Previous research and thinking on the treatment of personality disorders and on pedophilia indicate that both are difficult client groups who have been damaged by significant early traumatic experiences, often with their primary caregivers. One of the major effects of this is significant difficulty in trusting adults and in forming close adult relationships. Although not all individuals with insecure attachments develop into pedophiles, some of these individuals do take this course. What determines the difference is not clear. Both personality disordered clients and pedophile clients are resistant to change and are often described in the professional literature as poorly motivated and difficult. A basic premise of this article is that the sexually offending behavior is a symptom of significant personality difficulties that result from disturbed early attachments, rather than being preferred deviant sexual behavior. The primary aim of sex offender treatment is to prevent further offending behavior against children. Currently, the main treatment methodology is group programs that involve psychosexual education, cognitive/behavioral therapy, and relapse prevention training. Some programs also offer individual treatment alongside the group program. A significant shift is needed toward helping pedophiles understand their history and how that history has influenced their life to date, their emotional and cognitive vulnerabilities, and their emotional attraction to children. 49 references