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The purpose of this paper is to explore the views and experiences of probation staff working with individuals convicted of a sexual offence who have been prescribed medication to manage sexual arousal (MMSA).

Semi-structured interviews were utilised with a sample of probation staff (offender supervisors and managers, n=12), who supervise individuals convicted of a sexual offence, either in prison, or post-release in the community. Data were analysed using thematic analysis.

Two main themes emerged: barriers for probation staff and suspicious but hopeful. Theme 1 encapsulates factors that prevent probation staff from engaging with MMSA; theme 2 highlighted the samples’ uncertainty and mistrust of the use of medication as a potential tool for risk management and scepticism about individuals’ motivations, particularly in the community.

The main limitation of this study was the differing levels of knowledge the sample had about MMSA and their subsequent ability to discuss MMSA other than in a theoretical sense.

Practical implications include the need for further training for probation staff, improved collaboration between departments and ongoing support for staff to support the success of the MMSA intervention.

This study offers a novel perspective on MMSA – that of the probation staff supervising prisoners taking MMSA. This has not been explored before, and the findings and associated implications are of importance for the treatment and care of those convicted of sexual offences.

The main aim of this paper is to describe the content, structure and preliminary evaluation of a new Good Lives sexual offender treatment group (SOTG) for male mentally disordered offenders.

As evaluation and work on the SOTG is necessarily ongoing, case study descriptions of each patient who attended the SOTG and of their progress throughout SOTG are described.

Overall, the case study progress reports suggest that mentally disordered male patients made some notable progress on SOTG despite their differential and complex needs. In particular, attention to each patient's life goals and motivators appeared to play a key role in promoting treatment engagement. Furthermore, patients with lower intelligence quotient and/or indirect pathways required additional support to understand the links between the Good Lives Model (GLM) and their own risk for sexual offending.

Further evaluations of SOTG groups, that incorporate higher numbers of participants and adequate control groups, are required before solid conclusions and generalisations can be made.

Practitioners should consider providing additional support to clients when implementing any future SOTGs for mentally disordered patients.

This is the first paper to outline and describe implementation of the GLM in the sexual offender treatment of mentally disordered male patients group format. As such, it will be of interest to any professionals involved in the facilitation of sexual offender treatment within this population.

We are in the midst of a broad societal change in which women’s sexual problems are becoming increasingly medicalized, characterized as treatable medical conditions and defined and understood as a largely physiologically based disease, called “female sexual dysfunction” (FSD). When a condition is medicalized, a medical framework is used to understand it, and medical interventions are used to treat it. As part of this process, then, over the last several years, researchers and pharmaceutical companies have turned attention to developing medical treatments for FSD. As this medicalization continues to unfold with potentially important impacts, it is crucial that we understand the forces working to shape it.

The management of sexual offending is a major challenge, particularly in men who have an intellectual disability. Psychological therapies have been shown beneficial, and programmes designed for use in the general population have been adapted for use in offenders who have an intellectual disability. There is also a role for pharmacological management, although the quality of evidence for this is noticeably lacking, most likely associated with the ethical and legal issues encountered in conducting well designed and controlled trials in this area. The purpose of this paper is to look at the pharmacological management options available.

A literature search of electronic databases was undertaken. Additionally, the references lists for identified papers were examined for any further relevant publications.

The two main categories of drugs used in the management of inappropriate sexual behaviour are the testosterone-lowering drugs and the psychotropic drugs. Most trials were open and utilised self-report measures of drug effectiveness, limiting their usefulness. Most trials noted beneficial effect. Side effect profiles and patient adherence can limit the effectiveness of anti-libidinal medication in practice.

There is very limited evidence available for the use of pharmacological agents in the management of inappropriate sexual behaviour, owing to the lack of adequately controlled clinical trials. New studies are therefore required, particularly of larger sample sizes, longer durations, and examining characteristics of those who benefit from pharmacological treatment, although the ethical issues of conducting such studies is duly acknowledged.

Sex Offenders with a Major Mental Illness (SOMMI) are doubly stigmatized, as these individuals are members of two highly marginalized social groups (Guidry and Saleh, 2004). Within each of these groups SOMMI only represent a small minority. For professionals seeking to base their practice in empirical research this has led to a significant problem since the literature related specifically to this group is both limited and hard to locate. Additionally, intensity of psychological risk factors varies as a function of psychiatric decompensation for some SOMMI making it hard to apply certain procedures that work with ordinary sexual offenders. The purpose of this paper is to provide a review of the relevant literature and recommendations for clinical practice that are responsive to the particular challenges posed by this unusual group of sexual offenders.

