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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.
Experiences of implementing an Adapted Sex Offender Treatment Programme for people with learning disabilities in a secure setting
- Authors:
- MCNAIR Louisa C., WOODWARD Sarah C., MOUNT Pam A.
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 1(3), October 2010, pp.26-32.
- Publisher:
- Emerald
Calderstones Partnership NHS Foundation Trust is an inpatient learning disability medium and a secure services provider. In 2006, Calderstones adopted the Brooklands' Adapted Sex Offender Treatment Programme (ASOTP). This treatment model uses a cognitive behavioural framework and is a nurse-led initiative, utilising trained ward staff. Two groups commenced in 2006 with 13 men (dropping to 10); these lasted 2 years and 2 years 4 months respectively. A third group commenced in 2009 with 8 men (dropping to 6). This paper discusses their experiences of initiating and delivering the ASOTP programme. Several issues were encountered, including staff retention, clients discontinuing the group, the length of the group, the length of wait for clients to commence their treatment and high levels of administration. As a result of these, and developments to the Brooklands' model, several changes were made before the commencement of the second wave in 2008. The paper discusses how the ASOTP were able to overcome some, but not all, of the initial difficulties and highlights potential pitfalls for future groups.
The adaptation of a cognitive-behavioural treatment programme for special needs sexual offenders
- Authors:
- KEELING Jenny A., ROSE John L.
- Journal article citation:
- British Journal of Learning Disabilities, 34(2), June 2006, pp.110-116.
- Publisher:
- Wiley
This article describes the process of adapting an existing sexual offender treatment programme for use with sexual offenders who have special needs in an Australian correctional setting. The population comprised individuals with a variety of special needs including borderline or mild intellectual functioning, severe literacy problems, significant communication difficulties, and other important deficits and special needs. It should be noted that some of these special needs individuals would not meet the diagnostic criteria for intellectual disability and this programme is aimed at the broader group inclusive of a number of special needs. Therapeutic adaptations have been guided by current research and practice, and specific examples are described and discussed. The authors believe that these adaptations may also have some utility for mainstream sexual offender treatment programmes. Research into the efficacy of these treatment adaptations with this population is currently underway.
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.
Cognitive-behavioural treatment for men with intellectual disabilities and sexually abusive behaviour: a pilot study
- Authors:
- MURPHY Glynis, et al
- Journal article citation:
- Journal of Intellectual Disability Research, 51(11), November 2007, pp.902-912.
- Publisher:
- Wiley
A pilot study providing group cognitive behavioural therapy (CBT) for two groups of male sex offenders with ID in the south-east of England is described. Measures of change in sexual knowledge, victim empathy and cognitive distortions were collected, together with a log of further sexually abusive behaviour. Fifteen men were offered treatment but some dropped out and some declined to take part in the research. The results for the eight men who consented to the research and completed treatment showed significant positive changes in sexual knowledge and victim empathy (two men completed both groups, making 10 sets of data in all). Cognitive distortions showed significant change on only one of the two measures. Some men showed further sexually abusive behaviour either during or after the treatment group (all had been previously diagnosed as on the autistic spectrum). The authors call for a larger multi-site trial of treatment with a broad set of measures and the ability to analyse who benefits from such treatments and who does not.
Group treatment for men with intellectual disability and sexually abusive behaviour: service user views
- Authors:
- HAYS Sarah-Jane, et al
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 32(2), June 2007, pp.106-116.
