In this article, the authors discuss the pathways to sexual offenses, risk factors, treatment, and unique ethical challenges inherent in working with students who have a history of sexual offending behavior or exhibit risk factors for such behavior. We also address unique clinical competencies and knowledge and provide recommendations for clinicians who find themselves in a position of having to work with such students despite contraindications. Finally, we explore the consideration of implementing a systems approach to mitigate risks posed by a student with sexual behavior problems by way of the college or university's behavioral assessment or intervention team.