This thesis examines the use of psychological therapies adapted for adults with intellectual disabilities (ID). The systematic review identified that four third-wave therapies had been adapted for use with adults with ID: mindfulness-based approaches, Dialectical Behaviour Therapy, Compassion Focused Therapy, and Acceptance and Commitment Therapy. These therapies were found to significantly improve challenging and offensive behaviour, smoking, and mindfulness and acceptance skills. Third-wave therapies appeared to improve mental health problems for some but not all participants. While these findings are promising, they must be interpreted with caution due to the ‘weak’ quality of included studies. The empirical study explored the views of six sex offenders regarding the adapted Sex Offender Treatment Programme (aSOTP) using Interpretative Phenomenological Analysis (IPA). Analysis revealed three themes: choice, disclosure and ‘It’s like being back at school’. This study identified that sex offenders with ID learn to deny their sexual offences to avoid experiencing shame. The disclosure process requires them to drop this defense
mechanism. Participants either experienced relief or shame after disclosing, determined by the level of group safeness. Low levels of safeness appear to be associated with experiences of shame. Recommendations are put forward for aSOTP developers and facilitators based on findings from the empirical study.
The final paper integrates findings from the systematic review and empirical study to discuss implications for clinical practice and future research in greater depth. The final paper ends with a personal reflection on the whole research process.