Navigating MMPSA: understanding the experiences of individuals convicted of sexual offences taking medication to manage problematic sexual arousal

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Lievesley, R.A. ORCID: 0000-0003-4957-258X, 2019. Navigating MMPSA: understanding the experiences of individuals convicted of sexual offences taking medication to manage problematic sexual arousal. PhD, Nottingham Trent University.

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Abstract

Problematic sexual arousal (PSA) has been identified as a profound wellbeing issue, as well as a significant risk factor for sexual offending. However, psychological treatment programmes for individuals convicted of sexual offences (ICSOs) do not directly address PSA, potentially resulting in treatment needs relating to this being left unmet. As a result, in 2007 protocols were established within the UK to allow the voluntary pharmacological treatment of ICSOs, alongside psychological treatment, to assist with the management of PSA. This treatment was initially piloted at HMP Whatton before being rolled out as a national treatment pathway with the service termed medication to manage problematic sexual arousal (MMPSA).

This thesis presents one strand of the evaluation of this pilot project and explores the lived experiences of ICSOs on this treatment pathway. Specifically, it aimed to understand the development, awareness and management of PSA in ICSOs, explore the lived experiences of those taking MMPSA, explore the nuanced pathways of MMPSA treatment, and consider the potential implications of these experiences in relation to the use of MMPSA with ICSOs.

Study 1 (N = 21) uncovered themes related to early sexual experiences, the various functions of sex and the processes of escalation that led to the recognition that participants' sexual arousal levels were problematic. This escalation led participants to make a decision to address their PSA for various reasons, leading to the decision to engage with the MMPSA service. The subsequent studies explored the lived experiences of ICSOs while they were taking different form of MMPSA, namely, selective serotonin reuptake inhibitors (SSRIs; Study 2; N = 13) and anti-androgens (Study 3; N = 10). While there were some similarities in their experiences, the analyses elicited findings that highlight the differences in relation to their initial motivations, experiences of positive and negative medication effects, and their apparent intentions to continue taking their prescribed medications following release. Study 4 further explored the nuanced treatment journeys that individuals must navigate through MMPSA, establishing six distinct pathways through an analysis of the full clinical evaluation dataset (N = 139).

The work in this thesis is original, making important contributions to knowledge in this area, as it represents the first phenomenological analysis of the lived experiences of ICSOs taking MMPSA. In doing so, it complements the quantitative evaluation work by providing an additional depth of analysis that is not possible through purely quantitative analyses. Towards the end of the thesis, various recommendations are made about the effective and ethical use of MMPSA. The limitations of this work are also identified, as are opportunities for further research to understand the lived experiences of ICSOs on this developing treatment pathway.

Item Type:	Thesis
Creators:	Lievesley, R.A.
Date:	June 2019
Rights:	This work is the intellectual property of the author. You may copy up to 5% of this work for private study, or personal, non-commercial research. Any re-use of the information contained within this document should be fully referenced, quoting the author, title, university, degree level and pagination. Queries or requests for any other use, or if a more substantial copy is required, should be directed to the owner of the Intellectual Property Rights.
Divisions:	Schools > School of Social Sciences
Record created by:	Linda Sullivan
Date Added:	17 Sep 2019 11:19
Last Modified:	17 Sep 2019 11:19
URI:	https://irep.ntu.ac.uk/id/eprint/37683