Boston, Philadelphia and Los Angeles, all of which have recently ousted priests when decades-old allegations against them surfaced.
Baltimore does not employ zero tolerance because officials say they want to retain the right, although unlikely, to reassign a priest who has abused a minor if he successfully completes treatment.
The abuse cases that have received the extensive recent publicity are nearly all old cases, some many decades old, that church officials have found by examining their personnel files. Some of these dismissed priests may have been treated in the past.
Now, when a diocese learns of an accusation of child sexual abuse against a priest, he is usually sent immediately to a psychiatric center for evaluation and possible inpatient treatment, which can last from six to nine months.
This is followed by an extensive aftercare program, in which the client returns to the treatment center several times a year for weeklong refresher sessions, a process that continues for five years and longer.
Catholic priests accused of sexual abuse are sent to private psychiatric hospitals for evaluation and treatment, two of the most prominent being the church-run St. Luke Institute in Silver Spring, and the secular Institute of Living in Hartford, Conn.
These centers offer some of the most intensive and thorough treatment for sex abusers available, at a cost of hundreds of dollars a day, which is paid for by the priest's diocese or religious order.
Officials from the St. Luke Institute, the most prominent Catholic psychiatric center for priests, nuns and brothers, did not respond to repeated requests for information about their programs.
Though the church isn't talking about how many errant clerics are rehabilitated and returned to the ministry, some therapists contend it would be better to supervise priests by putting them in jobs where they would have no contact with children.
"If you're making jam in some Midwestern monastery, you're not going to be offending," said Plante, a professor at the University of Santa Clara who edited a book on Catholic priests who commit sexual abuse titled, Bless Me Father For I Have Sinned.
"You wouldn't let them be around children. You may not let them wear a clerical collar. But they can still minister and help others," agreed Dr. Fred S. Berlin, founder of the Baltimore-based National Institute for the Study, Prevention and Treatment of Sexual Trauma.
"Everyone is better off with that individual staying in the church than cutting them off and hoping for the best," said Berlin, a pioneer in the field who has been criticized by victims' advocates for being too sympathetic to offenders.
It is difficult to quantify the extent of clergy sexual abuse in the Catholic Church because so little formal research has been done. But in Plante's 1999 book, which he called the first academic study on the subject, he tries to clarify what he calls myths, particularly the popular belief that a much higher percentage of Catholic priests abuse minors than other clergy and the population at large.
"The best data we have is that approximately 5 percent of priests have a predilection toward minors. That seems to be consistent with other clergy who are not priests [such as Protestant ministers or rabbis]," he said. Research also shows that 8 percent of the general population is sexually attracted to children, higher than for priests and other clergy.
Therapists agree that pedophiles, as well as those who abuse older minors, cannot be cured. But through therapy and drugs such as Depo-Provera, which suppresses the sexual drive in men, they contend that the urges to molest children can be controlled.
"We now look at pedophilia the way we look at drug abuse or alcoholism, as a craving disorder," Berlin said. "We say we don't know about the cause. We do know they experience unacceptable cravings. If you give in to them, they can destroy your life and others'."
In treating a priest who has abused a minor, one of the therapist's tasks, through individual and group therapy, is to make him understand the harm he's caused, which is not always apparent to the abuser.
"The interesting thing about clergy abuse is the frequency with which you hear the individual say he was helping the child or educating the child," said David W. Ingle, a psychologist and director of adult programs at the Joseph J. Peters Institute in Philadelphia. "Very often, they don't look at it as sexual, but as an education or training function."
The key in therapy is in getting the priest to feel a sense of shame and accept responsibility.
"You try to take the priestly mask off them, take the collar off them," Plante said. "Don't call them 'Father,' so they see themselves as just another human being struggling with this problem instead of hiding behind the mask of being a priest."
The treatment available to priests is generally better than what is normally available to an abuser in the general population, who have to pay for therapists for outpatient treatment or, in the case of the incarcerated, are at the mercy of what state prison systems have to offer, mental health professionals said.
A handful of state prisons do have extensive treatment programs. One of the best is in Minnesota, which in the mid-1970s opened one of the nation's first residential programs for convicted felons who are sex offenders. The program has about 200 beds and tries to help prisoners fully accept responsibility, understand the triggers that led to their behavior and develop methods to prevent them from acting out again. The state program relies much less on drug therapy than private programs do.
"It's a much more practical manner of treating the way sex offenders think, feel and behave," said Stephen Huot, director of Sex Offender Services for the Minnesota Department of Corrections. Inmates are treated for a minimum of about a year, with an 18-month stint more typical. Studies show that 23 percent of inmates who complete the program are rearrested within six years, as opposed to 41 percent who either refused treatment or didn't complete it.
This compares to a relapse rate of about 10 percent claimed by centers such as the St. Luke Institute, a figure that is self-reported and has not been subjected to outside scrutiny.
Some therapists, however, reluctantly agree with zero tolerance.
"The new 'all-or-nothing' policy seems severe, but it is in line with what many lawyers have said and what many diocesan financial officers have said," said the Rev. James J. Gill, founder of the Christian Institute for the Study of Human Sexuality in Chicago and a consultant at the Institute of Living in Hartford.
"The people in the pews are more inclined to say, 'Keep them out of the active priesthood, be on the safe side for the sake of protecting our children.' And it makes sense to me," he said.
Ingle, of the Peters Institute in Philadelphia, which has had priests as clients, said that because any priest who abuses children has abused his religious authority, it is important to remove that authority.
"If congregations see [priest abusers] working in a soup kitchen or picking up trash or whatever, what they're seeing is that the church identified the problem and identified the priest as a pedophile but is still willing to support him in a position of authority, and I don't think that's acceptable," he said.
Although there is disagreement about what the church should do with its priests who abuse minors, there is general consensus among therapists that it is better for the Catholic Church to be open about the problem and its response.
"Secrets are things that bind perpetrators and victims. When any organization engages in secrecy, it is reinforcing for the perpetrator that powerful individuals may keep secrets and use these in a powerful fashion, and it reinforces for victims that they will remain victims," said Ingle. "I would encourage large religious organizations to undo the knots of secrecy and to do even more than what they're doing now."