The Treatment of Auto‐erotic Asphyxiation in a Man with Severe Intellectual Disabilities: the Effectiveness of a Behavioural and Educational Programme

Background  The treatment of individuals with severe intellectual disabilities who engage in self‐injurious sexual practices and are incapable of giving consent poses a significant challenge to health care services. Treatment options can be highly personal and intrusive, and potentially pose a risk of litigation. However, there is also a risk of being prosecuted for negligence if necessary treatment is not pursued. This paper discusses the treatment of an individual engaged in such a behaviour – auto‐erotic asphyxiation. It describes how the legal aspects of the design and implementation of the treatment approach were handled. Methods  The treatment approach involved a behavioural and psycho‐educational programme. A single case study methodology was utilized in order to assess the effectiveness of the intervention. Results  The intervention led to the learning of new adaptive behaviour. Auto‐erotic asphyxiation ceased and the individual's masturbatory behaviour changed sufficiently to reduce the threat of mortality. Qualitatively, a significant reduction in the level of stress experienced by the individual's family was reported. Conclusions  It is concluded that behavioural and educational techniques may be effective in the management of such cases. Further research replicating such techniques with similar cases is required prior to the efficacy of this treatment becoming established.