“It is because of that report [the report of Dr Pereira-Scott of November 2019] and other developments including subsequent work undertaken by LXR with his treating team – that his condition has changed materially both in terms of his own understanding of the cause of his psychological problems, and also in terms of his psychological presentation and symptoms, which have changed significantly.” 50. In our view, it is clear from this evidence that the material change is not directly attributable to the crime of violence i.e. the childhood sexual assault but rather to a change in his own understanding of the cause of his psychological problems and because of the report of Dr Pereira-Scott which cannot be said to be a “direct cause”