The Offence Process of Sex Offenders with Intellectual Disabilities:
A Qualitative Study.
Dr. Jude Courtney, yellowhouse, Heron Cross House, Grove Rd, Fenton Stoke on
Trent, Staffs, ST4 3AY
Dr. John Rose, School of Psychology, University of Birmingham, Edgbaston,
Birmingham, B15 2TT, United Kingdom.
Dr. Oliver Mason, Sub-Department of Clinical Health Psychology, University
College London, Gower Street, London WC1E 6BT
Address for correspondence: Dr. John Rose, School of Psychology, University of Birmingham,
Edgbaston, Birmingham, B15 2TT, United Kingdom J.L.Rose@bham.ac.uk, 01214154902
The authors wish to thank Dr Brenda Gardner and Care Principles, and The
Probation Service for their support of this research.
Intellectual disabilities or learning disabilities or mental retardation; sexual offending;
offence model; grounded theory; qualitative research
Suggested Running Head: Offence Process of Sex Offenders with Intellectual
The Offence Process of Sex Offenders with Intellectual Disabilities:
A Qualitative Study.
There have been few attempts to build a model of sexual offending for men with
intellectual disabilities and hence clarify appropriate intervention. This study
examines any commonalities that characterise the offence process of such men.
Using a grounded theory approach, qualitative interviews with sex offenders with
intellectual disabilities are analysed to generate a model of the offence process. Data
from qualitative interviews with clinicians is used to triangulate offender participants‟
data. The subsequent model highlights the importance of individual‟s attitudes and
beliefs and the impact that they have at all stages of the offence process. It raises
issues concerning the variation in the process that is seen within and between
offences. Additionally, it identifies a marked lack of awareness of any „decency insult‟
in these offenders, an inability to empathise with society‟s view of sex offending. A
clear implication is that thorough assessment and formulation are likely to be the key
to successful and appropriate intervention.
The sexual behaviour of people with intellectual disabilities forms a considerable part
of the work of professionals in this field. However, there is an absence of any clear
model of offending and concomitant intervention for men with intellectual disabilities
who commit sexual offences. Despite this, a range of treatments have been
developed. Some have implicit models of behaviour, others are based on the
assumption that „what works‟ for non-disabled sex offenders will also work for those
with intellectual difficulties.
The accepted definition of intellectual disabilities in the UK is assessed impairment of
both intellectual and adaptive/social functioning that have been acquired before
adulthood (American Psychiatric Association, 1998; British Psychological Society,
2001). Intellectual impairment is conventionally assessed psychometrically and
corresponds to an Intelligence Quotient (IQ) of 69 or less. However, many studies
include people who function at a higher level as measured by IQ, typically in the
borderline range of intellectual functioning (Lindsay 1999; Lindsay & Smith, 1998;
Lindsay, Neilson, Morrison & Smith, 1998; Bremble & Rose, 1999; Rose, Jenkins,
O‟Connor, Jones, & Felce, 2002). This paper accepts this reflection of clinical
practice and throughout includes all people who are accessing services for people
with intellectual disabilities.
Similarly, many writers have commented on the difficulties of defining sexual abuse
or offending (Brown 1997, Thompson 1997, O‟Connor & Rose 1998). While it is
important to define it correctly to convey the seriousness and complex legality of
events, it is difficult to avoid making subjective judgements as to what constitutes
appropriate, inappropriate and offensive sexual behaviour. Thompson and Brown
(1997) provide the definition “…any sexual act (not necessarily involving contact) with
another party who did not or cannot consent to the act or for whom there exists a
barrier to consent” (p. 141). Although there are problems with this definition due to
difficulties in determining consent, this definition is adopted throughout this paper.
Models of offending used in interventions for people with intellectual
The biological model suggests a hormonal or neurological problem. Perkins,
Hammond, Coles, & Bishopp (1998) report on two surgical procedures that have
been used in the past, castration and stereotaxic hypothalamotomy, yielding low
reconviction rates. Others note that drugs that affect testosterone levels are
commonly used (Thompson and Brown, 1997; Perkins, 1991; Day, 2000).
A variety of behavioural techniques have been used to attempt to reduce deviant
arousal with a presumed causality of inappropriate stimulus and response. Such
techniques have included covert sensitisation, masturbatory satiation, aversive
therapy and biofeedback from a plethysmograph, though some authors claim that
little evidence exists to support the use with sex offenders with intellectual disabilities
(O‟Connor & Rose, 1998; Thompson & Brown 1997). Operant negative conditioning,
using shock duration varied as a function of response delay has also been attempted
successfully in the short term (O‟Connor 1997).
