Cutbacks in clinical beds in regular and forensic psychiatry increase the burden on outpatient fo... more Cutbacks in clinical beds in regular and forensic psychiatry increase the burden on outpatient forensic care in The Netherlands.<br/> AIM: Since 2007, Dutch forensic (flexible) assertive community treatment (For(F)ACT) teams offer outpatient, intensive treatment to forensic clients with complex mental health issues. As the need for this form of intensive treatment increases, so does the need for unambiguous indication criteria to facilitate adequate care and accompanied reduction in criminal behavior.<br/> METHOD: The present study investigated the correlation between the clinical indication criteria and risk factors for criminal behavior in 76 For(F)ACT-clients, reviewing which criteria best predicted recidivism.<br/> RESULTS: A weak correlation was found between the indication criteria and risk factors. Further receiver operating characteristic (ROC) analysis showed that a combination of clinical indication criteria best predicted recidivism.<br/> CONCLUSION: The influential risk factors for For(F)ACT-clients are different compared to those for other groups of delinquents. Important treatment factors are breaking patterns, increasing safety and offering social and financial support. The clinical indication criteria should not be replaced by the START risk factors.
Background Juvenile antisocial behavior can have long-lasting and devastating effects for juvenil... more Background Juvenile antisocial behavior can have long-lasting and devastating effects for juveniles themselves, victims, and society. Evidence-based treatment is vital. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles showing severe antisocial behavior including aggression, (domestic) violence, and delinquent behavior. FAST has a flexible intensity and length, addresses individual and systemic risk and protective factors, and is responsive to the abilities of the client (system), intervention characteristics all considered crucial for effective treatment. The current study will investigate whether FAST is effective in reducing aggression of the juvenile, reaching client formulated subgoals, and improving family functioning. Processes of change will be examined, as well as mediation by reaching client formulated subgoals and improved family functioning. Methods A Multiple Case Experimental Design (MCED) with an...
International Journal of Offender Therapy and Comparative Criminology, 2018
Following the risk-need-responsivity (RNR) model, cognitive-behavioral therapy is considered most... more Following the risk-need-responsivity (RNR) model, cognitive-behavioral therapy is considered most effective in reducing recidivism when based on dynamic risk factors. As studies have found differences of these factors across age, exploring this seems beneficial. The current study investigates the Central Eight (C8) risk factors across six age groups of outpatient sex offenders ( N = 650). Results showed that recidivism rates and age were inversely related from 19 years and up. Half of the C8 did not predict general recidivism at all, substance abuse, antisocial cognition, antisocial associates, and history of antisocial behavior in only one or several age groups. However, factors differed between age groups, with the youngest group demonstrating the most dysfunction in several areas and the oldest group the least. It is concluded that the C8 risk factors seem to lose significance in the older age groups. Results may benefit targeting treatment goals.
Covering both individual and neuropsychological factors, the Forensic Symptom Inventory—Youth Ver... more Covering both individual and neuropsychological factors, the Forensic Symptom Inventory—Youth Version—Revised (FSI-YV-R) is the first broad spectrum questionnaire for adolescents in forensic care, measuring several deficits, such as executive dysfunctions, anger, and inadequate coping to enhance treatment goals and evaluate interventions. In this study, both the factor structure and the measurement and structural invariance of the FSI-YV-R were investigated. The sample consisted of 159 forensic juvenile outpatients (79.9% males and 20.1% females) aged 12 to 19 with a mean age of 16.07 ( SD = 1.57). Multi-Group Confirmatory Factor Analyses identified a second-order model (measuring executive functioning) and proved measurement and structural invariant across age groups (younger adolescents, 12–15 years and older adolescents, 16–18 years). Contrary to the expectations none of the FSI-YV-R subscales differentiated between younger adolescents (N = 74) and older adolescents (N = 85). These results and implications for both theory and practice are discussed.
