Diagnostic labels may negatively impact on clinicians' judgments and perceptions of individuals and therefore clinicians should think carefully about whether, and how, they use diagnoses and efforts should be made to destigmatize diagnostic terms.

The Gender Identity Development Service (GIDS) supports gender diverse young people, and their families but currently does not provide weekly psychological therapy as part of its core work. In addition, local Child and Adolescent Mental Health Services (CAMHS), may feel deskilled in providing support for this population. We, a group of three Clinical Psychologists, aim to share some common themes and observations gained from our work in GIDS. We talk about how existing Cognitive Behavioural Therapy (CBT) models can be relevant and helpful for the challenges facing gender diverse young people, without pathologising, or aiming to change a young person’s gender identity. An illustrative case study is presented, based on an amalgamation of young people we have worked with highlighting how third-wave cognitive behavioural theory, ideas and practice can be used to support young people to manage gender-related distress. Further reflections on the broader socio-political context, and implications for clinical practice and future research are discussed.

Purpose The purpose of this paper is to investigate whether the Stages of Change (SOC) model can be applied to working with offenders with learning disabilities (LD), and furthermore, to determine if it might be efficacious for this approach to be incorporated into a wider service model for this population. Design/methodology/approach This paper reports on the results of a consultation to a specialist forensic LD service in the South West of England. A two-pronged approach was taken to consult to the service in relation to the research questions. First, a comprehensive literature review was undertaken, and second, other forensic LD teams and experts in the field were consulted. Findings There is a dearth of research that has examined the application of the SOC model to working with offenders with LD, and as such, firm conclusions cannot be drawn as to its efficacy in this population. The evidence base for the SOC model in itself is lacking, and has been widely critiqued. However, there are currently no other evidence-based models for understanding motivation to change in offenders with LD. Research limitations/implications There is a clear clinical need for more robust theory and research around motivation to change, which can then be applied to clinical work with offenders with LD. Originality/value There has been a historical narrative in offender rehabilitation that “nothing works” (Burrowes and Needs, 2009). As such, it is more important than ever for the evidence base to enhance the understanding of motivation to change in offending populations.