Social skills training and sex education is a common part of treatment packages for
this group (O‟Connor, 1996; Griffiths, Quinsey, & Hingsburger, 1989; Swanson &
Garwick, 1990; Charman & Clare, 1992). These procedures place an emphasis on
both the reduction of offending and the increase in appropriate behaviour, assuming
offending to be a mistake made through lack or inappropriate use of skills, rather than
a deliberate choice (Day, 2000)
In cognitive behavioural interventions, causality is attributed to faulty cognitions and
self-regulatory capacities, leading to consequent deviant behaviour. Adapted
cognitive techniques are used to address denial and minimisation, cognitive
distortions and victim empathy. Thus the offender is helped to develop an awareness
of the role of underlying beliefs, monitor automatic thoughts, test the accuracy of
cognitions, develop new adaptive thoughts and assumptions, and practise these in
role plays (Lindsay, 1999; Allam, Middleton, & Browne, 1997).
Cognitive-behavioural interventions commonly utilise relapse prevention work, a
treatment adapted by Pithers (1990) from interventions with addictive behaviours and
used in non-disabled sex offender work. Implicit in the model is that sex offences are
not impulsive acts, but are based on certain sexual preferences and require a degree
of forethought (Finklehor, 1984). These predilections are seen as fixed and repetitive
(Wolf, 1984). Thus, offenders who are motivated to change should aim for self-
management to prevent high-risk behaviour from escalating to offence. This strongly
linear offence process model, emphasising cognitive-behavioural aspects of
offending dominates the non-disabled sex offender field. Three models have been
particularly influential. Firstly, Wolf (1984) suggested a “cycle of offending”, in which
men use cognitive distortions to defend against their poor self-image, justify and
maintain their offending, and minimise their culpability. Finkelhor‟s Precondition
Model of child sexual abuse (1984) added the necessary components that must exist
for sexual offending to occur; the existence of motivation to abuse, the ability to
overcome internal and external inhibitors, and the need to overcome resistance.
Thirdly, Marshall and Barbaree (1990) detailed the aetiology of sexual offending.
They suggested that adverse developmental factors in combination with biological,
social, and situational pressures lead some adolescents to attempt to meet their
sexual and social needs through offending. Together, these models have provided a
framework for intervention that has been popular amongst treatment providers. Thus,
in the early 1990‟s, they heavily influenced the development of prison and probation
service programmes in the UK, as directed by the Home Office (Mann & Thornton,
1998). However, these programmes have continued to evolve, incorporating
innovative ideas as they become accepted (Mann, 2004).
Recent criticism has challenged the assumption that all offenders follow a fixed route
to re-offending. Ward and Hudson (1998) suggest four different pathways that
offenders take to relapse, distinguishing firstly between approach and avoidant goals,
and secondly between the strategies selected to achieve them. This leads them to
suggest four different typologies of offenders, with different treatment needs and
potential for change.
In reality, most reported interventions for people with intellectual disabilities are multi-
modal (Murphy, Coleman, & Haynes, 1983; Haaven, Little, & Petre-Miller, 1990;
Murphy, Holland, Fowler, & Reep, 1991; Lund, 1992; Nolley, Muccigrosso, & Zigman,
1996; O‟Connor, 1996; Hill-Tout, Thomas & Dunkerton, 1998; Day, 2000; Keating,
2000; Rose, Jenkins, O‟Connor, Jones & Felce, 2002), involving a variety of
components and therefore guided by a number of underlying models. While it is
appropriate to formulate interventions for each individual and to provide a
comprehensive treatment package that incorporates their needs, these interventions
are often published as “ready-to-use” packages. Clare (1993) criticises this “assumed
psychological need rather than careful analysis of the offender‟s behaviour.” (p. 177)
and questions the generalizability of any treatment package due to the
heterogeneous nature of people with intellectual disabilities.
Need for further research.
The approach to interventions for sex offenders with intellectual disabilities is varied.
Some individual interventions flow from careful formulation and often, functional
analysis of the different components contributing to sexual offending. Other practice
is based on components taken from non-disabled intervention, with a dominant linear
model of offending with minimal consideration of individual differences. These
components are then often mixed together with educational and instructive elements
in multi-modal packages with subsequently competing, underlying theoretical models.
This lack of conceptual clarity is then compounded by little rigorous empirical testing
of the efficacy of such treatment.
Despite the fact that careful thought has been given to how to adapt the content of
„borrowed‟ material (Clare, 1993; Clare & Murphy, 1998; Haaven & Coleman, 2000),
there has been little consideration of the fit of the linear model of the offence process
to clients with intellectual disabilities. Indeed, there has been little discussion at all of
the somewhat confused conceptual models that inform current practice. Thus, the
challenges posed by authors such as Ward and Hudson (1998) have not filtered into
the intellectual disabilities literature.
It seems crucial to establish a model of the offence process for sex offenders with
intellectual disabilities that is based on their own experiences rather than borrowed
form non-disabled offenders. The current study examined the experiences of nine
sex offenders with intellectual disabilities, utilising grounded theory methodology to
analyse interviews with them. This provided a basis from which a model can be
generalised to other people with intellectual disabilities.
