Current treatment programs usually provide some combination of psychosocial, psychophysiological, cognitive, and biomedical therapies. Psychosocial therapies include heterosexual, social, and life skills training; anger management; assertiveness training; marital and family therapy; and alcohol and drug treatment. Concerns raised by these approaches include the possible misinterpretation of training by the offender, the possible effects of the treatment on the offender's spouse or family, and free consent to treatment in correctional contexts. Psychophysiological approaches generally rely on decreasing arousal to deviant stimuli while increasing arousal to socially appropriate stimuli using operant conditioning paradigms. Many of these treatments are intrusive or invasive; the use of aversive stimuli also is problematic. Cognitive approaches, aimed at changing deviant thoughts or feelings may involve covert sensitization, victim confrontation, and victimization recall. Again, consent to treatment and possible negative effects on the victim are problematic. Biomedical interventions aim directly at the reduction of sexual drive through psychoendocrine or surgical interventions. These approaches are intrusive, have side effects, and may be ineffective in controlling recidivism. 31 footnotes.