There is growing support surrounding what constitutes a successful treatment approach and that treatment for sexual offenders can reduce recidivism for some, yet there is still considerable debate concerning its real effectiveness. This chapter discusses the treatment approaches that have historically been used with sexual offenders, and how these can feed into future directions in work with this population. Earlier, the treatment of sexual offending focused on behavioural interventions, followed by the addition of the cognitive component of cognitive-behavioural treatment. The current perspective is that sexual offender treatment should be offered in a manner that considers the literature surrounding 'What Works' in offender rehabilitation. Newer approaches have been suggested which address some of the criticisms of the psychology of criminal conduct. In particular, the movement towards more positively oriented (as opposed to just risk management oriented) treatment approaches such as the Good Lives model, are encouraging and hold great potential.