Len Sperry describes his book as a 'one-of-a-kind resource,' of interest to people concerned about the sexual issues facing the Catholic Church today. His goal is to provide information and guidance in a non-ideological fashion. He achieves this goal admirably and provides a well-written, practical, and critically informed resource.

This clearly organized work is divided into three parts. The first part contains a chapter which concisely defines fifty-some terms necessary to follow the discussion, e.g., sexuality, celibate intimacy, androgyny, ephebophilia. The second chapter presents an integrative model of psychosexual development which accounts for biological, psychological, social, religious and spiritual lines of development, and identifies seven predisposing factors which influence development. It is then illustrated through three case studies with a nice flow from theory to practice. The final chapter in Part I examines the relationships among sexuality, intimacy, and celibacy. His rich understanding of character dynamics informs his insights. He assumes that for priests the goal of the ongoing process of psychosexual development is the integration of sexuality, intimacy, and celibacy.

Part I focused on the dynamics of healthy psychosexual development. In Part II Sperry examines what goes wrong in this psychosexual development to result in clergy sexual misconduct. His comprehensive model of clergy misconduct involves four factors: the priest and his theology of ministry, the dynamics and culture of his religious organization or community, his ministry assignment, and the nature of his ministry relationships. The complexity of the interplay of these four factors demonstrates the inadequacy of attributing the cause of clergy sexual misconduct simply to moral failure on the part of the priest. With practical wisdom he identifies the important role of transference and counter-transference in ministry and recognizes that it is natural to encounter sexual reactions in self and others in the course of ministerial work.

In the rest of Part II Sperry explores some of the personality issues that contribute to sexual misconduct. He defines abusiveness, describes types of abusive behavior, and explains developmental factors in the abusive pattern. In elaborating three abuse patterns and linking these to recognized Axis II personality disorders, he aids clinicians doing assessment or treatment.

Along with abusiveness another key factor in many cases is narcissism. Sperry explores the psychological, spiritual, and sexual dynamics in the narcissistic personality. He notes that individuals with a narcissistic pattern are often attracted to ministry and that they can create great havoc in their ministries.

Sperry cites a need for a theoretical model to explain clergy sexual misconduct which could facilitate treatment and prevention. His "Vulnerability Model" of sexual misconduct sees it as a function of the degree of abusiveness and the degree of compulsivity exhibited by a priest. By articulating the different possible combinations of abusiveness and compulsivity he develops a typology of six types of priests who engage in sexual misconduct. His typologies are logical, plausible, informative and have excellent clinical utility.

In Part III Sperry applies his theoretical models to pressing issues in response to clerical sexual misconduct. His suggestions here are concrete and practical. The first issue is that of selecting suitable candidates for the priesthood. Sperry argues for the indispensability of a comprehensive psychological assessment, including a sexual history and evaluation of psychosexual development, conducted by a specially trained and experienced clinician. He identifies specific red flags — patterns indicative of sexual misconduct of minors, such as confused sexual orientation, childish interests, and lack of peer relationships.

The second pressing issue is that of homosexuality and the priesthood. The commitment to a non-ideological stance limits what Sperry is able to say in this chapter. He examines the context of the debate on this issue which involves ideology, science, and compassion. At this point in the debate he sees science and ideology as hopelessly intertwined. To disentangle them would require an atmosphere of mutual respect and compassion. He calls for these conditions to "be held up as criteria in moving what is now a clearly ideological debate in the direction of a scientifically informed debate, and perhaps, even one day, in the direction of a true dialogue." [p. 147]

Chapter 10 presents decisional criteria for removing priests from active ministry as well as decisions regarding fitness for ministry. On removal from ministry Sperry identifies six criteria which reflect the behavioral, biological, moral, and spiritual indicators that he has previously outlined. The guidelines for decisions are clinically sound, logical, reasonable and confront the hysteria which may have given rise to zero-tolerance guidelines. On fitness for ministry, Sperry considers four moral ideals: honesty, integrity, self-surrender, and transparency of character. Integrating these psychological variables with Christian ideals generates criteria for ministry fitness and unfitness. The author summarizes his guidelines in a table integrating knowledge of DSM IV patterns of relapse prevention and recidivism, co-morbidity, and spiritual/moral ideals.

Sperry closes by addressing the prevention of sexual misconduct. This chapter's positive and inspiring tone focuses on healing and wholeness. He defines primary, secondary, and tertiary prevention, noting that the last is most often initiated in crisis situations. He underscores the linkage between visionary leadership and the initiation of primary prevention. His definition of visionary leadership includes strategic planning and challenges the church to become visionary and proactive. He quotes the psalmist, "Without a vision, the people perish" and asks "What is the vision and mission of the American Catholic Church?" However, Sperry moves from this global level of analysis to more pragmatic prevention strategies, identifying eight strategies for the prevention of sexual misconduct. He closes his book with the admonition, "To truly change or prevent sexual misconduct and other forms of impairment requires that both individual and religious organization change."

Len Sperry is a gifted writer and teacher. His narrative is complemented by illuminating case studies and then summarized well in helpful charts and tables. He writes with sensitivity and compassion and offers hope in the midst of profound organizational challenges to the institutional Roman Catholic Church.