Complex Needs I: Worrying or Harmful Sexual Behaviours.

Written by Clare Melvin

Complex Needs.

Feedback from the GLLDCOP consultation meetings included requests for guidance and information about when learning disabilities has additional or complex needs.  This post is the first of a series of slightly longer blogs addressing some of the issues raised and will include offending and harmful behaviours, profound and severe learning disabilities, mental health, immigration, and challenging behaviour.  This week explores concerning sexual behaviours and the resources and support available, along with a spotlight on SOTSEC-ID, an organisation providing support, training and information about adults and young people with IDD who display worrying or harmful sexual behaviours.  The usual news, events and training are found at the bottom of the post.

Sexual Behaviours.

Harmful or concerning sexual behaviours are displayed by a few individuals with LD, just as in those without LD, and this includes behaviours ranging from inappropriate masturbation, sexualised language, stalking, rape and internet behaviours.

Whilst inappropriate and harmful behaviours must be address, it is essential to acknowledge and respect an individual’s sexuality and not pathologise or deny typically developing sexuality and behaviours.  Love and sexual relationships has been discussed in previous blogs (Hard Conversations.Perky, Women with LD, and Relationships in CQC Inspections.) and included information on Supported Loving group, an award-winning campaign highlighting the importance of good support in helping people with learning disabilities find love and develop relationships. They have a blog, and accessible book, Sexuality and Learning Disabilities (2nd Edition), that is straight forward, without jargon, written for support workers, carers, professionals and may also be helpful for family members. It provides practical guidance and case examples on a range of topics including: Sex and Marriage, Masturbation, Relationships and the Internet, Domestic Violence, Sexual Abuse and Exploitation, When Sexual Behaviours become Harmful or Abusive, and Gender Identity/LGBTQ. You can find further details of the book here.

For children and young people, parents and professionals might find Freddy Jackson Brown and Sarah Brown’s When Young People with Intellectual Disabilities and Autism Hit Puberty helpful.

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Help for those who display concerning or offending sexual behaviours is more widely available than it used to be.  Historically, those with LD were excluded from mainstream group treatment programmes, however adapted programmes have since been developed. They cater for those with mild/borderline to moderate LD (IQ range typically between 55 and 80), and include people with other developmental disorders, such as autism. It is important to note here that the behaviour is far more common in men with LD than in women with LD (just as it is for the general population).

Group treatment programmes are available in prisons, secure services and the community.   There are various adapted programmes available (e.g. see SOTSEC-ID below) and the majority adopt a cognitive behavioural therapeutic (CBT) approach, helping to identifying the thoughts and feelings that underlie behaviours.  Group CBT treatment is currently considered best practice, although individual treatment and other approaches such as Dialectic Behavioural Therapy are available.  Group Treatment programmes include modules addressing sex and relationships, victim empathy, identifying thinking styles and patterns that encourage or maintain criminal behaviours and developing a relapse prevention planSome programmes may offer a maintenance group, continuing to provide support once the treatment group is complete.  There are also other options available post-treatment such as Circles of Support and KeyRing to provide further support (see more below). 

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SOTSEC-ID (adults)

SOTSEC-ID is an organisation, founded by Professor Glynis Murphy and Dr Neil Sinclair, which has devised and established a cognitive behavioural treatment for men with intellectual and developmental disabilities (IDD), who have engage in harmful sexual behaviour.

Watch a short video about SOTSEC-ID here.

SOTSEC-ID began in 2000 in response to a clinical need for tackling risky behaviours in a marginalised population of men with intellectual and/or developmental disabilities in community services. A research grant from the Department of Health (DoH) was awarded to evaluate the programme, with further funding provided by the Baily Thomas Foundation. Evaluation of the treatment showed statistically significant improvements in sexual knowledge, empathy, and cognitive distortions (thinking styles).  Furthermore, most  men  did  not  re-offend and long  term follow up,  over 3+ years,  showed  a  recidivism (repeating the behaviour)  rate  of  only  6%. The final report to the DoH and further publications are available here.

SOTSEC-ID offers twice-yearly SOTSEC-ID programme facilitator training for practitioners (e.g. clinical and forensic psychologists, social workers, probation officers) and annual training in forensic risk assessment for people with IDD, including the ARMIDILO-S and START (Short-Term Assessment of Risk and Treatability).  Training is typically held in Euston, London however, the organisation can also provide in-house, bespoke training. For upcoming dates and further details please see here.

ySOTSEC-ID (Young People)

In 2012, ySOTSEC  (young SOTSEC-ID) was formed as a collaborative group of practitioners and researchers working with children and young people with Intellectual or Developmental Disabilities (IDD) who behave in ways which are sexually harmful.  Funding from the Paul Hamlyn Foundation allowed for the development of an intervention specifically for adolescents drawing on some  SOTSEC-ID experience in their adult. The young person programme is called Keep Safe, you can read more about the development of the programme here.

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Demonstrating session activities in ySOTSEC-ID training.

