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Sex offenders who refuse a place on a sex offender treatment programme are estimated to make up about half the prison sex offender population in England and Wales. It is important to motivate refusers to participate in treatment to reduce the likelihood of their re‐offending. In this pilot study we used the Personal Concerns Inventory‐Offender Adaptation (PCI‐OA), a semi‐structured motivational assessment, further adapting it for treatment refusers. We examined the effectiveness of the PCI‐OA (TR) with nine prisoners who had refused sex offender treatment (the treatment group) compared with nine refusers who received no intervention (the control group). The treatment group were at least 0.6 times as likely to show a positive motivational shift towards sex offender treatment as the untreated group. The practice implications of these results are discussed, and further evaluation of the PCI‐OA (TR) is recommended.

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.

The role of the learning disability (LD) nurse has developed and expanded significantly within recent years, especially their responsibility for delivering a variety of specialist treatment programmes. The purpose of this paper is to discuss the facilitation of Sex Offender Treatment Programmes (SOTP) and the issues this raises in providing support for LD nurses.

This is an opinion paper and the views and opinions expressed are solely those of the author and do not necessarily reflect the views of any organisation or group with which the author is affiliated. The aims of this paper are: first, to explore the support needs of the LD nurse facilitators of SOTPs; second, to consider the practical implications of providing clinical supervision and support for LD nurse facilitators of SOTPs; and third, to highlight the need for further research in this area.

This paper does not contain original research findings but offers a discussion of the support needs of the LD nurse who facilitate SOTP, concentrating on the specific themes of training, clinical supervision and support.

Implications for clinical practice are identified and recommendations for further research are made.

Whilst this is not the first consideration of the support needs of facilitators of SOTPs, it offers a contribution to the discussion of how best to support the LD nurse to continue to deliver the high quality, specialist care for people with learning disabilities.

The topic of offender rehabilitation has been subject to much research over the past decade. Numerous meta‐analytic reviews of offender treatment, particularly group treatment based on cognitive behavioural principles, have been reported. Together with the ‘triad of principles’ — risk, need and responsivity — they have formed the foundation upon which most offending behaviour interventions have developed. However, outcome data from existing programmes provides mixed evidence, and evidence for interventions for those in forensic mental health settings are still in their infancy. This paper critically considers the current evidence for the treatment of offending behaviour, and its application in forensic mental health settings, in order to inform development of such treatments in low secure mental health care. Most of the research focuses on non‐mental health settings, and is largely what will be considered here. The paper concludes that low secure interventions need to capitalise on the evidence of ‘what works’ while revisiting key concepts such as ‘dose’ and responsivity in order to design appropriate treatments. Individual outcome evaluation needs to form part of development in this area.

The purpose of this paper is to examine the degree to which a US prison-based sexual offender treatment program adheres to the best practice responsivity principle and to shed light on why prison-based programs tend to have worse recidivism outcomes than community programs. Results will facilitate program development efforts as they transition from programming developed prior to the risk-needs-responsivity knowledge about what works in treatment.

A mix of qualitative and quantitative methods assessed treatment methods, therapeutic climate, group therapy environment, therapist style, and staff and participants’ perceptions.

Overall, the analyses revealed insufficient adherence to the responsivity principle. The program used methods known to be effective with sexual offenders, but with deficient implementation. In group therapy sessions, therapeutic style deficiencies were demonstrated for stimulating growth, nurturance, and direction and control. Treatment program advancement was associated with group environment declines in cohesion, leader support, expressiveness, independence, and task orientation.

Results suggest that improved treatment response can be achieved by modifying methods and style to foster participant internal control, eliminate unnecessary external control and fear-based compliance, maximize participant autonomy; implement strengths-based approaches and fewer deficit-based interventions; monitor and minimize participant shame, and create a transparent and consistent program milieu, with clear communication, individualization, and adequate resources. Study limitations include a lack of recidivism outcomes; that it is a single prison sample, excludes female and juvenile offenders, and lacks a community-based control group. Nonetheless, despite inherent responsivity vulnerabilities compared to community-based programs, this study indicates several ways that program developers can enhance adherence to the responsivity principle in institutional-based programs.

This paper aims to review the clinical approach adopted in prison-based therapeutic communities (TCs) for working with residents who have committed sexual offences. It reviews recent research and practice developments and explores the implications for TCs.

This paper describes a “think tank” review process which explores and reviews practice. This paper discusses the current approach adopted by TCs when working with those who have sexually offended and explores changes in clinical approach which could be considered in the light of current developments.

This paper explores the implications for TCs of the recent research and wider practice developments in interventions for those who have sexually offended.

This paper presents clinical options for working with those who deny their offence and undertaking victim empathy and offence disclosure work. It makes recommendations regarding staff training and support. It also discusses the strengths of the TC approach and how these can be built upon.

This paper makes recommendations concerning how practice could be improved which promotes safety and public protection and enhances resident well-being.

There has been no recent review of TC clinical practice for working with those who have sexually offended.

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.

The purpose of this paper is to report on an inpatient cognitive behavioural sex offender treatment group programme developed and provided to people with intellectual disabilities detained in medium and low security hospital settings. The programme was delivered five times between 2012 and 2020. This paper describes the integration of the programme within a wider treatment pathway model and provides analysis of outcome data.

The programme was evaluated over five group programmes using self-report psychometric measures related to treatment targets in the reduction of sexual offending risk, including cognitive distortions, sexual attitudes and knowledge and locus of control; recidivism data spanning up to 7 years post discharge is also provided. The treatment pathway and a description of the programme are provided.

The results of this paper showed improvements in sexual knowledge, cognitive distortions and locus of control, however not to a statistically significant degree. No recidivism was observed in the follow-up period.

This paper adds to the evidence base of interventions focused on cognitive behavioural approaches to the treatment and risk reduction of sexual offending in men with intellectual disabilities and adds to the debate regarding the effectiveness of such programmes with offenders with intellectual disabilities.

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.

Managing the risk of sex offending and sexually harmful behaviour presented by some men with intellectual disabilities is enhanced if community services map the number in their catchment area, apply appropriate risk assessment and management methods, and implement evidence‐based treatment. This paper describes the methods and progress of one community intellectual disability service in mapping and assessing the risks. A second paper is planned that will address progress in treatment.