Based in part on the assumption that sexual offenders lack the general capacity to empathize with others, improving empathy is considered a standard sex offender treatment procedure; however, studies that have used measures of generalized empathy have typically been unable to discriminate between sexual offenders and non-sexual offenders regarding general emphatic responses. On the other hand, studies that have used empathy measures that target either victims of sexual assault or the offender's own victims have reported differences between sexual offenders and non-offenders regarding empathy toward victims similar to those of the sexual offenders. This suggests that sex offenders disengage their emphatic feelings when their particular types of victims are involved. There are indications that sexual offenders have cognitive distortions regarding the harmful impact of their offending behaviors. The cognitive distortions in turn serve to protect the offender's sense of self-esteem in the face of their victimizing behaviors. Given this connection among empathy deficits, cognitive distortions, and self-esteem, this chapter emphasizes the importance for clinicians to acknowledge the function of offenders' clinging to cognitive distortions and resisting empathic responses to their victims. Treatment should maintain or strengthen the self-esteem of all participants in group therapy, which will provide a sanctuary of emotional security for abandoning cognitive distortions and becoming sensitized to the harms they have caused. 74 references