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More attention for sexuality

The 13th European Congress of Mental Health in Intellectual Disability (EAMHID) was held in Berlin, Germany,  September 23- 25, 2021. The central theme was 'From Science to Practice'. To kick off sharing the  knowledge we have interviewed some of the keynote speakers. This is an interview with Miriam Schuler, sex therapist and research associate, Institute of Sexology and Sexual Medicine, Charité Universitätsmedizin Berlin.


Research, intellectual disabilities, and mental health (or challenging behaviour). What comes to mind reading these key words? 

There are only a few studies targeting intellectual disabilities, sexual preferences and sexual behaviours. However, sexual offending behaviour is more often observed among individuals with intellectual disabilities compared to individuals without intellectual disabilities. Therefore, sexuality among individuals with intellectual disabilities needs more (scientific) attention; not only to prevent sexual abuse but also to meet the sexual needs of individuals with ID.  


What is the main research objective/theme/focus of the study you will be presenting? What are the main results from your study?

The “Prevention Project Dunkelfeld” (PPD) and the Prevention project "Just dreaming of them" (PPJ) offer clinical diagnostics and therapeutic treatment for individuals with sexual interest in pre- and/or early pubescent children. The workshop will focus on the projects in their work with adolescents and adults with ID. In addition to the diagnostic procedure and therapeutic program, difficulties and challenges will be presented.


How might outcomes of your (previous) studies affect daily practice in the support of persons with intellectual disabilities and mental health disorders and/or challenging behaviour? How can daily care providers improve their support based on your study/work?

Individuals with intellectual disabilities are more likely in contact with judicial authorities due to sexual offending behaviour compared with the general population. Sexual preference peculiarities can be observed among persons with intellectual disabilities, as well. Especially sexual interest in children and offense supportive cognitions are major risk factors for committing sexual abuse. Therefore, an extensive assessment is indispensable with individuals with intellectual disabilities and history of sexual offending behaviour. However, diagnostic procedure requires more time and patience and is limited due to impaired communication skills and introspection. Furthermore, persons with intellectual disabilities and history of sexual offending behaviour require  intensive therapeutic care, which is characterized by small steps,  repetition, and the integration of relatives and other significant persons. 


Can you suggest topics for future studies you will be working on? How can we better implement scientific findings in daily practices?

There are still a number of open questions regarding (child) sexual abuse in persons with intellectual disabilities. Regarding diagnostics, we need to focus on methods that are adapted to the reality of persons with intellectual disabilities. In order to improve treatment options, it is necessary to study risk and protective factors for offending behaviour more thoroughly. The same applies to treatment setting and accessibility of persons with intellectual disabilities.