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This paper aims to explore treatment implications of the self‐regulation model (SRM) for sexual offenders with an intellectual disability in an effort to provide practical applications that could be employed in treatment.

The SRM of sexual offending proposes that difficulties in self‐regulation may lead to an increased risk of sexual offending; describing four potential pathways to sexual offending that are based on self‐regulation style and offence‐related goals. Research has focussed on the application and implications of this theoretical model for mainstream sexual offenders. However, more recently, there has been an increasing interest into the application and treatment implications for the SRM for sexual offenders with an intellectual disability. This paper reviews literature on both the SRM and related work on offenders with intellectual disability.

The evidence reviewed supports the notion that the SRM is a valid theoretical model on which to base treatment programmes for people with intellectual disabilities and specific recommendations are made for the design of treatment programmes with this client group.

It is suggested that this model should be used when devising intervention programmes for people with intellectual disabilities in the future.

This paper reviews several issues in relation to offenders with intellectual disabilities. Although some authors have indicated an increased prevalence of offenders amongst the population of individuals with intellectual disabilities, other carefully controlled studies using recognised IQ tests have found only slightly increased incidences. Studies conducted in forensic settings have reported results somewhat different to those conducted in clinical settings with respect to both prevalence and characteristics. It is noted that individuals with learning disabilities commit offences across the spectrum of criminal behaviours but there may be some over‐representation in sexual offences and arson. Issues of assessment and treatment are also addressed with comments being made on extensions of interventions into community settings. With the amount of research increasing over the last 10 years, we are becoming clearer about the relevant issues involved in designing studies, developing assessments and providing treatment to this client group.

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.

This study summarises the results of a cognitive‐behavioural treatment group for sexual offenders (n=14) with intellectual limitations in the community.

All participants were convicted sex offenders serving probation orders or prison licences who attended a 14‐month treatment programme designed for sex offenders with intellectual limitations. The programme comprised of five main components: sex education; cognitive distortions; offending cycle; victim empathy; and relapse prevention. All participants completed psychometric measures specifically designed for people with intellectual limitations before and immediately after completing the treatment 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).

Post assessment 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.

Although none of the participants have been reconvicted for committing new sexual offences during the follow‐up period, given that the follow‐up was restricted to 12 months post‐treatment, it is not possible to conclude this intervention was successful in reducing risk of sexual recidivism.

The results from this study support the use of cognitive‐behavioural approaches in demonstrating positive cognitive shift (reconstructing cognitive distortions and attitudes to victim empathy) for sexual offenders with intellectual limitations.

De‐institutionalisation and resettlement have had a significant impact on offenders with learning disabilities (LD) who are now more visible in the wider community than before. Perhaps because of the challenges presented by people who were previously contained in institutions, there has been a growth of interest in their characteristics, the services and clinical interventions required to support them.This narrative review presents and discusses recent developments concerning offenders with LD. It looks at the historical association between crime and low intelligence, and then examines the evidence concerning the prevalence of offending by people with LD and recidivism rates. Recent research concerning service pathways for this population is summarised and progress in the development of actuarial, dynamic and clinical assessments of the future risk of offending is outlined.The second half of the paper focuses on a review of the evidence for and recent developments in the treatment of offending behaviour (anger/aggression, sexual offending and fire‐setting), utilising broadly cognitive behaviourally‐based approaches. Finally, future directions for research and practice innovation are proposed.

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.

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.

Several studies have related diagnostic information and adversity in childhood to criminal careers and risk of recidivism. Notably, ADHD and conduct disorder in childhood, schizophrenia, sexual abuse and physical abuse have been associated with offences in adulthood. This study investigates these variables in relation to large cohorts of offenders with learning disabilities. A case note review was undertaken for 126 individuals referred but not accepted into forensic learning disability services and 197 individuals accepted for such services. Results are reported on diagnostic information and experience of adversity in childhood. ADHD/conduct disorder featured prominently in both groups. Autistic spectrum disorders were not particularly over‐represented. For adversity in childhood, general socioeconomic deprivation featured prominently in both groups. This also increased significantly for those accepted into services. Sexual abuse and non‐accidental injury were featured at around 13‐20% for both groups. These results are broadly consistent with the mainstream literature on offending, ADHD/conduct disorder and general deprivation featuring significantly in all groups and rising for those accepted into offender services. It is important to deal with these aspects during assessment and to provide appropriate psychotherapeutic services for these individuals.

Risk assessment studies involving recidivism in sex offenders with intellectual disabilities (SOIDs) continue to be scarce, limited and producing mixed results. This study aims (to test the ability ...) to test the ability of one such instrument (the Static-99R) to predict intramural sexual and violent incidents involving members of this group.

The Static-99R was prospectively scored for 38 SOIDs. Occurrences of any violent or sexual incident and/or illegal sexual behaviour were recorded during a minimum period of six months. Predictive accuracy was analysed using several performance indicators.

The Static-99R significantly predicted sexual incidents (area under the curve = 0.70) but failed to predict violent and illegal sexual incidents. Regarding illegal sexual incidents, the instrument was better at detecting low-risk individuals than high-risk offenders.

Risk assessment studies, both in offenders with and without an intellectual disability (ID), rarely use multiple accuracy estimates. The current study used both discrimination and calibration indicators to evaluate the ability of the Static-99R to detect low- and high-risk offenders.