Effectiveness of group cognitive behavioural treatment for men with intellectual disabilities at risk of sexual offending

Background: For non-disabled men, group cognitive-behaviour therapy is a successful form of treatment when men have committed sexual offences. However, men with intellectual disabilities and sexually abusive behaviour are rarely offered treatment for their sexual behaviour and little research data on the effectiveness of such treatment has been collected.

Method: Nine collaborating sites ran 13, 1-year long cognitive-behavioural treatment groups for men with intellectual disabilities and sexually abusive behaviour. The men came from both community and secure provision and were assessed for sexual knowledge, victim empathy and cognitive distortions before and after the group treatment. Treatment was guided by a common treatment manual.

Results: Forty-six men consented to take part in the research. Most men (83%) had engaged in more than one incident of sexually abusive behaviour but only 57% of the men who came for treatment were required by law to attend. Almost all the men (92%) who began treatment (and consented to take part in the research) completed treatment 1 year later, indicating considerable motivation amongst the men to get treatment for their difficulties. Over the period of treatment, the men showed statistically significant increases in sexual knowledge and victim empathy, as well as reductions in cognitive distortions. These changes were still significant at 6-month follow-up for sexual knowledge and cognitive distortions. Few men showed further sexually abusive behaviour during the 1-year period when they were attending treatment (three men) or during the 6-month follow-up period (four men). Only the presence of autistic spectrum disorders appeared to be related to re-offending (though this result should be treated with caution, given the small numbers who re-offended).

Conclusions: This large treatment trial provides some evidence of the effectiveness of such treatment for men with intellectual disabilities but there remains a need for a longer follow-up period and a randomized controlled trial