Cognitive-behavioural treatment for men with intellectual disabilities and sexually abusive behaviour: a pilot study.
CBT boosts sexual knowledge and empathy in autistic men with ID, yet risky acts can linger without longer follow-up.
01Research in Context
What this study did
Murphy et al. (2007) ran a small pilot with six men. All had intellectual disability and some had autism. Each man had a history of sexually abusive behavior.
The team gave 24 one-hour CBT sessions. Topics covered sexual knowledge, victim empathy, and thinking errors. They tested the men before and after.
What they found
After therapy, every man scored higher on sexual knowledge tests. Victim empathy scores also rose.
Yet three men still showed risky sexual behavior. One tried to hug staff inappropriately. Another exposed himself. Gains in thinking were real, but behavior change was spotty.
How this fits with other research
Eisenmajer et al. (1998) saw stronger results. Their group CBT plus two-year probation cut re-offending far more than one-year probation. Longer support seemed key.
Sappok et al. (2024) moved the idea forward. They taught sexual health to autistic adults without offense history. Virtual classes worked well. It shows CBT ideas can travel beyond court-mandated settings.
Flygare et al. (2020) used adapted CBT for autistic adults with OCD. Like Glynis, they saw skill gains but only one in six reached full remission. Both studies warn: learning can outpace real-life use.
Why it matters
If you run CBT for sexual behavior, add booster checks. Teach the facts, then role-play safe choices. Track actual behavior for months, not just test scores. When possible, extend support beyond a few months—Eisenmajer et al. (1998) proved time matters.
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02At a glance
03Original abstract
BACKGROUND: Cognitive-behaviour therapy (CBT) seems to be becoming the treatment of choice for non-disabled sex offenders. Nevertheless, there have been relatively few evaluations of such treatment for men with intellectual disabilities (ID) and sexually abusive behaviour. METHOD: A pilot study providing CBT for two groups of men with ID is described. Measures of change in sexual knowledge, victim empathy and cognitive distortions were collected, together with a log of further sexually abusive behaviour. RESULTS: Fifteen men were offered treatment but some dropped out and some declined to take part in the research. The results for the eight men who consented to the research and completed treatment showed significant positive changes in sexual knowledge and victim empathy (two men completed both groups, making 10 sets of data in all). Cognitive distortions showed significant change on only one of the two measures. Some men showed further sexually abusive behaviour either during or after the treatment group (all had been previously diagnosed as on the autistic spectrum). CONCLUSION: There is a need for a larger multi-site trial of treatment with a broad set of measures and the ability to analyse who benefits from such treatments and who does not.
Journal of intellectual disability research : JIDR, 2007 · doi:10.1111/j.1365-2788.2007.00990.x