The current paper provides a review of literature on risk factors for sexual recidivism and validity of current risk tools as it pertains to SOMMI. Recommendations for risk assessment with SOMMI are provided.

The static actuarial tools appear to be useful with SOMMI. However, risk assessments measuring dynamic risk factors have poorer predictive validity. Additional factors that will need to be considered involve a possible higher recidivism rate for SOMMI and a variable relationship between major mental illness and sex offending with it sometimes predisposing, sometimes exacerbating existing risk factors, and sometimes mitigating risk.

There is a paucity of research and guidance in assessment and risk management of SOMMI. The current paper is the first to thoroughly explore the efficacy of current sex offender risk assessment tools with SOMMI and provide structured guidance for making decisions about risk and risk management needs for this challenging population.

This case study illustrates the rehabilitation of a woman who suffered chronic sexual, physical and emotional abuse throughout childhood that resulted in 20 years of secure psychiatric care and a ‘psychopathic personality’ diagnosis. Rehabilitation used a survivor‐orientated approach to resolve symptoms of posttraumatic stress disorder, institutionalisation and a dysfunctional narrative.

This paper identifies considerations for managing the risks of abuse during intimate and personal care for people with learning disabilities and complex needs. Drawing on insights gleaned from research involving interviews with staff, policies and procedures in specialist day and residential services, and the development of a staff training resource, the paper identifies a framework for adult protection practice in this critical area of support.

Surveys of offender treatment programmes have revealed that practitioners delivering specialist programmes are often unaware of much of the theoretical and research literature behind the interventions they deliver. For practitioners working less routinely with offenders, such as forensic nurses, this problem is likely to be more acute. In this paper, we provide a general overview of the theoretical and research literature relevant to programmes targeting sexual and aggressive offending that should be of interest to a range of professionals working with offenders in different clinical settings.

The purpose of this paper is to describe and discuss interventions of stabilisation of emotions and behaviour in adults with post-traumatic stress disorder (PTSD). This topic is understudied in persons with intellectual disability.

The aim of this study was to investigate interventions of stabilisation in persons with more severe intellectual disability; i.e. persons with moderate or severe intellectual disabilities. Five patients in a specialised psychiatric inpatient unit for patients with intellectual disabilities were included. Information about treatment of the patients was collected through case files, observations, and interviews. The authors of this paper followed a training programme for trauma therapists in addition to the inpatient treatment of the five patients.

Six main areas of stabilisation of emotions and behaviour were identified: validation, anxiety relief, treatment of depressed mood, increased mastering of daily activities, protection against anxiety triggers, and facilitated staff communication. Protection from anxiety triggers seems to be a core element of milieu therapy interventions. Interventions for neurotypical PTSD patients, such as exposure therapy may be contraindicated for patients with more severe intellectual disabilities.

Research on interventions of stabilisation towards adults with more severe intellectual disabilities is still in its infancy. The case reports may help milieu therapists to facilitate interventions towards patients with moderate or severe intellectual disabilities.

A Viagra-inspired drug, flibanserin, was marketed to treat women’s hypoactive sexual desire disorder (HSDD). This paper aims to explore the value orientation of flibanserin as a treatment for female’s HSDD among different consumer segments.

Two surveys were run in the UK (Study 1, n = 223) and Israel (Study 2, n = 233), in which partnered heterosexual adults evaluated the value of the drug before and after being exposed to information on its side effects. Then, using content analysis of 36 online reviews among women who had tried the drug, the reported effectiveness and side effects were explored.

HSDD prevalence in both studies was about 50% (Study 1) and 66% (Study 2) (no gender differences in evaluations). All segments gave the drug less than neutral or negative value orientation ratings. Women did not relate low sexual desire to low levels of sexual thoughts that would increase flibanserin’s value orientation; however, men did. Information about flibanserin and its side effects decreased its value orientation for women, especially those with HSDD. The content analysis of user’s reviews showed most women reported side effects, said it was not effective and gave it a poor rating.

The results reveal the strategic problems in the marketing of the drug, both in its value orientation before and especially after exposure to information.

This research points to the necessity of evaluating the value orientation of flibanserin before marketing and satisfying the core expectations from the product (effectiveness and limited aversive side effects) among women with HSDD.