Adapted offending behaviour programmes Andy Inett Consultant Forensic Psychologist Learning Disability Forensic Service Kent and Medway Partnership NHS and Social Care Trust PowerPoint in 16:9 ratio, i.e. Widescreen

KMPT Learning Disability Forensic Services: Tarentfort Centre 20 Low secure beds, adult males Brookfield Centre 13 bedded step down / locked rehab unit, adult males East Kent Community Forensic Psychology Service The learning disability services covers: inpatients services such as Tarentfort Centre (20 service users, Forensic and mental health needs), Brookfield (Mostly Forensic needs looking a rehabilitation 12 SU), Birling Centre (A&I Non Forensic but SU that challenge the service 10 SU) and east Kent Community team ….

Pathways into LD forensic services (Lindsay et al 2013) Childhood adversity Witnessing violence Offending Intellectual disability PD / ADHD

CBT for PWLD Insufficient evidence to conclude that CBT is an empirically validated treatment, although promising evidence base (Verenooghe and Langdon, 2013)

Adapted SO Treatment Williams et al 2007: Adapted SOTP in Prison: reductions in assessment scores after treatment in 150 men with LD SOTSEC ID (2010): Significant improvement in offence supporting attitudes, victim empathy and sexual knowledge post group and at 6 month follow up Treatment gains maintained, and Low recidivism rate at follow up (Heaton and Murphy, 2013).

Treatment groups Kent Partnership Adapted Sex Offender Treatment Programme (KPA-SOTP), run in partnership with Kent probation Received Howard league nomination, recognised by the courts as accredited program. Year long program based on SOTSEC-ID / Adapted probation model. Two referral routes:

Person displaying risky sexual behaviour becomes known to Community LD team Person commits sexual offence, enters CJS Identified as a person with LD pre trial / pre sentence Referral to Forensic Psychology team Legally stipulated attendance via a treatment order via the courts / licence conditions post release from prison Assessed for suitability, discussed at central supervision meeting KPA SOTP

KPA SOTP modules 1. Getting to know you outline of the group/ what to expect, Introduce ways of working pre group assessments , Brief disclosure Group rules, group formation activities (e.g. Geese Theatre exercises)

KPA SOTP modules 2. Sexuality and the law How the body develops and changes Pregnancy, STDs Relationships Consent Illegal behaviours Use pictures, group tasks and discussions, videos, role-plays, quiz.

KPA SOTP modules: 3. My Offending Understanding thoughts, and the link to feelings and behaviour How thoughts can be unhelpful and increase risk of offending Self talk Steps to offending Aim is to help the men take responsibility, identify their unhelpful thinking and behaviour. Good Lives model

How we adapt GLM for ID offenders: Learning new things Being creative / Making things Relationships Enjoying activities that you are good at Spirituality Healthy Living Feeling in control of what happens to you Feeling Calm/Stress Free

KPA SOTP Modules 4. Victim Empathy Understanding victim's perspective Negative effects of offending Taking action to address the harm that was done Victim statements, ripple effect, role-play, videos

KPA SOTP modules: 5. Relapse Prevention / New life planning Planning to live a good life in the future Possible barriers to achieving your goal of not offending Skills training Managing feelings Assertiveness and relationship skills Problem solving: STOP THINK DO Developing “Steps away from offending”

Outcomes Service user feedback on Staying Safe group: They felt that the group would help them to remember to keep safe and not to re-offend. They described learning new strategies to cope, One service user felt that they group helped him to understand that at times his behaviour was inappropriate Described the group as “good” and “worth it”

Outcomes Audit in 2014 showed positive shifts in attitudes that support offending and Victim empathy in 70 – 90% of KPA SOTP participants (n=10) Similar patterns in 2014 and 2015 groups Follow up recidivism audit underway

Fire setting Intervention Program for Developmental and Intellectual Disabilities (FIP DID) Some evidence for fire setting treatment in ID, i.e. Taylor et al, 2002; 2006 28 week group based adapted Cognitive Behaviour Therapy (CBT) based intervention, based on FIP MO, adapted for people with LD Collaboration between Kent forensic services and University of Kent Piloted at Trevor Gibbens Unit, manual developed and being trialled across the UK Based around Risk Need and Good lives model

FIP DID Modules: Group formation (2 sessions) Understanding my offending (6 sessions) Fire interest / safety (4 sessions) Mood and coping (2 sessions) Communication and relationships (4 sessions) Offence supporting cognitions (2 sessions) Mental Health and offending (1 session) Exploring offence patterns (4 sessions)

Other EKCFPS adapted treatments Staying Safe group Thinking Skills EQUIP

Challenges Compliance / Coercion Lack of legal frameworks/ robust provision Valuing people vs risk management Consent Understanding of legislation / prohibitions Lack of LD training for probation staff