The red brick building in Silver Spring is set amid acres of wooded land. A sign near the front door with its name -- St. Luke Institute -- is inconspicuous to passersby on the street. Keeping a low profile is important, because most of the 70 residents are troubled Roman Catholic priests, a quarter of them accused of molesting children.
Founded in 1981 by a priest-psychiatrist who later died of AIDS, St. Luke is one of a handful of church-sponsored treatment programs across the country that U.S. bishops have turned to for assistance in dealing with priests who abuse children. In some instances, court records have revealed, priests accused of abuse were sent periodically to these treatment centers and then returned to ministry.
As the Catholic Church staggers under the scandal of bishops covering up for pedophile priests, St. Luke and places like it are facing new scrutiny. Critics question whether such centers have been lenient in their recommendations on a priest's future, whether they have the independence to honestly advise bishops and whether they have contributed to the climate of secrecy that has pervaded the church's handling of pedophiles.
"I guess it reminds me of Enron," said Robert J. McAllister, associate medical director of Taylor Manor Hospital, a psychiatric hospital in Ellicott City. Like the bankrupt energy company with too-cozy accountants, the church is "sort of doing their own evaluations [of priests], and I think they do it partly for the benefit of the secrecy," he said.
St. Luke's medical staff, which includes non-Catholics, uses therapies common in secular programs for sexual disorders. But the institute, named for the patron saint of healing, also is infused with Catholic spiritual ideals, including a belief in the possibility of rehabilitation -- even for some child abusers.
The very notion that some abusive priests can change their behavior is at odds with calls from many rank-and-file Catholics for bishops to adopt a "one strike and you're out" rule at their meeting next month in Dallas -- a policy that would remove priests from ministry after a single incident of child molestation.
St. Luke "has a good staff and bases its treatment on a solid medical model," said A.W. Richard Sipe, a former priest and California psychologist who has treated priests with sexual disorders. "The difficulty comes in making any prediction about future lapses," he said. Although the institute's staff is "more cautious now," Sipe said, "in the past they were . . . much more hopeful about the outcome of treatment than they are today."
Such criticisms are rejected by the Rev. Stephen J. Rossetti, St. Luke's president and chief executive. "We are closely tied to the church," said Rossetti, a psychologist. "At the same time, we are a free-standing organization, and the bishops expect us to tell them the truth. And we do."
Rossetti said that of 121 priests treated at St. Luke for child molestation since 1997, only three are known to have offended again. That rate, he added, is similar to earlier surveys of priests treated there.
After treatment, the institute indicates to the priest's bishop "how much of a risk this person is," Rossetti said. Its recommendations typically include suggestions for continued supervision and therapy and a stipulation of "no unsupervised contact with minors," he added. "It's up to the church to decide whether or not he goes back to ministry."
Luisa M. Saffiotti, a psychologist in private practice in the District, worked at St. Luke until 1996. "My experience with them was overwhelmingly that the clinical teams . . . bent over backwards to be cautious," she said. Most staffers, she added, "are parents themselves, and there is great sensitivity that we need to protect children."
Rossetti did not discuss how often bishops have heeded St. Luke's recommendations. But in at least one high-profile case, they did not.
Former priest John Geoghan, who was accused of molesting about 130 children in the Archdiocese of Boston, was a patient at St. Luke in 1989 and 1995. In 1989, according to media reports based on Massachusetts court papers, the institute determined that Geoghan was a "homosexual pedophile" at high risk of committing further abuse. Nevertheless, he was returned to parish work, and he molested again. He was sentenced in March to serve nine to 10 years in prison.
Michael R. Peterson, a psychiatrist who converted to Catholicism and became a priest, founded St. Luke to help alcoholic priests. It later began treating child abusers and then added programs to help nuns.
Today, at any one time, about 25 percent of its residents are being treated for molesting minors. The rest are there because of a variety of other ills, including other sexual disorders, depression, alcoholism, overeating, prescription drug addiction and spending compulsions. Two-thirds of its clients are men, and the average stay is four to seven months.
On a recent tour of the facility, Rossetti was at pains to point out that it is not a prison, but also not a place where priests can hide from the law. "The front doors are unlocked -- people can walk out," said the former Air Force intelligence officer who has worked in the field of sex abuse for a dozen years, most of them at St. Luke.
At the same time, if an arrest warrant is issued for a resident, "we will turn them in within hours," he said. "We just couldn't get away with harboring criminals."
Although St. Luke's 70 beds were occupied that day, an eerie quiet filled the building, because most residents were in supervised activities. Doors to their empty bedrooms were ajar. In one, a teddy bear sat alone on a chair. In the chapel, a modernistic sculpture of Christ in the process of resurrecting -- still looking beaten down and suffering -- hangs over the altar.
Bishops send accused priests to the facility for week-long psychological evaluations to determine the nature of their problems and the type of treatment needed. Both the priest and his bishop are given copies of the final report, Rossetti said.
If further treatment is recommended, priests who have abused minors are put through a months-long residential program whose first goal is to bring down the wall of denial commonly built by such perpetrators, Rossetti said. "This is not summer camp," he added. "Our society fosters a victim mentality. That doesn't work here. You need to . . . take responsibility. This is a place of truth-telling."
The program also includes cognitive behavioral and psychodynamic, or talk, therapy, Rossetti said. "A minority" of abusers, he said, are given Depo-Provera to lower their sexual drive. Clients also have art and drama therapy, and those with compulsive sexual addictions are placed in 12-step programs.
An important aspect in treating child abusers, Rossetti added, is forcing them to acknowledge the pain and trauma they inflict on their victims. "They have to realize the harm they are causing," he said. "If they don't, they are not going to get better."
St. Luke also operates as a halfway house for those who complete the program.
The facility gets most of its $6.1 million annual operating budget from dioceses, which pay rates of $120 to $350 per day for their priests, depending on which program they are in. The Washington Archdiocese declined to say how much it has paid the institute for its priests' treatment in recent years.
Rossetti makes a distinction between pedophiles, who molest prepubescent children, and ephebophiles, who are sexually attracted to teenagers. In general, he said, ephebophiles are more likely to be treated successfully and less likely to re-offend. Sipe, the California psychologist, said he also has found that to be true.
But other experts in sexual disorders disagreed.
"I think there are differences of opinion on that," said Frederick S. Berlin, founder of the Sexual Disorders Clinic at Baltimore's Johns Hopkins Hospital, explaining that he had not found ephebophiles more treatable than pedophiles.
But he agrees with Rossetti that some priests who have committed abuse can be returned to a restricted ministry under close supervision. "I'm not going to tell the church what its policies should be," he said, but "clinically, I've seen that to be the case."
From the standpoint of community safety, Berlin added, "you can make a case that the church may be able to do more" by keeping such priests under church supervision than by letting them loose in society.
Rossetti, who is a consultant to the U.S. Conference of Catholic Bishops on the issue of child sex abuse, contends that a "one strike and you're out" rule would unfairly punish priests who successfully change their behavior through treatment and who accept supervision while working in jobs that do not involve children.
He also acknowledged that such a rule could have an impact on St. Luke, because priests headed for dismissal may not be inclined to enroll in its programs.
Rossetti said he sees no conflict between his spiritual commitment, including a belief in rehabilitation, and therapeutic realities.
"Any good therapist has hope for his clients," he said. "If you don't have hope, you can't expect the clients to have hope. . . . At the same time, we have to be realistic about what we can and cannot do. The fact is that we regularly discharge people who basically are not making progress."
Staff writer David S. Fallis and staff researcher Bobbye Pratt contributed to this report.