The results counter the current typical clinical approach of treatment programs for sexual behavior problems (SBP) found in a Safer Society 2002 Survey that included practice elements originally designed for adolescents or adult sexual behavior offenders: child components of relapse prevention, assault cycle, and arousal reconditioning. Despite the popularity of these treatments, only two of the tested treatments included these practice elements, and the elements were not significant predictors of the effect size for SBP; including these elements did not seem to increase SBP reduction, and the estimated effect size was negative for the Child Behavior Checklists (CBCL). The results emphasize that the primary agent of change for SBP appears to be the parent or caregiver. Treatments for SBP which do not include caregiver involvement are not supported by these results. Further, the results questioned current practices of treating children with SBP as the primary problem in inpatient or residential care facilities without significant caregiver involvement during treatment or aftercare. The Parenting/Behavior Management Skills was by far the practice element most strongly associated with reduced SBP. Examining Behavior Parent Training (BPT) approaches as a treatment for SBP appears to be an important next step in SBP treatment. Data were collected in a search of treatment outcome studies conducted for inclusion in the meta-analysis. This study and treatments had to have the following predetermined criteria of inclusion: outpatient treatment, treatment for children, treatment of sexual behavior problems either as a primary or secondary target, access to detailed description of treatments, evaluation and treatment outcomes, published study providing pre and post or difference means and standard deviations on a measure of SBP, and research provided in English or French. Tables, notes, references