Bemidjiblade: from what I've seen, there is no "seeking help before acting out". If they have the inclination to the point they might act on it, they don't stop and go "oh... this is wrong. I should seek help". There's a disconnect in their brain, so that they don't REALIZE what they're doing is wrong...
During a BACA training, the nurse related a case where she dealt with the abuser (trying to figure out how an abuser's mind works). Guy had raped his 13 year-old babysitter. His "defense", when asked why, was "she FELT like a woman". His brain couldn't wrap around the idea that you don't get sexual with a 13 year old...
I look at cases like this the same I look at rabies: you destroy the animal in question to a)put them out of thier misery, and b)to protect society...