Title: RCT of group CBT for men with intellectual and/or developmental disabilities and harmful sexual behaviour: the HaSB-IDD trial
Funder: Department of Health and Social Care

Abstract: The public are concerned about men who commit sexual offences. Cognitive behavioural treatment (a specific kind of talking therapy) seems to help these men, if they have committed sex offences. Mostly this treatment is available in prisons, probation and in health settings, and research shows this is helpful in stopping men from reoffending. _x000D_ _x000D_ Some men who commit sex offences have learning disabilities or autism. However, these men often do not get any treatment. _x000D_ _x000D_ This project will offer men with learning disabilities and/or autism the same kind of treatment that non-disabled men get. The treatment has been specially adapted for them and is called SOTSEC-ID. We will look at whether this is helpful for the men, in the way they feel and the way they behave. _x000D_ _x000D_ So, men with learning disabilities and/or autism who have done harmful sexual behaviour, from 4 areas of England (South East, East, Midlands and North), will be asked to join the project. They will get Treatment as Usual (TAU) or the special new treatment, called SOTSEC-ID. They will be asked how they feel, and we will write down whether they have done any offences, at the start of the research, then 6 months later, then one year later, and two years later._x000D_ _x000D_ The research will last for 54 months overall (4 and a half years), and if the treatment is successful, this will make the men less risky so that they do less sexual offences. It will improve public safety, and reduce the number of victims. It will also mean that the cost of care for the men is lower.

Lay abstract: Research question_x000D_ Does group cognitive behavioural treatment lead to a reduction in cognitive distortions and further harmful sexual behaviour, while improving empathy, sexual knowledge, self-esteem and locus of control for men with IDD who have engaged in harmful sexual behaviour in comparison to treatment-as-usual?_x000D_ Background_x000D_ Cognitive behavioural treatment for non-disabled men who engage in harmful sexual behaviour is widely available in prisons, probation and in health settings. Such treatment has been well researched and the majority of studies report positive outcomes in terms of reduced re-offending. This kind of treatment is far less widely available for men with intellectual and/or developmental disabilities (IDD) and has been less often researched. The studies that do exist have been reviewed in a number of recent systematic reviews and said to be promising, but none have involved randomised controlled trials._x000D_ Aims and objectives_x000D_ We aim to conduct a single-blind cluster-randomised controlled trial of a well-established group CBT programme known as SOTSEC-ID, across 30 sites in the UK, in secure services and community settings, for men with IDD and harmful sexual behaviour. We will assess cognitive distortions, frequency of harmful sexual behaviour, sexual knowledge, victim empathy, self esteem and locus of control in treated and untreated men with IDD and harmful sexual behaviour. We will also assess quality of life and costs and cost effectiveness of the treatment._x000D_ Methods_x000D_ Men with IDD and harmful sexual behaviour will be recruited across 4 areas of England (South East, East, Midlands and North). Following assessment for suitability, and consent procedures, they will be recruited and assessed (Baseline, time 1) for cognitive distortions, harmful sexual behaviour, sexual knowledge, victim empathy, self-esteem and locus of control. The sites will be randomised to receive either 6 mths of SOTSEC-ID treatment with risk management, or to receive TAU. At six-months post-baseline (time 2) all men will be re-assessed, and then again at 12-months post baseline (time 3), and 24-months post-baseline (time 4). A modified CSRI will be used to measure costs of treatment/TAU, and the EQ-5D-5L to measure health-related quality of life, so as to allow costs and cost effectiveness of the intervention to be analysed. In addition, a qualitative study will examine the men's views and therapist views of the treatment (including its acceptability) in small purposive samples._x000D_ PPI has been considered important and has been built into the project in a number of ways, with consultation with people with learning disabilities and carers throughout the project._x000D_ Timelines and impact_x000D_ The trial will last for 54 mths overall, and it is anticipated that if the treatment proves to be successful, this would significantly reduce the threat of harm posed by individuals who were successfully treated. It would improve public safety, particularly for vulnerable individuals with disabilities (potential victims) and reduce the need for treatment for victims. It will also enhance the confidence of therapists who are providing this treatment and reduce the care costs associated with risk management strategies currently used to manage these individuals with IDD and harmful sexual behaviour.

Research activity codes: 6.6 PSYCHOLOGICAL AND BEHAVIOURAL
Health categories: MENTAL HEALTH