Document Sample
					       The Offence Process of Sex Offenders with Intellectual Disabilities:
                             A Qualitative Study.

                                   AUTHOR DETAILS
 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, 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
Table 2.
                               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

Data analysis

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

overcoming inhibitors:

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

down below.

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

secrecy/covering up.

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.

“Offence planning”

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.

“Decision point”

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

opening up.

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”,

via blaming:

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

and beliefs”:

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?

P4: Yeah.

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

of ignorance.

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

to bed.

R: So you know what the punishment is here very clearly, and does that stop you or do you have to be

stopped sometimes?

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?

P3: No

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

been illuminating.

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

Marshall, 2004).

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

relevant information.

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



       Allam, J., Middleton, D., & Browne, K. (1997). Different Clients, different

needs? Practice issues in community-based treatment for sex offenders. Criminal

Behaviour and Mental Health. 7 69-84.

       American Psychiatric Association. (1994) Diagnostic and Statistical Manual of

Mental Disorder (4th edition). Washington, DC: Author.

       Arscott, K., Dagnan, D., & Stenfert-Kroese, B. (1998). Consent to

psychological research by people with an intellectual disability. Journal of Applied

Research in Intellectual Disabilities. 11 (1), 77-83.

       Bremble, A & Rose, J. (1999). Psychological intervention for adults with

learning disabilities accused of sexual offending. Clinical Psychology Forum, 131, 24-


       British Psychological Society. (2001). Learning disability: Definitions and

Contexts. Leicester: Professional Affairs Board of the British Psychological Society.

       Brown, H. (1997). Introduction to Special issue on Sexuality. Journal of

Applied Research in Intellectual Disabilities, 10 (2), 80-82.

       Brown, H. & Thompson, D. (1997). The Ethics of Research with Men Who

Have Learning Disabilities and Abusive Sexual Behaviour: A Minefield in A Vacuum.

Disability and Society, 12 (5), 695-707.

       Charman, T. & Clare, I. (1992). Education about the laws and social rules relating

to sexual behaviour. Mental Handicap, 20, 74-80.

       Clare, I. (1993). Issues in the assessment and treatment of male sex offenders

with mild learning disabilities. Sexual and Marital Therapy, 8 (2), 167-180.

       Clare, I.C.H., & Murphy, G.H. (1998). Working with Offenders or Alleged

Offenders with Intellectual Disabilities. In E. Emerson, C. Hatton, J. Bromley, & A. Caine

(Eds.), Clinical Psychology and People with Intellectual Disabilities. (pp. 154-176).

Chichester: John Wiley and Sons Ltd.

       Day, K. (2000) Offenders with Mental Retardation. In C.R. Hollin (Ed.), Handbook

of Offender Assessment and Treatment. Chichester: Wiley.

       Elliott, R., Fischer, C.T., & Rennie, D.L. (1999). Evolving Guidelines for

Publication of Qualitative Research Studies in Psychology and Related Fields. British

Journal of Clinical Psychology 38, 215-229.

       Finklehor, D. (1984). Child Sexual Abuse: New Theory and Research. New

York: Free Press.

       Griffiths, S., Quinsey, V., & Hingsburger, D. (1989). Changing Inappropriate

Sexual behaviour: A community based approach for persons with Developmental

Disabilities. Baltimore, MD: Paul H. Brookes.

       Haaven, J., Little, R., & Petre-Miller, D. (1990). Treating Intellectually Disabled

sex offenders: a model residential program. Orwell, VT: Safer society Press.

       Haaven, J.L., & Coleman, E.M. (2000). Treatment of the Developmentally

Disabled Sex Offender. In D.R Laws, S. M. Hudson, & T. Ward. (Eds.), Remaking

Relapse Prevention with Sex Offenders: A Sourcebook. (pp. 369-388). Thousand

Oakes: Sage.

       Hill-Tout, J., Thomas, A., & Dunkerton, K. (1998). Managing the Support of a

Sex Offender with Learning Disabilities in the Community: A Team Approach to

Intervention. Journal of Learning Disabilities for Nursing Health and Social Care 2 (3),


       Keating, T.P. (2000). RESPECT: A 7 step system to treat pedophiles who are

mentally retarded, have mental illness, and physical handicaps. Journal of

Psychology and Human Sexuality, 11(3), 89-114.

       Keeling, J. & Rose, J. (In Press) The Adaptation of a Cognitive-Behavioural

Treatment Programme for Special Needs Sexual Offenders Relapse Prevention with

Intellectually Disabled Sexual Offenders. British Journal of Learning Disabilities.

       Lindsay, W.R. (1999). Cognitive Therapy. The Psychologist, 12 (5), 238-241.

       Lindsay, W.R., Neilson, C., Morrison, F, & Smith, A. (1998b). The treatment

of six men with a learning disability convicted of sex offences with children. British

Journal of Clinical Psychology, 37 (1), 83-98.

       Lindsay, W.R. & Smith, A.H.W. (1998a). Responses to treatment for sex

offenders with intellectual disability: A comparison of men with 1- and 2- year

probation sentences. Journal of Intellectual Disability Research, 42 (5), 346-353.

       Lund, C.A. (1992). Long-term treatment of sexual behavior problems in

adolescent and adult developmentally disabled persons. Annals of Sex Research, 5

(1), 5-31

       Mann, R.E. (2004). Innovations in sex offender treatment. Journal of Sexual

Aggression, 10 (2), 141-152

       Mann, R.E & Thornton, D. (1998) The Evolution of a Multisite Sexual offender

Program. In Marshall, W. L., Fernandez, Y. M., Hudson, S. M., & Ward, T. (Eds.),

Sourcebook of Treatment Programs for Sexual Offenders. (pp. 47-57). New York:


       Marshall, W.L., & Barbaree, H.E. (1990). An Integrated theory of the etiology

of sexual offending. In W.L. Marshall, D.R. Laws, & H.E. Barbaree, (Eds.), Handbook

of sexual assault: Issues, theories, and treatment of the offender. (pp. 257-275).