Several meta-analyses have examined the Central Eight risk factors for reoffending in the general... more Several meta-analyses have examined the Central Eight risk factors for reoffending in the general forensic population. To our knowledge, this is the first meta-analysis to focus exclusively on the predictive validity of risk factors for recidivism in forensic outpatients. A multilevel meta-analysis was conducted of studies in which static and dynamic risk factors were investigated as predictors of violent and/or general recidivism in forensic outpatients. Twenty-seven studies were included, with 543 effect sizes in a unique population of 116,982 adult offenders. The Central Eight risk domains were found to be predictive of violent and general recidivism; however, these factors predicted recidivism with small-to-moderate effects. Overall, in the same domain, the dynamic risk factors were more strongly related to recidivism than the static risk factors. This knowledge may be used to guide future outpatient treatment.
Behandelaren in de reguliere geestelijke gezondheidszorg krijgen steeds vaker te maken met client... more Behandelaren in de reguliere geestelijke gezondheidszorg krijgen steeds vaker te maken met clienten met psychopathische trekken of een antisociale persoonlijkheidsstoornis (ASPS), die al dan niet gepaard kan gaan met agressie of verward gedrag. Dit kan leiden tot een zekere terughoudendheid om met deze clienten een behandelrelatie aan te gaan. Kennis over forensische theorieen/modellen en instrumenten voor het beoordelen van veiligheidsrisico’s en zorgbehoeften kan deze drempel mogelijk verlagen. Het Risk-Need-Responsivity-model biedt handvatten om het behandelbeleid en de behandelinhoud vorm te geven op basis van risicotaxatie-uitkomsten, bijvoorbeeld met de FARE (Forensisch Ambulante Risico Evaluatie). Ook werken met personen met verward en agressief gedrag vereist kennis over de doelgroep en van instrumenten om de veiligheid en de zorgbehoefte op adequate wijze in te kunnen schatten. Deze bijdrage biedt een overzicht van instrumenten om (acute) veiligheidsrisico’s en zorgbehoefte...
Background Antisocial behavior during adolescence can have long-lasting negative effects and lead... more Background Antisocial behavior during adolescence can have long-lasting negative effects and leads to high societal costs. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles aged 12–21 showing severe antisocial behavior. The intensity, content and duration of FAST can be adjusted to the needs of the juvenile and their caregiver(s), which is considered crucial for effective treatment. Next to the regular version of FAST (FASTr), a blended version (FASTb) in which face-to-face contacts are replaced by minimally 50% online contacts over the duration of intervention was developed during the Covid-19 pandemic. The current study will investigate whether FASTb is equally effective as FASTr, and through which mechanisms of change, for whom, and under which conditions FASTr and FASTb work. Methods A randomized controlled trial (RCT) will be carried out. Participants (N = 200) will be randomly assigned to FASTb (n = 100) ...
In opdracht van KFZ werd onderzoek gedaan naar de statische en dynamische risico- en beschermende... more In opdracht van KFZ werd onderzoek gedaan naar de statische en dynamische risico- en beschermende factoren die het sterkst met recidive samenhangen. Het uitgangspunt was om, vertrekkend vanuit het RNR-model, een kernset van factoren te identificeren die voor het grootste deel van de ambulante forensische populatie zou gelden. De projectgroep heeft gekozen voor een multi-method design (meta-analyses, secundaire data-analyse op prospectieve data, veldonderzoek) waarbij de focus lag op de empirische onderbouwing van de kernset. In dit hoofdstuk worden kort de bevindingen weergegeven van de deelstudies die ten behoeve van de opdracht werden uitgevoerd.
Cutbacks in clinical beds in regular and forensic psychiatry increase the burden on outpatient fo... more Cutbacks in clinical beds in regular and forensic psychiatry increase the burden on outpatient forensic care in The Netherlands.<br/> AIM: Since 2007, Dutch forensic (flexible) assertive community treatment (For(F)ACT) teams offer outpatient, intensive treatment to forensic clients with complex mental health issues. As the need for this form of intensive treatment increases, so does the need for unambiguous indication criteria to facilitate adequate care and accompanied reduction in criminal behavior.<br/> METHOD: The present study investigated the correlation between the clinical indication criteria and risk factors for criminal behavior in 76 For(F)ACT-clients, reviewing which criteria best predicted recidivism.<br/> RESULTS: A weak correlation was found between the indication criteria and risk factors. Further receiver operating characteristic (ROC) analysis showed that a combination of clinical indication criteria best predicted recidivism.<br/> CONCLUSION: The influential risk factors for For(F)ACT-clients are different compared to those for other groups of delinquents. Important treatment factors are breaking patterns, increasing safety and offering social and financial support. The clinical indication criteria should not be replaced by the START risk factors.