- Publisher:
- Taylor and Francis
Men with intellectual disability (ID) and sexually abusive behaviour are a disempowered and marginalised group. Nevertheless, as service users, they can be consulted and involved in a variety of different ways, including ascertaining their views of the services they receive. A group of 16 men with ID and sexually abusive behaviour were interviewed to ascertain their views approximately 2 months after completing a 1-year group cognitive behavioural treatment (CBT) for sexual offending. Two raters independently reviewed interview transcripts and participant responses were summarised. The most salient components of treatment recalled by participants were: sex education; legal and illegal behaviours and their consequences; and discussions about specific sexual assaults. Only 3 of the 16 participants stated that they had problems with sexual offending, and only 1 identified that he had learnt about victim empathy, although this is an important component of treatment. Having support, the knowledge that they had the same problems as other group members, and talking through problems, were appreciated as some of the "best things" about the group, while the "worst things" were generally person-specific. Participants had mixed views on talking about their own offences during group sessions and, overall, viewed the experience as difficult but helpful. Valuable insights into the aspects of treatment that group members found useful were explored. Such insights are often not captured by studies that assess the efficacy of treatment models using treatment-specific measures only, and these are important in defining the quality of services provided.
Project STOP: cognitive behavioral assessment and treatment for sex offenders with intellectual disability
- Authors:
- NEZU Christine Maguth, GREENBERG Jeffrey, NEZU Arthur M.
- Journal article citation:
- Journal of Forensic Psychology Practice, 6(3), 2006, pp.87-103.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
This article provides relevant background concerning the prevalence, characteristics and vulnerabilities of intellectually disabled (ID) sex offenders, as well as scientifically-informed guidelines for assessment and treatment. Specifically, the authors suggest assessment methods concerning the various areas of vulnerability associated with sex offending risk, with emphasis on dynamic or changeable areas of vulnerability. Treatment guidelines are consistent with an individualized case formulation approach aimed at changing each individual's unique area of vulnerability. They provide a description of Project STOP, as a case example of these principles. A program evaluation of this project revealed a low rate of recidivism and a high degree of treatment adherence. Finally, the authors propose which elements of the case formulation approach appear to be associated with successful outcome. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Comparing offenders against women and offenders against children on treatment outcome in offenders with intellectual disability
- Authors:
- LINDSAY William R., et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 24(4), July 2011, pp.361-369.
- Publisher:
- Wiley
The most significant developments in the field of sex offender treatment have been based on problem solving and Cognitive Behaviour Therapy techniques. Several studies have shown the positive effects of sex offender treatment for men with intellectual disabilities who have perpetrated sex offences. The aim of this study was to provide a comparison of the process of treatment change amongst men with intellectual disabilities who have offended either against adult women or against children. The participants comprised of 15 men who had offended against adult women and 15 who offended against children. All were treated for 36 months and had at least 2 years follow-up after the treatment to determine the rate of reoffending. Groups were compared with repeated measures using the Questionnaire on Attitudes Consistent with Sexual Offending. The findings showed that at baseline the offenders against women had higher scores than the offenders against children on the rape scale. Both groups showed significant improvement with scores reducing to levels consistent with non-offenders by 36 months. Significant improvements were recorded from 18 to 36 months of treatment. Re-offending across both groups was 23%. The article concludes that sex offender treatment can produce significant reductions in cognitive distortions in sex offenders with intellectual disabilities. The findings also demonstrate the importance of continuing treatment for longer than 12 months.
Is the Good Lives Model of offender treatment relevant to sex offenders with a learning disability?
- Author:
- AUST Sarah
- Journal article citation:
- Journal of Learning Disabilities and Offending Behaviour, 1(3), October 2010, pp.33-39.
- Publisher:
- Emerald
The Good Lives Model is a treatment model that was developed for use with mainstream offenders in prison, it aims to reduce the risk of re-offending and to help offenders to have a more fulfilling life. This article explores the use of the Good Lives Model and its relevance to people with a learning disability and forensic needs. The article presents the rationale for using the model; arguing that it has the potential to address the complexities of meeting both the person-centred agenda in learning disabilities services and the public protection agenda in relation to the management of mentally disordered offenders, including those detained under the Mental Health Act (2007). The model is compared with other treatment models, such as the Risk-Need-Responsivity Model (RNR). The paper briefly explores how the model may be practically applied in a service for people with learning disabilities who have committed, or who are at risk of committing, sexual offences.