Transforming a specialist community service model for working with men with sexual convictions and personality difficulties

The purpose of this discussion paper is to describe the transition over the past five years of a highly specialist group treatment programme to a tiered public health delivery model within the offender personality disorder (OPD) pathway. The focus of this journey of transformation has been the Challenge programme, currently the only OPD specialist service for men with sexual convictions in the community in England and Wales, and now a pan-London service.

More than 600 high-risk men with sexual convictions are screened into the OPD pathway and reside currently in the community across London. The programme leads have developed a triage model – based on the wider OPD model – that applies the principles of the least intervention necessary and the most effective use of limited resources.

Preliminary informal feedback was sought on the new consultation approach and innovative joint casework delivery models. The model of care is discussed in relation to the preliminary feedback, which was encouraging in terms of satisfaction with the consultation service and in terms of the people on probation who found that participating in the joint casework enhanced their working relationship with offender managers. The consistent use of a single model of care and a careful triage approach across the city to working with this group of individuals is still in development. Early feedback suggests that the service has to potential to be effective, but establishing this requires formal evaluation.

Practice implications include the need to address the lack of confidence that many practitioners report when working with people with sexual convictions. Virtually delivered group consultation may enhance the development of skills as it may providing a flexible toolkit for delivery.

This practice paper describes the only specialist community service for men with high-risk, high-harm sexual convictions and personality difficulties in the UK.