The bulk of the research does not support the popular view that psychopaths do not respond to treatment. Recent research indicates that at least some psychopaths may benefit from treatment interventions that are appropriately designed and delivered, such that their recidivism rates are reduced. The most effective treatments are intensive, lasting many months and involving the use of well-established cognitive-behavioral treatment principles, such as relapse prevention. Regarding psychopathic sex offenders, those with high scores on the Hare Psychopathy Checklist-Revised (PCL-R) have recidivated at higher rates than those with low PCL-R, regardless of treatment features. One of the criminogenic needs often associated with psychopathy as well as the risk of recidivism among sex offenders is substance abuse. Several authoritative reviews of the research concluded that there is an established relationship between psychopathy and substance-use disorders. This is especially true for alcohol abuse. Thus, sex offenders suffer from concurrent disorders, with the paraphilias (deviant sexual arousal) and substance-abuse disorders, particularly alcohol abuse, being two of the most frequently encountered in clinical practice. More research is needed on those risk factors for recidivism that are changeable in high-risk sexual offenders. In the Canadian context, most of these high-risk offenders are serving determinate sentences, meaning they will be released into the community; therefore, there should be a strong effort to develop research and treatment that will reduce the recidivism rate for these offenders. 111 references