Sexual Abuse: A Journal of Research and Treatment, Vol. 17, No. 4, October 2005 (
Relapse Prevention with Intellectually Disabled
Jenny A. Keeling
and John L. Rose
The adaptation of relapse prevention theory to sexual offending (W. D. Pithers,
J. K. Marques, C. C. Gibat, & G. A. Marlatt, 1983) has represented an important
movement in cognitive-behavioural treatment for sexual offenders. However, this
model of relapse prevention has been criticised for its limited view and over-
simpliﬁcation of the relapse prevention process (R. K. Hanson, 2000; T. Ward
& S. M. Hudson, 1996). As a result, T. Ward and S. M. Hudson (2000a) have
developed a multiple pathway model of the relapse prevention process based on
self-regulation theory. Although this model continues to be empirically validated
on sexual offenders (J. A. Bickley & A. R. Beech, 2002; T. Ward, S. M. Hudson,
& J. C. McCormick, 1999), there has been no empirical research regarding the
application of this theory to intellectually disabled sexual offenders. This paper
discusses whether the characteristics of offenders in each of the relapse offence
pathways, as described by T. Ward and S. M. Hudson (2000a), may be similar
to the characteristics of intellectually disabled sexual offenders. From a review
of the literature, it appears that the intellectually disabled sexual offender may
be most likely to offend via the approach—automatic pathway or the avoidant-
passive pathway. The potential treatment implications of the self-regulation model
for intellectually disabled sexual offenders is discussed, as well as the need for em-
pirical evaluation with regards to the application of this model to the intellectually
disabled sexual offender population.
KEY WORDS: intellectual disability; relapse prevention; sexual offenders.
Research into sexual offending behaviour has more recently focused on
the application of treatment to distinct populations of sexual offenders, such
as intellectually disabled sexual offenders (Lindsay, 2002). This research has
Department of Psychology, University of Birmingham, Birmingham, United Kingdom.
To whom correspondence should be addressed at Department of Psychology, University of
Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom; e-mail:firstname.lastname@example.org.
2005 Springer Science+Business Media, Inc.