Background Aggressive behaviour has been identified as a significant problem amongst people with intellectual disabilities living in institutional settings. Anger is a key activator of aggressive behaviour, as well as being an important element of clinical distress related to adverse life experiences. There is some evidence for the value of cognitive-behavioural treatments for anger problems with people having intellectual disabilities. No controlled studies of anger treatment involving intellectually disabled offenders living in secure settings have been conducted to date. A pilot study of an elaborated anger treatment protocol for this client population was undertaken, comparing the specialised anger treatment with routine care. Methods Detained men with intellectual disabilities and histories of offending were allocated to specially modified cognitive-behavioural anger treatment (n ¼ 9) or to routine care waiting-list control (n ¼ 10) conditions. Eighteen sessions of individual treatment were delivered over a period of 12 weeks. Treatment outcome was evaluated by participants' self-report of anger intensity to an inventory of provocations and by staff-ratings of the anger attributes of participants' ward behaviour. Results Participants' reported anger intensity was significantly lower following the anger treatment, compared to the routine care wait-list condition. There were largely no treatment condition effects in staff-rated anger. Limited evidence for the effectiveness of anger treatment was provided by the staff ratings of participant behaviour post-treatment. Conclusions Detained offenders with intellectual disabilities can benefit from intensive individual cognitive-behavioural anger treatment. Further research is required to examine the mechanisms for change and their sustainability.

Detained men with mild-moderate intellectual disabilities and histories of severe aggression can successfully engage in, and benefit from, an intensive individual cognitive-behavioural anger treatment that also appears to have beneficial systemic effects.

Following treatment, significant improvements were found in all areas assessed, excepting depression. Despite the limitations of the study design, the results provide encouragement and some guidance to practitioners who are required to develop interventions for this challenging, yet much neglected client group.

Background This report describes a cognitive behavioural group intervention for women with mild and borderline intellectual disabilities detained in a secure hospital setting because of their fire-setting behaviour. The study aimed to examine participants' motivations for setting fires, their responses to an intervention designed specifically for this group and to monitor their progress over an extended follow-up period. Methods A number of fire-specific and clinical assessments were administered before the intervention started and immediately after it concluded to examine trends in the group data. Detailed case study material was collected in order to describe participants' engagement in and reactions to the treatment process, and their status at 2-year follow-up. ResultsThe intervention successfully engaged participants in the therapy process, all of whom completed the programme. Scores on measures related to fire-related treatment targets and clinical measures pertinent to motivations for fire-setting generally improved following the intervention. There were no reports of participants setting any fires 2 years after the intervention programme was completed. Conclusions The group intervention appeared to be acceptable and beneficial to study participants. This pilot study needs to be extended into a more robust evaluation of this approach with this group.

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