Nine male sex offenders with intellectual disabilities were interviewed about their
experiences of the offence process. Participants were from two different sources, one
residential and one community based. All were white Caucasian, aged 20 to 62
(mean=37.3), with IQs ranging from 53 to 77. Seven had been officially convicted of
criminal offences and some were undertaking treatment on a mandatory basis.
Offences included indecent assault, gross indecency, attempted buggery, and
indecent exposure. Participants‟ details are shown in Table 1.
Insert Table 1 about here
A worker for each of these men was also interviewed in order to verify their stories
and provide information from a different perspective. Six workers were interviewed,
three having responsibility for two or more participants. Their details are shown in
Insert Table 2 about here
As consent for people with intellectual disabilities is a contentious issue, the strategy
recommended by Arscott, Dagnan, and Stenfert-Kroese (1998) was utilised. All
participants were interviewed using a flexible interview guide rather than a
prescriptive structure. The guide was initially shaped by knowledge of the literature
and experience of working with sex offenders and offending processes. As new
themes emerged from the data, these were incorporated into later interviews. All
interviews were conducted by the first author, a researcher independent of the clinical
service. Interviews were also audio taped and transcribed.
Workers were interviewed about their client, the work that had been undertaken with
them and their opinions concerning the offence process of men with learning
The offenders‟ data was then analysed using grounded theory techniques (Strauss &
Corbin, 1990, p. 24). Concepts that illuminated the data were identified from the first
few interviews. Concepts pertaining to similar phenomena were then grouped
together into more abstract categories that were developed in terms of their
properties and dimensions. The remaining interview data was checked repeatedly
against these categories in order to validate them and demonstrate their usefulness.
New concepts and categories were also developed. To increase the validity of this
process, two “additional analytic auditors” (Elliott, Fischer & Rennie, 1999, p.222)
were separately used. Analysis of the worker interviews was carried out after the
development of the model to allow source triangulation, to ascertain whether this data
could verify, disconfirm and illuminate the model. To suit this purpose, a different type
of analysis process was used. The material was examined for mention of the themes,
categories and concepts already generated, and in particular for instances of
contradiction and alternatives. This is a process sometimes termed „analytic
induction‟ (Denzin 1988). This increased confidence that the original findings are not
solely a product of the source or method.
Eight major categories emerged from the analysis: “targeting the victim”, “decision
point”, “offence planning”, “offence”, “stopping the offence”, “reactions to offence”,
and “consequences of being caught”. These cluster around the core category of
“offender attitudes and beliefs”. The categories and the concepts that underpin them
are presented in Table 2. An integrated summary of the analysis, highlighting the
linear and theoretical relationships between categories is presented in Figure 1.
Insert Table 3 and Figure 1 about here
“Targeting the victim”
This refers to the factors that drew them to their victim, such as the nature of the prior
relationship with the victim and the attraction of the victim in terms of physical
characteristics, age and maturity.
The nature of the relationship with the victim prior to the offence being committed
varied. For some, there was already a connection to the victim as they were
neighbours or fellow residents. Others spent time building up a friendship or „in loco
parentis‟ relationship, linking this category to “offence planning” via the concept of
P5 (participant 5): the kids were there and it started off, what colour pants have we got on and….that‟s
when it started and then I planned it that way.
R (researcher): Why were you asking the questions?
P5: To get the confidence in me.
R: And why were you doing that? What were you hoping to achieve?
P5: I was hoping to achieve what I planned…To do it with the kids…To… feel… them, to feel them
Several deliberately chose people whom they did not know. This was partly to
prevent anticipated family problems, linking this to “reactions to offence” and to
P4: I used to go up to er…to me nephews… to his children, and I thought well …er.. I thought, if I did
anything … it was in my mind, I thought I daren't, cos these are gonna have a bad name because their
uncle‟s a dirty… you know.
It also seemed to be an attempt to prevent detection, thus linking this to “offence” via
R: Why pick her?
P7: Most probably cos I thought I would have got away with it
Some denied any choice of victim and instead claimed that their victim initiated
events, linking this to “offender attitudes” via blaming.
The personal characteristics of the victim were significant, particularly age and
attractiveness. P9 had sat in wait for victims who resembled his girlfriend. Perceived
physical maturity dictated the choice of victim for some, linking this to “decision
point”, via victim readiness.
A crucial concept involved in planning was the length of time spent preparing for the
offence. This varied dimensionally. Two ends of a continuum could be clearly
distinguished, „groomers‟ and „grabbers‟. „Groomers‟ worked towards an offence for a
considerable length of time. For example, P6 waited for several years. „Grabbers‟
typically picked victims whom they did not know and were more opportunistic. P1, P7,
P8, and P9 all had examples of this type of approach. Offenders‟ approaches varied,
implying that such typology does not remain fixed. Interestingly there was also
variation within offences. For example, P5 offended against two sisters, aged 2 and
8. His approach to each was different, illustrating a link to “targeting the victim”, via
characteristics of victim.
