For years, the Catholic Church has quietly sent priests accused of sexual transgressions to psychiatric centers for treatment, many of them affiliated with the church.
Dr. Leslie Lothstein has treated more than 300 Catholic priests at one of those centers, the Institute of Living in Hartford, Conn. (The institute no longer has an official relationship with the church.)
Lothstein, who is not Catholic himself, says many of his patients have sexual problems. And he says the church does not always follow psychologists' directives about patients who are treated.
"My experience was that if it was said to one of the clergy who was in charge ... that this person needs to have much more supervision, they would say, 'Oh yes, yes, it'll be there, they'll have supervision,' " Lothstein tells NPR's Michele Norris. "But then what happened was they went back to their normal, everyday work. And in going back to it, we learned much later that they didn't have the supervision."
Lothstein says there's a "universal feeling" that if a priest has had sexual activity with a child, he should not be around children. But, he says, it didn't always work out that way.
"In my experience, there were some people who were sent right back to working in youth ministries, and they often offended," he says. "There was also a subgroup of people that I saw in my private practice where they were sent back by their religious order to a foreign country, and within that country continued to molest children. And it was just horrible."
One of the biggest challenges in treating priests, Lothstein says, is that they don't have the same kind of sexual experiences -- or history of talking about such experiences -- that an ordinary adult may have.
"Many of the priests tend to be psychosexually immature," he says. "They've never taken a course in healthy sexuality."
He says some of them have gone into minor seminary at age 14 and developed "a sense of self without having appropriate lines of dating, meeting other people, experimenting with touch, kissing, ordinary sexuality."
And Lothstein says the Catholic Church has a real challenge ahead: To heal, it must be transparent, honest and sincere.
"And I think that's what the public wants in every situation, whether it's local or international."