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Simons stated that the important distinction for treatment practitioners to make among sex offenders is to determine whether or not they are pedophilic or nonpedophilic (2015). Pedophilic offenders have a preference for sex with children. Nonpedophilic offenders do not prefer children, although they may offend against them. Some abusers that have sexually violated children are not pedophilic, while some abusers that have assaulted adults are pedophilic. The distinction is not necessarily based on the offense, but rather the preference of the offender and the fixation of the offender.

Pedophillic offenders often attempt to develop and maintain relationships with children in an effort to exploit those children sexually. Offenders that abuse females self-report twice as many as victims as same-sex offenders. Offenders that abuse either gender report the highest number of victims, and also have the highest rates of re-offense. Nonpedophillic offenders are often rapists. Their motives include power-reassurance, vengeance, and sadistic pleasure. Unlike many pedophillics, they are not fixated on the sexual act per se, but rather, the dominance, retaliation, or brutality involved in their sexual violations.

The distinctions between the fixations, behaviors, and victim choices of pedophilic versus nonpedophillic offenders is critical when devising treatment plans and assessing the potential for re-offense. Because the underlying motives and pathologies of both types of offenders is very different, treatment plans should not be the same for both type of offenders.   

Although the underlying pathologies of both types of offenders is complex, research shows that pedophillics report more experiences of sexual violation in their own youth than nonpedophillic rapists do, therefore, dealing with the traumas associated with their own abusive past may increase empathy for victims, and has been shown to decrease likelihood of re-offense. Rapists, however, report higher rates of physical violence and emotional violence in their childhoods. Treatment for these individuals should include learning how to use anger productively and coping with explosive feelings.

Of course, treatment for every type of sex offender should be multifaceted. Challenges for all offenders include levels of motivation to change, underlying physical and mental pathologies, varying degrees of intelligence, and psychopathy for some offenders. While some generalizations can be made about treatment differences for pedophillic versus nonpedophillic offenders, all treatment should be both generalized to the typology of offender, but then specialized to the individual and his or her own specific treatment needs.