Such „grabbing‟ offences were sometimes reported as a failed attempt to initiate
social contact, thus linking to “attitudes and beliefs”, via ignorance of skills. There is
also a link to “offence” as length of grooming influenced the type of offence possible.
Whatever the approach, there was still a need to overcome both external and internal
inhibitors to allow the offence to take place:
P4: There was only me and her in the lounge.
R: How had you managed for it to be just you with her in the lounge?
P4: Most of the lads go to the rooms to either watch their own TV or music or whatever…I like waited
until the night staff go into the office for the handover.
Others worked at getting the victim alone through their relationship with them or
through manoeuvring the victim into an appropriate place. There is also a link here to
secrecy as this was often an attempt to be undetected. P9 committed his offences on
a particular set of stairs at a shopping centre, saying
P9: There are no cameras around so no one can‟t (sic) see us.
Internal inhibitors were overcome by some, though they found it hard to speak about
this, perhaps reflecting their limitations in accessing and commenting on their internal
worlds. Others still claimed that at the time they were unaware of wrongdoing, linking
this to “attitudes and beliefs” via ignorance.
Offenders indicated that they reached a point at which they decided to go ahead with
the offence. This varied along a continuum of time, linked to a choice of victim and/or
type of offence, depending upon victim readiness and desired goals.
For some the decision was made at a point at which they felt the victim was „ready‟
for the offence to occur. For P6, for example, this was due to both perceived physical
P6: I thought oh I bet she…. she is getting older now… I bet she is ready, her private parts are
and also to the grooming that he had done:
P6: And I thought “oh, if her goes back and tells, oh, old P6 is snugged” … but she didn't, see. See,
and I was thinking, in a way I thought “well, is she or will she keep it to herself or what”. And this one
day I just, I just says “try it”. I did try it and that's what happened.
There was also a link here to “attitudes and beliefs” as P6 and others put the blame
on the victim, perceiving them to be sexually complicit:
P6: Yeah and I thought with her being er… aroused herself, I thought she ain't never going to tell
them, she is going to keep it to herself.
The “decision point” was also related to the goal that the offender was pursuing. For
those who wished to have a full sexual relationship, including penetrative sex, more
grooming was required. Those who were aiming at a fleeting sexual encounter were
able to initiate this within moments of encountering their victim.
The type of offence committed related to levels of offenders‟ sexual arousal during
the offence, how the victim responded and secrecy/covering up. This category is
therefore closely linked to “stopping the offence”.
Openness about their sexual arousal varied amongst the participants and possibly
limits the clarity of this concept. Some report continuing the offence because of
arousal, linking this to “planning”, via internal inhibitors. Others report a lack of
arousal that limits the offence, linking this to “stopping”:
P2: Then I stuck my penis up his bum…
R: ….Once you‟d put your penis up his bum, then…?
P2: …It hurt me.
R: And what happened then?
P2: I stopped.
R: You stopped? Did you think that it was going to feel nice?
P2: Yeah…It was a surprise.
The response of the victim affected the type of offence. Some met with resistance to
their sexual activities, leading to events being cut short. Others interpreted their
victim‟s lack of resistance as encouragement, linking this to “attitudes and beliefs”,
P8: When I touched her she gave me a little smile and I thought I‟ll carry on if she‟s smiling at me cos
it might lead somewhere.
There was variation amongst participants in their attempts to cover up the offence.
One used coercion and threats but most merely relied upon their relationship and on
the grooming process, linking this back to “targeting the victim” and “offence
planning”. It is notable that those who committed more opportunistic offences did little
to hide the offence, perhaps indicating a genuine unawareness of wrongdoing, linking
this to “attitudes and beliefs”, via ignorance and denying offender status.
“Stopping the offence”
Most participants stopped the offence because they were apprehended or the victim
escaped. Only one participant reported attempting to stop himself from committing
the offence. Some had clearly not thought about the need to stop at all, again
perhaps linking to “attitudes and beliefs” about denying offending. Others attempted
to place the responsibility for stopping on the victim, again linking this to “attitudes
P2: He should have ran
R: He should have run away from you?
P2: Yeah, before … before I could do it.
“Reactions to offence”
Participants commented only briefly upon their own and others responses to their
offence. There was little empathy but much stress on how the reactions impacted on
them, linking this to “attitudes and beliefs” via „denial‟ and „poor me‟. Some reported
violence or rejection but most emphasised the continued support of friends and
family, with little understanding of any wider feelings beyond immediate reactions to
the participant. P4, who offended against another resident, said:
R: How do you think other people feel about what you did with her?
P4: Shocked… When they (staff) knew that I was coming in, they thought, oh he‟ll be all
right, he just being himself, be all right
R: So they‟d be shocked that you didn‟t behave the way that they thought you were going to,
is that what you mean?
