The treatment of men with a learning disability convicted of exhibitionism

This paper reviews work on the treatment of men convicted of exhibitionism or indecent exposure. Recidivism is extremely high after treatments, with true figures on recidivism unavailable until 4 years after conviction. It is extremely difficult to control for treatment effects because of the ethical issues surrounding withholding of treatment, but cognitive techniques provide a promising treatment approach. The present study attempted to address all these issues for men with a learning disability. A cognitive treatment is presented and data are available for at least 5 years after conviction. An AB design was used and treatment effects were monitored carefully. Treatment dealt with the issues of accepting that the offense took place, taking responsibility for the offense, accepting the intention of the offending behavior, victim awareness, and behavior consistent with offending for four offenders. All the men responded to treatment, although one offender with only 1 year of probation responded less convincingly than others. Beliefs relating to indecent exposure being fun or not causing harm to women seemed most open to alteration. The beliefs in which the perpetrator thought that the victim shared responsibility for the offense and that women may take a long while to recover from such an incident, seemed the most difficult to alter. Individual characteristics of the case examples are discussed in terms of these general trends.