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The treatment of sexual offenders in prisons is still a controversial topic. Against this background, we carried out an evaluation of sexual offender treatment in seven social-therapeutic prisons and an umbrella review of meta-analyses. In the first part of our research, we investigated more than 1,200 individuals who were in prison for a sexual offence. Using Propensity Score Matching we compared individuals who received long-term therapy with a control group from regular prisons. The mean follow-up period was 9 years. There was a tendency of less frequent sexual recidivism in the treatment group, but due to the low base rate this was not significant. There were some significant effects and desirable tendencies in other outcome criteria (including less harm) and also differences due to the organizational climate and aftercare. The findings in our primary study are compared to the results of a recent umbrella review of meta-analyses. These showed significant mean effects, but they were clearly smaller than in the community. Implications for policy, practice and research will be discussed.