Participants‟ own responses did include some negative emotions but typically they
were only fleeting and often again were focused around the likely consequences of
being apprehended rather than any guilt about the offence, linking this to
“consequences”. Only P2 reported longer-term depression. This seemed focused
around his feelings of betrayal arising from his victim‟s reporting the offence.
Despite being asked directly, most were unwilling or unable to empathise with the
reactions of the victim beyond a very simple level or repeating work that they had
covered in their treatment programmes.
P6: Well I suppose she‟s upset… if she‟s thinking about it still what I done
mm… “dirty old man” or something like that…And there again I don‟t know she might forgot
it…She might be running around like a lark, I don‟t know… I mean I‟m not there to find out.
“Consequences of being caught”
Three concepts were identified, positive and negative consequences, and new
inhibiting factors that assisted participants to deal with deviant urges.
The negative consequences most frequently mentioned were the restrictions on
liberty and the increased risk of stigma and accusation, particularly false accusation,
in future. This links to “attitudes and beliefs” via „poor me‟ and denial of offending
status. This self-focus varied dimensionally and some were also able to comment
upon the worry caused to family members by their offending.
Surprisingly, positive consequences were identified also. Several of the participants
spoke of the structure and support given to them by the probation group programme
and their supervision. Esteem could be gained through being a „good‟ group member
and contributing to the treatment of others.
Knowledge was also a crucial gain for many. This was evident in the new inhibiting
factors that participants reported being of assistance since their index offence. Chief
amongst these was clarity about issues of legality and the official response that
would ensue if they re-offended. This links to “attitudes and beliefs”, via the concept
R: Do you ever feel (sexually aroused) like that about anybody else here?
P4: Yes, but here you get a very, very tight rule; any hands on… I will be restrained, injected and put
R: So you know what the punishment is here very clearly, and does that stop you or do you have to be
P4: Well actually, since I have been here I have been quite good.
“Offender attitudes and beliefs”
As indicated throughout this section, all other categories link into and through this
category. It is composed of four closely related concepts; blaming others, denying
that they are an offender, seeing themselves as the victim of the offence, and
claiming ignorance of the skills required to initiate an appropriate social encounter or
of the illegality of the offence.
Most participants put blame on others, mainly the victim, regardless of age or
circumstance. Occasionally, this would be spread more widely, for example to
workers and family. P3 seemed almost to blame his whole community:
R: Why do you think that the boys were doing that in the garden
P3: Don‟t know. They must have been trying to entice me
R: And why would they want to entice you over?
P3: I don‟t know actually. I didn‟t get on in the village where I used to live.
Blame varied also in amount. Some offenders acknowledged a shared responsibility,
or at points blamed themselves entirely, perhaps reflecting new values they were
taking on from their treatment. It was also notable that separate offences were
explained differently by the same participant. Some were more prepared to take
responsibility for older offences.
Sometimes blame was given to the victim because of their response to the offence,
linking this back to “reactions”:
P7: She done the dirt on me because she… if she doesn‟t go back and tell, I would be still at
the centre now. And I might have had a relationship with her and all that.
Closely related to this concept is the denial of offender status. For a limited number,
this takes the form of minimising to the point of alteration their part in the offence.
Others deny recollection or understanding. This may be an inability to recall or to
comprehend the question. However, as it did not match other responses in the
interview, it seemed to be an attempt to distance themselves, as if to deny taking
R: How did you feel about the sex part then?
P2: I didn‟t know, I didn‟t know what I was doing at first.
R: Why did you take Peter round the back of the shops then? How did you happen to be there?
P2: No idea
For most, denial also seemed to be revealed less in specific comments but was
embodied in the tone of most of their conversation. P6 mistakenly called his indecent
assault offence a “decency insult”. This phrase sums up this tone; a lack of
awareness of any insult to decency and little understanding of the distaste with which
the public would regard these offences and offenders.
Another concept, closely aligned to denial, was ignorance. Frequently ignorance of
the appropriate social skills was claimed and the offence presented as a failed social
P7: I wasn‟t going to do things with her, I just wanted to get a relationship with her and take her out for
drinks and have her in me house.
However, soon afterwards, P7 claimed:
P7: I just wanted to have sex with her. That‟s all I want to do with her.
This leaves confusion about his motivation, as it may well be that in his ignorance of
how relationships work, he assumes that sexual relations form a major part. Indeed,
given the limited opportunities to form relationships, this may reflect reality for such
men. The use the services of sex workers by such men may also add to this
Related to this are the claims of ignorance about the illegality of the offence. While
most were fully aware that their actions were illegal, some remained confused even
after intervention, particularly about with whom it is legal to have sexual relationships.
P3 acknowledged having a sexual preference for men and was asked about the
legality of this:
P3: It‟s wrong sometimes isn‟t it?...If I touched anybody, I‟d be in big trouble wouldn‟t I? It‟d be against
the law, against the law, wouldn‟t it?
