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Integrating treatment for offenders with an intellectual disability and personality disorder
- Authors:
- TAYLOR Jon, MORRISSEY Catrin
- Journal article citation:
- British Journal of Forensic Practice, 14(4), 2012, pp.302-315.
- Publisher:
- Emerald
The authors provide an overview of the rationale for appropriate treatment for offenders with personality disorder co-morbid with intellectual disability (ID). They also describe a specific approach to treatment which has drawn upon this evidence. The relevance and validity of the construct of personality disorder in intellectual disability is reviewed. Evidence from treatment of personality disorder in mainstream populations is then summarised. A treatment pathway used in a large high-secure hospital catering for high–risk male offenders with ID in central England is described. This integrates adapted cognitive behavioural programmes with a social milieu approach adapted for those with mild ID. It is argued that this treatment model addresses the criminogenic, psychological and social needs of those with personality disorder and intellectual disability.
Treatment of erotomania using cognitive behavioural psychotherapy approaches
- Author:
- HURLEY Anne Desnoyers
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(2), 2012, pp.76-81.
- Publisher:
- Emerald
Erotomania is a delusional disorder in which the person believes that another loves him or her although there has been no evidence to encourage this belief. Erotomania is a rare disorder that occurs in people with intellectual disability and can last for many years. The cause of erotomania is believed to be loneliness as it occurs most frequently in socially isolated people. This article presents a case report illustrating successful treatment of a woman with erotomania and intellectual disability. Pharmacotherapy assessment suggested its ineffectiveness and medicines were slowly reduced and discontinued. Cognitive behavioural psychotherapy provided a venue to discuss personal issues and work on solutions. The community support system was enlisted to approach the problem using 2 main psychotherapeutic strategies: eliminating social attention for the delusion; and increasing social relationships. This treatment resulted in great improvement, and within 3 years the individual returned to previous functioning with no symptoms of the delusional disorder.
Treating sexual offenders with intellectual limitations in the community
- Authors:
- CRAIG Leam A., STRINGER Ian, SANDERS Cheryl E.
- Journal article citation:
- British Journal of Forensic Practice, 14(1), 2012, pp.5-20.
- Publisher:
- Emerald
The aim of this study was to evaluate a community-based cognitive-behavioural treatment group for sexual offenders with intellectual limitations. All participants (n=14, mean age 35 years, IQ range 67-79) were convicted sex offenders serving probation orders or prison licences in the UK who attended a 14-month treatment programme designed specifically for sex offenders with intellectual limitations. The programme had five main components: sex education; cognitive distortions; offending cycle; victim empathy; and relapse prevention. All participants completed appropriate psychometric measures before and immediately after completing the programme. The four core measures include: Victim Empathy; Sexual Attitudes and Knowledge Assessment (SAK); Questionnaire on Attitudes Consistent with Sexual Offenders (QACSO); and Sex Offences Self-Appraisal Scale (SOSAS). The results reveal significant improvements in sexual offence related attitudes; reductions in attitudes relating to cognitive distortions and pro-sexual assault beliefs; and significant improvements in victim empathy. The authors note that although there have been no reconvictions in the group for committing new sexual offences, a follow up of only 12 months means that it is not possible to conclude that this intervention reduced the risk of sexual recidivism. The results support the development of specifically designed assessments and treatment manuals for sex offenders with intellectual limitations rather than adapting other programmes.
Utilising behavioural family therapy (BFT) to help support the system around a person with intellectual disability and complex mental health needs: a case study
- Authors:
- MARSHALL Keith, FERRIS Jan
- Journal article citation:
- Journal of Intellectual Disabilities, 16(2), June 2012, pp.109-118.
- Publisher:
- Sage
- Place of publication:
- London
Family members and staff who provide support to people with intellectual disabilities with mental health difficulties are more likely to experience increased stress. Previous research has demonstrated that psycho-educational family interventions have a positive impact on the person with mental health difficulties and on the family members who support them. This article uses a case study to illustrate the implementation of a family intervention with the support system around ‘George’, a 45 year old man with mild intellectual disabilities and diagnoses of schizophrenia and autism. Following behavioural family therapy, which encourages service users to take the lead in discussions about how their illness affects them and their family, the family members reported a decrease in levels of strain. Both the family and team members reported improvement in functioning within the support system. The authors concluded that the family based intervention was a cost-effective way of building resilience and reducing stress.
A treatment component designed to enhance empathy in sex offenders with an intellectual disability
- Authors:
- MICHIE Amanda M., LINDSAY William R.
- Journal article citation:
- British Journal of Forensic Practice, 14(1), 2012, pp.40-48.
- Publisher:
- Emerald
The authors describe the introduction of a component designed to enhance empathy into an established cognitive behavioural treatment program for sexual offenders with an intellectual disability. The treatment group (n=10, mean age 36.4 years, average IQ 65.8) received an empathy component and was compared with a control group. The study employed a cognitive behaviour approach in a group setting. The empathy enhancing treatment consisted of six sessions over eight weeks aiming to expose participants to the cognitive, emotional and behavioural experiences of victims. Therapeutic efficacy was assessed pre- and post-treatment and at 3, 6 and 9-month follow-up using the interpersonal reactivity index which assesses fantasy, perspective taking, empathic concern, and personal distress experienced due to others' misfortune. There were no significant differences between treatment and control groups at baseline. For the treatment group, significant differences were identified between pre, post and three-month follow-up assessments indicating an increased empathy at post-treatment assessment. The treatment group had significantly improved over the controls. The authors conclude that empathy responses can be included in a programme for sex offenders with ID however they point to a number of limitations of the study. Increased empathetic responses may improve self-regulation.
A sex offender treatment group for men with intellectual disabilities in a community setting
- Authors:
- ROSE John, et al
- Journal article citation:
- British Journal of Forensic Practice, 14(1), 2012, pp.21-28.
- Publisher:
- Emerald
This paper describes the development and initial evaluation of a sex offender treatment programme adapted for individuals with relatively severe intellectual disability in a community setting all of whom had no compulsion to attend. The aim was to motivate men with intellectual disability who had been involved in sexually inappropriate behaviour but may not have been charged to attend a fairly lengthy adapted community groupwork programme. The group was based on a cognitive behavioural model. So far the group has been run on two occasions and preliminary data on outcomes are discussed. Participants (n=12, average age 39.5 years) showed a reduction in attitudes consistent with offending, an increase in sexual knowledge, and a more external locus of control on completion of the group. One of the 12 men who attended was recorded as offending again within 18 months of group completion but three were able to move to less well supervised placements. The authors conclude that this style of treatment has some advantages over other models and may be more effective, but further research is required.