This article first reports the main results and conclusions from a study on 24 pedophile sex abusers in treatment in a Canadian specialized institution. The aims of this study were to better understand what motivates abusers to enter treatment as well as how they experience the treatment on a daily basis and consider it to be helpful. In investigating the dynamics of the treatment program, it appeared that the patients gave much care to the interpersonal aspects of the treatment, particularly with the therapists. These results are discussed using psychodynamic theories. Finally, the results are also discussed in the light of recent empirical findings in psychotherapy process research. It is suggested that the abuser is not a passive recipient of the therapist's technique but rather is proactive, having very often a different therapy agenda than the therapist.