By James L. Franklin, Globe Staff, 7/19/1992

oth the large number of alleged victims and charges that he continued to abuse children while in treatment make the James Porter case highly unusual, say those responsible for the treatment of sexual offenders among Catholic priests. Officials of three of the four leading centers that treat priest sex offenders -- Southdown near Toronto, St. Luke Institute in Maryland, and the Institute of Living in Hartford -- said in interviews last week that improved treatment yields great success, with as little as a 10 percent recidivism rate.

They and other specialists said many offenders can be returned to active ministry so long as the clergy and their supervisors accept lifelong restrictions and follow-up care.

The fourth leading center in the United States and Canada is run by the Servants of the Paraclete, a Catholic religious order based in New Mexico, which uses a retreat house method relying on traditional spiritual counseling. It accepted Porter in 1967 after he was accused of abusing children at three parishes in the Catholic Diocese of Fall River.

Dr. Jay Feierman, a psychiatrist in charge of treatment at the center, declined to comment on the Paraclete program.

But lawyers representing families in Minnesota, Missouri and New Mexico said last week that Porter molested children while doing part-time pastoral work when he resided at the Paraclete order's halfway houses before he left the priesthood in 1974.

Unlike the monastery model used by the Servants of the Paraclete, the other facilities use combinations of medical treatment and therapies for addictive behavior, with strict limits on the freedom of residents.

The director of psychological services at the Institute of Living in Hartford, who asked that his name not be used to protect relationships with patients, said the religious approach used by the Paraclete order has helped "more than 600 priests, even though they don't have locked doors or medical treatment."

He said the Porter case is an extreme and thus poor basis for assessing the effectiveness of programs dealing with clergy sexual offenders. "From what we know from news reports this individual was out of control and probably needed to be in an in-patient medical facility.

"We need to put the Porter case in perspective. It is awful, and it must be judged by his peers, the courts and the church, but I have known 700 cases, and he's a rare bird," said the director, a psychiatrist who has also worked in Ohio. The more typical clergy offender, he said, has been involved "with no more than 10 people over a long period of time."

A wide variety of medical problems and behaviors can be seen in clergy sex offenders, he said. Individuals range from clasic pedophiles to persons with brain dysfunction or hormonal imbalance, which can be treated by a variety of drugs and behavioral therapies.

A minority, no more than 5 to 10 percent, do not respond to such treatment "and do belong in jail," he said. "However, research we have done at the Institute of Living suggests that what we are looking for is a brain disorder, frontal and temporal lobe brain abnormalities.

"As a parent, I understand the disgust, horror and sense of betrayal, which is all the more heinous when seen in a priest or minister," the director said. "But if we have a condition that responds well to psychological and pharmacological treatment, it would be wrong not to treat them, not only because of the injustice to the individual offender but because society will suffer if we do not respond."

One of the pioneers in the treatment of sex offenders, Dr. Gene Abel, director of the Behavioral Medical Institute of Atlanta, said the public needs to know that "there is considerable good news in this area.

"Treatments prior to 15 years ago weren't very effective" because they weren't based on an assessment of the individual offender and because "they didn't have the components we have now demonstrated to be effective," said Abel, a psychiatrist who did his initial work in the field at Columbia University.

Using a combination of "cognitive behavioral treatment, including relapse prevention and sometimes antihormonal drug therapy . . . the recidivism rate runs less than 10 percent," according to a number of studies, some with a 5- to 10-year follow-up, he said.

"For more recalcitrant offenders, we sometimes have to add on six months to 10 years' use of Depo-Provera, a drug that reduces the male hormone testosterone," Abel said. Of the 250 patients in his treatment program, only 10 have been prescribed Depo-Provera, he said.

When the offenders are professionals who have access to children through their work as doctors, nurses, priests and ministers, there are additional controls and demands, he said.

Generally the offender would not be allowed to work with the gender or age group he was involved with in the past, Abel said.

In addition, offenders must participate in continuing education programs related to sexual misconduct in their professions and produce a review of the literature on the subject "to demonstrate they have become acquainted with the pitfalls of sexual misconduct," he said.

Also the offender must agree to be monitored by three coworkers who make monthly reports on the offender's behavior, and a quarterly questionnaire is sent to the offender's clients or parishioners to evaluate his performance.

The success of this treatment, while still not widely known, is due to the coincidence of three factors, Abel said. The states had an increasing population of sex offenders, the federal government fostered research by establishing the Center for Prevention and Control of Rape and the National Organization for Women lobbied effectively for federal financing of treatment research, he said.

"In the last 15 years this is finally coming together, and right now the National Institute of Mental Health is in the process of sending out an initiative to once again clarify to researchers the importance to the federal government of reducing sexual violence," Abel said.

Treatment of sexual offenders not only saves damage to victims but is cost- effective, he argued. "If we can treat 100 offenders and reduce recidivism to the rates we are now seeing, the savings in money otherwise spent to care for victims would allow you to treat 924 other perpetrators," Abel said.

The St. Luke Institute in Suitland, Md., which is affiliated with the Sexual Disorders Clinic at Johns Hopkins University in Baltimore, serves Catholic priests.

Rev. Canice Connors, a Conventual Franciscan priest, said the institute he directs was founded 12 years ago to treat addiction in Catholic priests and members of religious orders.

He said that pedophilia -- sexual abuse of children -- "is treated within the framework of a 12-step program," based on the addiction treatment pioneered by Alcoholics Anonymous.

Those who are treated are referred by their diocese or religious order, must complete a weeklong evaluation program before being accepted for treatment and must agree to full disclosure of information to the diocese or order, Father Connors said.

The typical residential program varies between seven months and a year, and those in treatment "are not allowed off the grounds and are never, never involved in any ministry whatsoever," he said.

After release, priests are expected to return to the institute twice a year for a one-week stay, over a five-year follow-up period, Father Connors said.

Recommendations on whether priests can resume ministry vary, "but I would heartily agree that we have to be extremely cautious," he said. Often the institute recommends that priests not be allowed to do any ministry involving children but instead work in fields, such as AIDS ministry or a home for the elderly, in which there is little or no access to young people.

At the Emmanuel Convalescent Foundation in Aurora, Ontario, near Toronto, Rev. J. Allan Loftus, a Jesuit priest and psychiatrist, uses a "multimodal" approach that avoids treating sexual disorders as addictive behavior.

The 40-bed facility, which is better known as Southdown, admits 20 men and 20 women, "which is unique in terms of our kind of facility," he said.

Treatment methods have undergone great change in the recent past, Father Loftus said. "I can't imagine anyone doing the same things we used to, because we have learned so much more about sexual offenders."

Staff members at Southdown -- a 26-year-old Catholic facility with a lay board -- will present a paper on their work at a meeting of the American Psychological Association next month, he said. While he would not disclose the results, Father Loftus said he is convinced that their methods are effective.

"If great care is exercised when we consider returning a priest to ministry, we can't say ahead of time that no one could be allowed back," he said.

Any patient admitted to Southdown who fits a formal protocol for sexual abuse must meet detailed standards before the staff recommends a return to ministry, Father Loftus said. "This is a fairly stringent set of criteria, such as a clear acceptance on the part of the priest of the need for continued monitoring, of the need to stay away from the target population, that he must be forthcoming with his sexual history and accept medical, psychological and spiritual treatment."

This story ran in the Boston Globe on 7/19/1992.
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