Most sexual offenders have the intellectual capacity and verbal skills necessary to participate in specialized programming. Some clients, however, require special services to meet their unique needs. These individuals include the intellectually challenged and the psychiatrically impaired. Often individuals in these groups are at higher risk of recidivism due to poor sexual impulse control secondary to central nervous system damage, and psychotic processes that result in idiosyncratic patterns of thinking and impaired judgment. Specialized programming that is adapted to meet the needs of these individuals has been effective in reducing recidivism. By simplifying treatment concepts, utilizing medication to reduce sexual drive or control the symptoms of psychosis, and developing creative programming, the intellectually challenged and psychiatrically impaired offender can learn to recognize his or her "cycle," triggers, and high risk situations. Further, he or she can acquire effective behavioral self-management techniques. It is a source of inspiration to watch these individuals address their problems with courage and tenacity.