New York: Plenum.

       Murphy, W.D., Coleman, E.M., & Haynes, M.R. (1983). Treatment and

Evaluation Issues with the Mentally Retarded Sex Offender. In J.G. Greer, I.R. Stuart

(Eds.), The Sexual Aggressor: Current Perspectives in Treatment. New York: Van

Nostrand Reinholt.

       Murphy, G.H., Holland, A., Fowler, P., & Reep, J. (1991). MIETS: a service

option for people with mild mental handicaps and challenging behaviour or

psychiatric problems. 1. Philosophy, service, and service users. Mental Handicap

Research, 4 (1), 41-66

       Nolley, D., Muccigrosso, L., & Zigman, E. (1996b). Treatment successes with

mentally retarded sex offenders. In E. M. Coleman, M. S. Dwyer, & N. J. Pallone

(Eds.), Sex offender treatment: Biological dysfunction, intrapsychic conflict,

interpersonal violence. (pp. 125-141). New York: Haworth Press.

       O‟Connor, C. & Rose, J. (1998). Sexual Offending and Abuse Perpetrated By

Men with Learning Disabilities: An Integration of Current Research Concerning

Assessment and Treatment. Journal of Learning Disabilities for Nursing, Health and

Social Care. 2 (1), 31-38.

       O‟Connor, W. (1996). A Problem-Solving Intervention for Sex Offenders with

an Intellectual Disability. Journal of Intellectual and Developmental Disability, 21(3),


       O‟Connor, W. (1997). Towards an Environmental Perspective on Intervention

for Problem Sexual Behaviour in People with an Intellectual Disability. Journal of

Applied Research in Intellectual Disabilities. 10 (2), 159-175.

       Perkins, D. (1991) Clinical Work with Sex Offenders in Secure Settings. In C.

Hollin & K. Howells (Eds.), Clinical approaches to Sex Offenders and their Victims.

(pp.151-178) Chichester: Wiley.

       Perkins, D., Hammond, S., Coles, D., & Bishopp, D. (1998). Review of Sex

Offender Treatment Programmes. Dept. Of Psychology, Broadmoor Hospital.

Prepared For The High Security Psychiatric Services Commissioning Board

       Pithers, W.D. (1990). Relapse Prevention with Sexual Aggressors: A method

for enhancing therapeutic gain and enhancing external supervision. In W.L. Marshall,

D.R.Laws, & H.E.Barbaree. (Eds.), Handbook of Sexual Assault: Issues, theories,

and treatment of the offender (pp.343-361). New York: Plenum.

       Rose, J., Jenkins, R., O‟Connor, C., Jones, C., & Felce, D. (2002) A group

treatment for men with intellectual disabilities who sexually offend or abuse. Journal

of Applied Research in Intellectual Disabilities. 15 (2), 138-150.

       Strauss, A. & Corbin, J. (1990). Basics of Qualitative Research: Grounded

Theory Procedures and Techniques. Newbury Park, CA: Sage

       Swanson, C.K, & Garwick, G.B. (1990). Treatment for Low-Functioning Sex

Offenders: Group Therapy and Interagency Co-Ordination. Mental Retardation, 28

(3), 155-161.

       Sykes, G., & Matza, D. (1957). Techniques of Neutralization: A Theory of

Delinquency. American Sociological Review. 22 (6), 664-670.

       Thompson, D. (1997). Profiling the Sexually Abuse Behaviour of Men with

Intellectual Disabilities. Journal of Applied Research in Intellectual Disabilities. 10 (2),


       Thompson, D. & Brown, H. (1997). Men with Intellectual Disabilities Who

Sexually Abuse: A Review of the Literature. Journal of Applied Research in

Intellectual Disabilities 10 (2), 140-158.

       Ward, T., & Hudson, S.M. (1998). A Model of the Relapse Process in Sexual

Offenders. Journal of Interpersonal Violence, 13 (6), 700-725.

       Webster, S.D. & Marshall, W.L. (2004) Generating data with sexual offenders

using qualitative material: A paradigm to complement not compete with quantitative

methodology. Journal of sexual Aggression, 10, 117-122.

       Wolf, S. (1985). A multifactor model of deviant sexuality. Victimology: an

international Journal, 10, 359-74.

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,
                        from file)
                                                                            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.
                        from file)
                                     months                                 Gross indecency with      incidents recorded in        psychologist       Known as
                                                                            a minor.                  notes.                                          local friends
                                                                            Both 1993
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.
                        from file)
                                                        to concerns         near home to              Numerous “incidents”         psychologist       Neighbours
                                                        Convicted           neighbourhood             recorded in notes.
                                                                            children. 1999
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
                        from file)
                                     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
                                                                            1999                      recorded
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.
                                                    other offenders.
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
                                                    other offenders.
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.

                Category                            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
                                       Victim‟s behaviour
                                       Secrecy/covering up
   “Stopping the offence”              Attempts to stop
   “Reactions to offence”              Post offence feelings of offender
                                       Others‟ reactions
   “Consequences of being caught”      Positive consequences
                                       Negative consequences
                                       New inhibitors
   “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

  consequences of
  being caught

                                                              offence planning

                          offender's attitudes
                            and beliefs

reactions to offence

                                                                  decision point

          attempts to stop

            Linear link
            Theory link

  Figure 1: An integrated summary of the analysis, highlighting the linear and
                  theoretical relationships between categories.


Shared By: