Project STOP: Cognitive behavioral assessment and treatment for sex offenders with intellectual disability.

Abstract

Abstract In this brief article, we provide relevant background concerning the prevalence, characteristics and vulnerabilities of intellectually disabled (ID) sex offenders, as well as scientifically-informed guidelines for treatment. Finally, we provide a description of Project STOP, an outpatient cognitive behavioral assessment and treatment program. Keywords: intellectually disabled, sex offenders, cognitive behavioral assessment and treatment , problem solving, intervention Introduction Sex offending behavior in persons with intellectual disabilities (ID) is a serious problem with significant and long-term consequences for the victims, offenders, and their communities (Barron, Hassiots, & Banes, 2002). A growing awareness of such problems in persons with ID requires effective solutions with regard to assessment and treatment. Defining Sex Offending The term sex offender is a broad one that is applied to individuals who commit a sex offense (Lanyon, 2001). Examples of sex offenses include sexual conduct with a minor and forcible, nonconsensual sexual acts toward an adult, including sexual acts involving an individual who is unable to give consent for sexual acts. Moreover, people who sexually offend may be diagnosed with additional psychological or behavioral disorders, including s, deviant sexual interests, mood or anxiety disorders, psychotic disorders, personality disorders, brain injury, or ID, such as mental retardation. Thus, sex offenders represent a heterogeneous population for which few generalizations can be made regarding etiology, assessment, or treatment that can be easily applied to all offenders. Sex Offenders with Intellectual Disabilities The prevalence of people with mental retardation among sex offenders is estimated between 10 and 15% (Murphy, Coleman, & Haynes, 1983) and much higher if persons with borderline intellectual functioning are included in this estimate. However, there is no support for a direct or causal association between intellectual functioning and sex offending behavior (McCurry et al., 1998), and estimated rate may be partially due to the decreased likelihood that people with ID can evade detection and arrest. When compared to other sex offenders, the availability and investigation of effective treatment programs for ID offenders has lagged far behind those of than their non-disabled cohorts (Barron, Hassiotis, & Banes, 2002; Lindsay, 2002; Timms & Goreczny, 2002;). In order to develop effective interventions for this population, it is important to understand what diathetic factors contribute to the development of sex offending behavior in persons with ID. This requires an integration of existing scientific knowledge concerning both sex offending treatment and the unique challenges to sexuality concerning persons with ID. Unique Challenges of Sexual Risk for ID Offenders Due to a history of institutionalization, the sexual of lives of persons with ID have been historically under society's control (Kempton & Kahn, 1991; Pitceathly & Chapman, 1985). Such societal controls, including and sterilization, were viewed as acceptable prevention methods and no education in sexuality or treatment for sexual disorders were provided (Woodill, 1992). Despite several decades of a nationwide de-institutionalization and a trend toward community integration, negative community biases still serve as obstacles to the adaptive sexual expression of people with ID. One extreme stereotypic view characterizes people with ID as having uncontrollable sexual desires. An alternative, but equally extreme view is that they are innocent and naive persons who have no sexual desire (Szollos & McCabe, 1995). It is unfortunate that such views prevail, because significant restrictions concerning sexuality continue to occur. Without the support from caregiving systems to provide accurate and effective sexual educative experiences, the sexual knowledge that an individual inadvertently learns can be subject to significant distortion and misinterpretation (Jurkowski & Amado, 1993). …