A review of the relevant research indicates that accountability and offender denial are inversely related and should be addressed as treatment targets rather than treatment obstacles. Research also indicates that a conceptualization of denial as a coherent construct with multiple forms has distinct clinical advantages over a view of denial as a dichotomous construct. Further, denial is closely related to the construct of cognitive distortions; denial often results in distorted and biased thinking that stems from explanations designed to excuse the offender's behavior. Denial can have a number of facets that include denial that an offense occurred, claims that nothing harmful happened to the alleged victim, denial of the extent of the offense, denial of intent to commit an offense, and denial of responsibility based on the assertion of victim desire. Even after offenders acknowledge their responsibility for an offense, they may not be prepared to admit that they are the type of person who is vulnerable to committing sexual offenses. Whether the offender's portrayal of the offense stems from pre-existing beliefs, is grounded in evidence accrued through biased data-collection strategies, or reflects a deliberate attempt to avoid perceived consequences, it still constitutes an absence of personal accountability for one's actions. Because denial stems from a combination of intentional deceit and distorted thinking, indirect approaches designed to analyze denial, rather than immediately eliminate it, are likely to be more effective. The recent development of a psychometrically sound measure of denial, the Facets of Sexual Offender Denial Scale (Schneider and Wright, 2001), holds promise for measuring within-treatment change and should improve methods of examining the relationship between denial and recidivism. 129 references