Human rights re-centred PBS for harmful sexual behaviour at the forensic frontiers

Purpose This paper aims to examine how positive behaviour support (PBS) can be enhanced for people with learning disabilities in forensic contexts, where behaviours of concern intersect with vulnerabilities, detention and risks to others. It shows how the integrated theory of sexual offending (ITSO; Ward & Beech, 2006) can be translated into PBS to produce rights-based formulations. It also offers a framework for prioritising interventions aligned with NICE guidance and multidisciplinary team practice that resists the narrowing, or range recession, of PBS into approaches focused mainly on control and containment. Design/methodology/approach ITSO is integrated with PBS and mapped against the Behaviour Support Plan Content Appraisal Tool (BSP-CAT; Gore et al., 2024). The approach re-politicises PBS’s person-centred ethos by outlining how ITSO’s focus on neuropsychological vulnerabilities, ecological context, emotional regulation and cognitive processes can be incorporated. Findings The model broadens PBS to address harmful sexual behaviour while holding public protection and individual rights together. It offers a framework for case conceptualisation in forensic contexts without reducing practice to mechanicalism, showing that rights-based practice is not a “soft” alternative to public safety but a primary route to achieving it. Originality/value This is the first integration of ITSO and PBS within the BSP-CAT structure. It provides a practical and clinically defensible approach to complex interventions in forensic learning disability services, grounded in both evidence and the social movement origins of PBS.