R: So you mustn‟t touch anybody ever?
This ignorance is not surprising given the complex legal situation that surrounds
sexual relations and intellectual disability. Although a relationship can seem to be a
mutual one, it can be deemed illegal depending upon the relative abilities of each
party. Such confusion is reflected in the responses of services, families and even the
criminal justice system.
Blaming, denying, and ignorance all link closely to the „poor me‟ stance that could be
seen in many participants. It is common when doing wrong to use a “technique of
neutralisation” (Sykes & Matza, 1957). Men with intellectual disabilities, who
necessarily have a more limited view of themselves and the world, present their
offending as a confusion of limited experience, shameful desires, mistaken intentions,
uninhibited and overly enthusiastic responses to others. It is then met with mixed and
confusing reactions, beginning with the victim themselves through every person they
then encounter on their journey forward. Unsurprisingly, participants frequently saw
themselves as the true victim at all stages of the offence.
Though brevity precludes illuminating quotes from the worker data, their accounts
verified the initial stages of the linear offence process and the “facts” of the offences.
They spoke of targeting victims and planning the offence, including grooming and
overcoming inhibitors. They identified goals for the offending, though most saw this
predominantly in terms of sexual fulfilment. However, they did not verify much detail
from the point that the offending behaviour started. There was no mention of
concepts related to the offence or stopping the offence, and little mention of reactions
to the offence or consequences of being caught, with the exception of being aware of
the potential to gain new inhibitors through the experience of being caught. Although
there was general mention of the importance of participants‟ attitudes and beliefs,
workers did not detail these. There was an implicit acknowledgement of offenders
denying responsibility, blaming others and seeing themselves as victims but no direct
comment to verify it. Finally, there was no report of the individual variance in the
offence process both within and between offences.
Through examining the experiences of sex offenders with intellectual disabilities, this
study has developed a tentative model of the offence process. There are clear
similarities between the model that has been developed and previous models (e.g.
Wolf, 1984; Ward and Hudson, 1998). The findings from offenders‟ data suggest that
attitudes and beliefs are central to the offence process. The way in which an offender
plans, carries out, responds to, and moves on from such an event is shaped by their
understanding of what constitutes an offence, who is responsible for it, and how
relationships and offences occur. In this sample, offender participants tended to
blame others, claim ignorance of social skills, deny their status as an offender, and
claim that they were the victims. However, there was variation along the continuum of
each of these concepts, with each offender exhibiting these to a greater or lesser
degree for each offence that they committed.
There were also some important themes that emerge from the data. Four main
findings from the data are of note. Firstly, offences do not fall into easily
distinguishable types. The stereotypes of childlike sexual experimentation with a
victim of a similar mental age or of uninhibited lunges are too simplistic. Elements of
these can be found but equally there is more sophisticated and planned offending.
Men vary along a continuum from extensive grooming to immediate „grabbing‟ but
crucially they vary over each offence. For example, P5 acted differently with different
sisters against whom he was offending at the same time. It was also found between
offences, for example P2 planned and groomed his victim in detail on one occasion
but against a different victim at a different time, was more impulsive and
opportunistic. Although the heterogeneous nature of the sample may play a part in
this variance, further study of the causality and detail of this variety is merited.
Currently, these findings seem to contradict both the single linear model of offending
and the four pathways suggested by Ward and Hudson (1998) and suggest the need
for a more complex and individualised approach.
Secondly, few men understood a „decency insult‟ and were unable to empathise with
society‟s view of their crimes. Two expressed remorse and sorrow yet still spoke in
surprise at their punishment, rather than assistance. Clinically, this seems common to
all sex offenders, but whether this is more dominant in sex offenders with intellectual
disabilities is a deserving question.
Thirdly, only one concept from the data seemed to distinguish sex offenders with
intellectual disabilities from their non-disabled counterparts. This was the concept of
ignorance of knowledge or skills. Whether this ignorance is real or claimed to avoid
culpability is an important assessment consideration. It could be considered that
disability also has impact on lack of awareness of wrongdoing, of the „insult to
decency‟, or on the „poor me‟ stance. Little is known about comprehension of these
issues and accuracy in self-reporting about such beliefs and behaviours in offenders
with disabilities. However, clinicians with experience of non-disabled sex offenders
will recognise that their clients also make these claims of ignorance. Comparative
study of both groups of sex offenders would illuminate the extent of these similarities
and differences more clearly.
