Men with intellectual or developmental disabilities who have engaged in harmful sexual behaviour will receive group cognitive behavioural therapy in a large-scale trial across 30 UK sites. This matters because existing CBT programmes for harmful sexual behaviour are designed for non-disabled men and are widely available in prisons and health settings. For men with IDD, such treatment is rarely offered and has never been tested in a randomised controlled trial. The researchers will compare a 6-month group CBT programme called SOTSEC-ID against standard care, measuring cognitive distortions, re-offending, sexual knowledge, victim empathy, self-esteem, and quality of life over two years. If the treatment proves effective, it could reduce the threat of harm from successfully treated individuals, improve public safety—particularly for vulnerable people with disabilities who are potential victims—and lower the care costs of current risk management strategies. It would also give therapists more confidence in providing this treatment. A qualitative component will capture the men’s and therapists’ views on acceptability. The trial runs for 54 months across four English regions.
View original technical description
Research question Does group cognitive behavioural treatment lead to a reduction in cognitive distortions and further harmful sexual behaviour, while improving empathy, sexual knowledge, self-esteem and locus of control for men with IDD who have engaged in harmful sexual behaviour in comparison to treatment-as-usual? Background Cognitive behavioural treatment for non-disabled men who engage in harmful sexual behaviour is widely available in prisons, probation and in health settings. Such treatment has been well researched and the majority of studies report positive outcomes in terms of reduced re-offending. This kind of treatment is far less widely available for men with intellectual and/or developmental disabilities (IDD) and has been less often researched. The studies that do exist have been reviewed in a number of recent systematic reviews and said to be promising, but none have involved randomised controlled trials. Aims and objectives We aim to conduct a single-blind cluster-randomised controlled trial of a well-established group CBT programme known as SOTSEC-ID, across 30 sites in the UK, in secure services and community settings, for men with IDD and harmful sexual behaviour. We will assess cognitive distortions, frequency of harmful sexual behaviour, sexual knowledge, victim empathy, self esteem and locus of control in treated and untreated men with IDD and harmful sexual behaviour. We will also assess quality of life and costs and cost effectiveness of the treatment. Methods Men with IDD and harmful sexual behaviour will be recruited across 4 areas of England (South East, East, Midlands and North). Following assessment for suitability, and consent procedures, they will be recruited and assessed (Baseline, time 1) for cognitive distortions, harmful sexual behaviour, sexual knowledge, victim empathy, self-esteem and locus of control. The sites will be randomised to receive either 6 mths of SOTSEC-ID treatment with risk management, or to receive TAU. At six-months post-baseline (time 2) all men will be re-assessed, and then again at 12-months post baseline (time 3), and 24-months post-baseline (time 4). A modified CSRI will be used to measure costs of treatment/TAU, and the EQ-5D-5L to measure health-related quality of life, so as to allow costs and cost effectiveness of the intervention to be analysed. In addition, a qualitative study will examine the men's views and therapist views of the treatment (including its acceptability) in small purposive samples. PPI has been considered important and has been built into the project in a number of ways, with consultation with people with learning disabilities and carers throughout the project. Timelines and impact The trial will last for 54 mths overall, and it is anticipated that if the treatment proves to be successful, this would significantly reduce the threat of harm posed by individuals who were successfully treated. It would improve public safety, particularly for vulnerable individuals with disabilities (potential victims) and reduce the need for treatment for victims. It will also enhance the confidence of therapists who are providing this treatment and reduce the care costs associated with risk management strategies currently used to manage these individuals with IDD and harmful sexual behaviour.
Plain English summaries and category classifications on this site are generated by AI and may not perfectly reflect the original research.
Is something wrong? Let us know