 

The Keep Safe Development Group included clinicians and researchers from the Tizard Centre, colleagues and professionals from community and secure specialist services as well as advisors with learning disabilities from the Aldingbourne Trust/Powerful Trainers.

You can watch the Power Trainers Focus Group video ‘Experts by Experience’ here

Since it’s inception, SOTSEC-ID & ySOTSEC-ID have:

  • Trained over 500+ practitioners to deliver the adult SOTSEC-ID treatment programme,
  • Trained a variety of practicing clinicians, across the UK, as well as in the Netherlands, Spain, Switzerland, New Zealand, Australia and a large group of practitioners in Japan,
  • Published an updated treatment manual (the SOTSEC-ID model),
  • Trained over 120 professionals in the new Keep Safe (ySOTSEC-ID) intervention for addressing  harmful sexual behaviours in adolescents with IDD,
  • Initiated a trial of Keep Safe programme across parts of UK,
  • Published the Keep Safe treatment manual.
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Glynis Murphy and Neil Sinclair, founders of SOTSEC-ID (front) and Rowena Rossiter of Keep Safe (second row far left).

In addition, SOTSEC-ID has:

  • Evolved into a self- funded academic and practitioner organisation,
  • Developed a professionals network that includes health, criminal justice, social care and voluntary sector members which provides peer support and a forum to discuss treatment and ethical issues,
  • Won multiple awards including the Howard League – Community Alternatives to Custody (runner up), the MB Shapiro award (for contributions to clinical psychology, academic co-chair of SOTSEC-ID, Glynis Murphy) and been awarded numerous PhD scholarships and awards for research around the SOTSEC-ID and ySOTSEC-ID programmes.

SOTSEC-ID & ySOTSEC Resources

As well as training, SOTSEC-ID and ySOTSEC-ID provide resources for professionals, families, carers and individuals with learning disabilities.  These include: assessments, top tips and advice on keeping safe, links to useful organisations, sex & relationships education materials (ySOTSEC-ID); plus easy-read guidance about the criminal justice system, including booklets on Being at the Police Station,  In the Court Room (including youth courts), On Probation (including youth) and liaison and diversion services, research and publications, and easy-read information the law and pornography and being on licence (SOTSEC-ID).

For information about training, resources or the SOTSEC/ySOTSEC programme please see the website or email: sotsec@kent.ac.uk

 

Additional Resources/Sources of Information for working with and supporting individuals with IDD who display worrying or harmful sexual behaviours:

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  • G-MAP offers a range of services for children and young people who sexually abuse others, working with their families, carers and the agencies and practitioners who support them.  G-MAP also offer a specialist service for young people with learning disabilities – Read more about their approach here.
  • NSCATs, the NSPPC specialist service for children at high risk of harmful sexual behaviour. They provide information and guidance, including resources for parents and children about keeping safe, they offer an online course for working with younger children (12 and under) and provide an evidence-based framework for working with children and young people who display harmful sexual behaviours.
  • Circles UK seeks greater public protection by working towards a substantial reduction in sexual offending by providing a range of services to local Circles of Support and Accountability Projects. It also aims to develop a greater public understanding of community approaches to public protection. Find out more at their website.
  • KeyRing work towards finding the right package of support for someone with a learning disability as they believe that this can be the key to turning their life around.  KeyRing members and others form the Working for Justice group. This Group helps the criminal justice system to support people with learning disabilities. The Group won the National Learning Disabilities Award (2014) for their work making the system more accessible. Learn more about the Working for Justice group here and find out about experiences of the group here.
  • The Good Lives Model for Adolescents Who Sexually Harm edited by Bobbie Print – Find out more here.
  • Assessment and Treatment of Sexual Offenders with Intellectual Disabilities edited by Craig Leam, William Lindsay and Kevin Brown. A book for professionals. Read more here.

LD in the news

  • Nike Signs First Professional Athlete with Cerebral PalsyNike has signed Justin Gallegos as the sportswear brand’s first professional athlete with cerebral palsy.  Watch a video of him receiving the news and read Justin’s take on the news here.image
  • GMB, a trade union, has launched a ‘Thinking Differently at Work’ campaign to reduce discrimination. A toolkit has been produced, designed to help create more inclusive environments in light of the discrimination faced by neurodivergent workers.  Read more here and access the toolkit here.
  • Gary Bourlet one of the founders of Learning Disability England’s has been recognised for his years of campaigning and made no. 8 in The Disability Power 100 list.

Events & Training:

  • MindED, an elearning forum to support healthy minds have just release free online training resource about people with intellectual disabilities and challenging behaviour, autism, and those with mental health problems .  Sessions are open to all users. Sign up and find out more here.
  • SOTSEC-ID facilitator training 12th and 13th November 2018 in Dublin. If you are interested in attending please email sotsec@kent.ac.uk
  • There are just over two weeks until  the GLLDCOP free launch event! 7th November 2018 at the Holiday Inn London Bloomsbury. Come along and join the new community providing opportunities for people with learning disabilities, families, carers and professionals. Find out more and Book your place here.

Don’t forget to join our GLLDCOP facebook group and follow us on Twitter @glldcop

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