Fourthly, there were marked distinctions between the workers‟ and offenders‟
accounts. Workers verified the basic details of the offence however, they reported
little detail from the point at which the offence commenced. It may be that workers
who focus on relapse prevention have good understanding of the earlier parts of the
process through completion of offence analysis with clients but see little benefit in
understanding the outcome of offending, particularly if they are not trained to place
such importance on formulation and reformulation . It would be interesting to look in
more detail at the differences between accounts from different professions in future
research. Additionally, workers showed little awareness of the individual variation
found in the offence process used by the participants. Further study of this would be
The study‟s limitations include the low numbers of participants with a relatively broad
range of intellectual functioning who are drawn from only two sources. Additionally
most participants had received some intervention aimed at increasing their
awareness of the issues and reducing their offending. The effects of this treatment
could be heard in men‟s responses and some explicitly attributed their opinions, for
example, regarding their victim, to their treatment. Many also spoke without
prompting about their changed behaviour and the strategies they were attempting to
use to manage their risk. It would be interesting to differentiate between such men
and offenders who had not received any treatment. Comparison between the
accounts of participant‟s at differing levels of intellectual disability would also have
Further, the variation in defining what constitutes a sexual offence for men with
intellectual disabilities by different people and at different times echoes through this
study. Participants have been asked about offences that they have been reported as
having committed, either recorded as criminal records or recorded in residential
patient files. Such offence histories had to be accepted on face value. The reality
behind these „facts‟ may have misled through under- or over-reporting.
Further methodological problems were encountered by choosing a qualitative
approach with such participants. Most struggled with comprehension and
communication and some had speech defects which added to their difficulties.
Expecting participants to speak freely and follow their own train of thought could not
be relied upon and participants had to be guided with numerous questions,
interpretations of mumbled responses had to be checked, and previous conversation
had to be frequently recapped to keep participants on track. This raises concerns
about potential influencing by the interviewer of participants‟ responses. Comparative
study, using similar questioning and recapping techniques, of offenders with differing
degrees of cognitive impairment may shed light on the influence of methodology
here. Additionally, there is a more general concern about participants‟ cognitive
deficits posing a threat to the accuracy of their data. However, verification of their
accounts against “official” accounts from their files and data from their corresponding
worker, showed that there was little deviation from the “facts” of the offences. Indeed,
they provided rich detail about the context of their offences, which was often missing
from both sources of official accounts.
Such limitations mean that these results cannot be said to be typical of all sex
offenders with intellectual disabilities. They represent a moment in time for a few
such men. However, it is hoped that this study may still provide a useful starting point
when considering similar offenders. The quality of the data collected also suggests a
useful role for a qualitative approach with this group of men however, in the future it
may be useful to combine qualitative and quantitative approaches (Webster and
The findings of this study carry several clinical implications. The results do suggest
similarities between these men and non disabled offenders and give some validity to
the use of programmes adapted from mainstream sex offender programmes (e.g.
Rose et al, 2002; Keeling and Rose, In Press). However some relapse prevention
approaches may be too mechanistic, leaving no room for the individual within a linear
view of the offence process that is postulated. The same applies to the multi-modal
approaches, which offer a mixed package of relapse prevention plus education and
skills training. These packages may overload the individual and be far too
demanding for an individual and the most important work could be lost in less
A thorough assessment of all the factors in an individual‟s situation, with particular
emphasis on their attitudes and beliefs, will be crucial in deciding whether and what
type of education is required, or whether cognitive distortions are present and need
to be addressed.
Sex offenders with intellectual disabilities need to be put at the heart of a treatment
package. Information about the various elements of their offence process is needed
in order to build the most detailed, and therefore most useful, map of their
experience. This study also indicates that groupwork programmes are extremely
helpful to some men. However, it may be that any programme should only cover
basic work and must enhance and be enhanced by careful individual work. In short, it
may be that as psychology has often claimed, the key to successful treatment is
through allowing a thorough formulation and reformulation of the individual to inform
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Table 1: Client Participant details
Age Contact IQ Current living Details of Last offence details Previous offence details Treatment type Details of
made arrangements statutory order and length victims
P1 36 Secure 54 Secure unit for Section 2 MHA Masturbating in public All previous offending Currently All females –
unit (Wais-R past 2 years Unconvicted toilets during nappy sexual in nature. 4 Individual work adults,
changing of young previous convictions, 2 with children and
baby. 1996 previous cautions, one psychologist. babies. Not
offence charges dropped. Previous previously
Numerous “incidents” specialist known.
recorded in notes SOTP
P2 28 Secure 65 Secure unit for Section 3 MHA Attempted buggery of No other previous Individual work Both male
unit (Wais-R past 2 years, 10 Convicted a minor. convictions. Two previous with Age 10 + 9.
months Gross indecency with incidents recorded in psychologist Known as
a minor. notes. local friends
P3 46 Secure 53 Secure unit for Recalled by Indecent exposure and Previous convicted arson Individual work Males – aged
unit (Wais-R past 2 years Home Office due assault in the street offences 1972-76. with 13.
to concerns near home to Numerous “incidents” psychologist Neighbours
Convicted neighbourhood recorded in notes.
P4 20 Secure 59 Secure unit for Section 3 MHA Sexual assault x 2 on Previous convicted Individual work Female.
unit (Wais-R past 2 years, 6 Unconvicted female resident at offence of violence with fellow
months previous home. against staff at home and psychologist resident with
Reported to police but arresting police officer. severe
no action taken as Incident of violence to intellectual
victim not considered a mother. No other sexual disabilities.
“credible witness”. offences or incidents
P5 38 Probation 64 Probation hostel Convicted. 5 year Indecent assault x 3 During prosecution Specialist group All females
Service (WASI) for 10 months parole licence. on sisters over many disclosed previous abuse treatment for 9 aged
“learning since release Served 18 months months. Repeated on 3 other children months. Indiv. 2,5,6,8,11.
needs” of 36 month digital penetration and including niece. work with prob. All
group prison sentence. simulated sex. 1998? Similar previous convicted officer and befriended or
offences also. keyworker. related.
Table 1: Client participants details (con‟t).
Age Contact IQ Current living Details of Last offence details Previous offence details Treatment Details of Victim
made arrangements statutory type and
through order length
P6 62 Probation 77 Probation hostel Convicted. Indecent assault on Allowing home to be used Specialist Female aged 10.
service (WASI) for 6 months Parole female child. 1998. for immoral reasons – group befriended for 2
“special since release licence- Lengthy grooming 1970‟s treatment for 5 years
needs” from prison. served 15 process. months. Indiv.
group Previously living months of work with
in supported 30 months prob. officer
independent prison and
accommodation sentence keyworker.
P7 39 Probation 62 Supported Convicted. Indecent assault on 2 previous indecent Under All females.
service (WASI) independent 2 year female with intellectual assaults involving supervision for Current victim
“special living for past probation disabilities at sheltered approaching girls in the past 7 years. adult with
needs” year. Reliant on order employment scheme. Put street and talking and Regular intellectual
group support from hands down her trousers then grabbing at them. specialist disabilities,
family in close and underclothes. 2000 One previous indecent group previous victims-
proximity. exposure mentioned in treatment. age 11,15
P8 35 Probation 56 Supported Convicted. Indecent assault on Non sexual offences only, Specialist Female aged 15
service (WASI) independent 2 year young female in shopping harassment and group
“special living for past probation centre. Followed her dishonesty offences. treatment for
needs” year. Reliant on order around, making indecent 12 months.
group support from suggestions. Approached Indiv. work
family in close and grabbed her. 2000 with prob.
proximity. officer and
P9 32 Probation 73 Lives at home Convicted. Indecent assault x 4 on No previous convictions. Specialist Adult females
service (WASI) with mother. 3 year females in shopping No further action taken by group aged approx. 20-
“special Has had probation centre. Grabbed buttocks police on another incident treatment for 6 50. Not known
needs” contacted with order. when passing on stairs, – grabbed female‟s months. Indiv. previously.
group LD services having waited for victims genitals in street. work with
throughout life. to appear. 2000 prob. officer
Table 2: Worker participant details
Role and place of employment Experience of work with sex offenders with learning Working with offender participants
W1 Clinical psychologist in secure unit Specialist work with sex offenders with learning P1
Qualified disabilities. P4
Wide experience of work with people with learning Limited work with P2
W2 Clinical psychologist in secure unit Experience of work with sex offenders with learning P2
Qualified disabilities. P3
Wide experience of work with people with learning
W3 Specialist group worker responsible for Experience of work with sex offenders with learning Interviewed specifically about P5 and
“learning needs” sex offender group. disabilities. P9.
Qualified probation officer Experience of work with non-disabled sex offenders and Also working with P6, P7, and P8.
W4 Keyworker in probation hostel Limited experience of individual work with sex offenders. P6
Unqualified worker Personal experience of people with learning disabilities.
W5 Field probation officer responsible for Limited experience of work with sex offenders with P8
individual supervision learning disabilities. Has also worked with P7 in the past
Qualified probation officer Experience of work with non-disabled sex offenders and
W6 Field probation officer responsible for Little experience of work with sex offenders with learning P7
individual supervision disabilities.
Qualified probation officer Some experience of work with non-disabled sex
offenders and other offenders.
Table 3. Categories and their underlying concepts.
“Targeting the victim” Relationship with victim
Characteristics of victim
“Offence planning” Grooming → grabbing
Overcoming external inhibitors
Overcoming internal inhibitors
“Decision point” Victim “readiness”
“Offence” Sexual arousal during offence
Type of offence
“Stopping the offence” Attempts to stop
“Reactions to offence” Post offence feelings of offender
“Consequences of being caught” Positive consequences
“Offender attitudes and beliefs” Blaming –“it‟s their fault”
Denying – “ I‟m not an offender”
„Poor me‟ – “I‟m the victim”
Ignorance – “I don‟t have the
knowledge or skills”
targeting the victim
reactions to offence
attempts to stop
Figure 1: An integrated summary of the analysis, highlighting the linear and
theoretical relationships between categories.