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For the 3.8 per cent of people with intellectual disabilities (IDs) who have offended sexually, the main form of treatment is the group-based, cognitive-behavioural, adapted sex offender treatment programme (ASOTP) that focusses on challenging cognitive distortions condoning sex offending. The purpose of this paper is to provide an evaluation of how effective the ASOTP is at reducing ID sex offenders’ cognitive distortions.

Three databases were searched systematically: PsycINFO, MEDLINE and Web of Science. Six studies met the inclusion criteria, yielding 118 participants. Using a random-effects model, effect sizes were calculated using pre- and post-treatment scores on a measure of cognitive distortions. The standardised mean difference (SMD) was 1.77 (95 per cent CI: 1.06, 2.46), which was statistically significant (p<0.001) and “large”. Sensitivity analysis demonstrated that this SMD was robust, and a check for publication bias revealed that it was unlikely that the “file drawer problem” confounded the meta-analysis.

These results indicated that the ASOTP can significantly reduce ID sex offenders’ cognitive distortions, regardless of treatment length, IQ level, language abilities, or offence type. Consistent with earlier reports, longer treatment resulted in the greatest reductions: the optimum treatment length was 24 months.

The ASOTP’s current evidence is comprised wholly of case and quasi-experimental studies, none of which employed control groups. This paper highlights how there is a dire need for high-quality experimental evaluation of the ASOTP.

Clinicians are advised to continue using the ASOTP as the main treatment for ID sex offenders until the effectiveness of the ASOTP is further examined using randomised controlled trials.

This is the first meta-analytic review of the effectiveness of the ASOTP.

In 2006 the Brooklands' Adapted Sex Offender Treatment Programme (ASOTP) was adopted by Calderstones Partnership NHS Foundation Trust. To date, two groups of men (n = 10) have completed the programme and one group (n = 6) is currently in progress. This treatment model uses a cognitive behavioural framework and is a nurse‐led initiative, utilising trained ward staff. This paper discusses 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 purpose of this paper is to describe a study which investigated the diverse needs of multiple stakeholders in an adapted sex offender treatment programme (ASOTP) and then evaluated a pilot programme set up to respond to the identified needs efficiently and effectively. The paper reports on an innovative approach to delivering ASOTP in secure learning disability services. It aims to address many of the criticisms and concerns of conventional closed format programmes, particular in the climate of value for money and payment by results.

The multiple views of stakeholders were identified by means of questionnaires and semi‐structured interviews in order to ascertain the key issues necessitating change. Stakeholders included purchasers of Partnerships in Care Learning Disability Services (PiC LDS), referred clients, internal and external clinicians involved in their care, group facilitators and, in some cases, clients' families or advocates. A rolling format ASOTP (based on the content of the Prison and Probation Service ASOTP) was designed and piloted to address highlighted needs, including time frames for the commencement and completion of treatment.

Initial feedback obtained by means of structured interviews and discussions with all stakeholders has been positive. In particular, participants have shown an increase in motivation, knowledge, and, unexpectedly, enhanced levels of risk disclosure. Facilitators have reported increased satisfaction and decreased stress levels. These findings are tentative in light of the small numbers involved and the absence of a randomised control trial.

This study has a number of implications for future research in terms of improving treatment effectiveness by means of increasing knowledge retention and enhancing risk disclosure, as well as a reduction in facilitator burnout.

The programme was tailored to respond to individual treatment needs within a group setting whilst ensuring programme integrity and effective risk management within a forensic learning disability service.

Traditionally, services for people with learning disabilities (LD) and forensic needs are underdeveloped. This paper aims to describe the setting up of a tiered model of LD forensic service provision in Leicester, Leicestershire and Rutland, facilitated and driven by a core team of professionals who have the skills and expertise in this area.

With no dedicated funding, this team is virtual in nature and provides support for the community and in‐patient teams in the assessment and management of offenders with LD. A care pathway including a process map is included to represent a visual idea of the referral, assessment, intervention and disposal strategies across the four tiers of service delivery. The service has a unique partnership arrangement with the independent sector that allows for staff training in order to deliver quality outcomes. The virtual team can support patients with learning disabilities and forensic needs in the community and in‐patient settings, both by avoiding unnecessary in‐patient admissions and by improving the treatment outcomes of those discharged from in‐patient settings.

Further research is required to demonstrate the clinical and social outcomes for offenders with LD using the tiered model of care and care‐pathway.

The virtual team and the LD forensic care pathway were developed because of a gap in service that was identified as part of a mapping exercise and stakeholder discussion. In the current economic climate, additional resources to address this gap in service may not be readily available; therefore, an innovative way of addressing this gap in service was by developing a care pathway for use by community LD teams based on lean principles and evidence‐based medicine and the pooling of specialist skills to develop the virtual team to enable and support the implementation of the care pathway.

This is the second of two papers which aims to describe the development of a sex offender assessment and treatment service for men with intellectual disability (ID) within a community ID service. The first paper by McBrien et al. in 2010 described the mapping of need, the assessment methods and results.

This paper describes how decisions were made about whether or not to enrol 20 assessed men on group treatment and outlines the treatment group and outcomes.

None of the seven men who completed treatment had committed a further sexual offence at 12‐24 months follow‐up. Other outcomes are discussed including the outcomes for the men who did not start or complete treatment. The available measures are not sufficiently sophisticated to detect change in individuals.

This paper contributes to the literature that describes the assessment and treatment of men with an ID who have committed sexually harmful behaviours. It describes one community service's response to the complex needs of this client group.

This paper describes an innovative, multi‐modular group therapy programme based on cognitive‐behavioural principles and psycho‐education. It introduces participants to strategies and skills to assist with deficits such as poor social skills, low self‐esteem, poor emotional regulation and problematic inter‐personal relationships. The manual‐based format of this programme enables members to be introduced to working in a group, and enables facilitators to obtain qualitative information about group members to promote existing skills in future treatment programmes. The core deficit areas targeted by the programme are not by any means exclusive to individuals in in‐patient forensic learning disability settings, so the programme can be useful for clients with learning disability and offending behaviours who are resident in the community.

This paper aims to provide a commentary on the previous paper in this issue on “The development of a sex offender assessment and treatment service within a Community Learning Disability Team (the SHEALD project): part 2”.

The authors consider the nature of traditional service delivery for people with learning/intellectual disabilities and the potential that services have for the physical, emotional and sexual abuse of these vulnerable people.

The authors argue that effective community based treatment/support is best delivered in a way that acknowledges and employs the range of skills offered by practitioners from health and social care backgrounds.

Both SHEALD and HIST are examples of community treatment programmes which show that a person‐centred approach supported by a dedicated and consistent team of practitioners may be an effective way of addressing complex, high‐risk behaviours.