Background Juvenile antisocial behavior can have long-lasting and devastating effects for juvenil... more Background Juvenile antisocial behavior can have long-lasting and devastating effects for juveniles themselves, victims, and society. Evidence-based treatment is vital. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles showing severe antisocial behavior including aggression, (domestic) violence, and delinquent behavior. FAST has a flexible intensity and length, addresses individual and systemic risk and protective factors, and is responsive to the abilities of the client (system), intervention characteristics all considered crucial for effective treatment. The current study will investigate whether FAST is effective in reducing aggression of the juvenile, reaching client formulated subgoals, and improving family functioning. Processes of change will be examined, as well as mediation by reaching client formulated subgoals and improved family functioning. Methods A Multiple Case Experimental Design (MCED) with an...
International Journal of Offender Therapy and Comparative Criminology, 2018
Following the risk-need-responsivity (RNR) model, cognitive-behavioral therapy is considered most... more Following the risk-need-responsivity (RNR) model, cognitive-behavioral therapy is considered most effective in reducing recidivism when based on dynamic risk factors. As studies have found differences of these factors across age, exploring this seems beneficial. The current study investigates the Central Eight (C8) risk factors across six age groups of outpatient sex offenders ( N = 650). Results showed that recidivism rates and age were inversely related from 19 years and up. Half of the C8 did not predict general recidivism at all, substance abuse, antisocial cognition, antisocial associates, and history of antisocial behavior in only one or several age groups. However, factors differed between age groups, with the youngest group demonstrating the most dysfunction in several areas and the oldest group the least. It is concluded that the C8 risk factors seem to lose significance in the older age groups. Results may benefit targeting treatment goals.
Covering both individual and neuropsychological factors, the Forensic Symptom Inventory—Youth Ver... more Covering both individual and neuropsychological factors, the Forensic Symptom Inventory—Youth Version—Revised (FSI-YV-R) is the first broad spectrum questionnaire for adolescents in forensic care, measuring several deficits, such as executive dysfunctions, anger, and inadequate coping to enhance treatment goals and evaluate interventions. In this study, both the factor structure and the measurement and structural invariance of the FSI-YV-R were investigated. The sample consisted of 159 forensic juvenile outpatients (79.9% males and 20.1% females) aged 12 to 19 with a mean age of 16.07 ( SD = 1.57). Multi-Group Confirmatory Factor Analyses identified a second-order model (measuring executive functioning) and proved measurement and structural invariant across age groups (younger adolescents, 12–15 years and older adolescents, 16–18 years). Contrary to the expectations none of the FSI-YV-R subscales differentiated between younger adolescents (N = 74) and older adolescents (N = 85). These results and implications for both theory and practice are discussed.
Several meta-analyses have examined the Central Eight risk factors for reoffending in the general... more Several meta-analyses have examined the Central Eight risk factors for reoffending in the general forensic population. To our knowledge, this is the first meta-analysis to focus exclusively on the predictive validity of risk factors for recidivism in forensic outpatients. A multilevel meta-analysis was conducted of studies in which static and dynamic risk factors were investigated as predictors of violent and/or general recidivism in forensic outpatients. Twenty-seven studies were included, with 543 effect sizes in a unique population of 116,982 adult offenders. The Central Eight risk domains were found to be predictive of violent and general recidivism; however, these factors predicted recidivism with small-to-moderate effects. Overall, in the same domain, the dynamic risk factors were more strongly related to recidivism than the static risk factors. This knowledge may be used to guide future outpatient treatment.
Behandelaren in de reguliere geestelijke gezondheidszorg krijgen steeds vaker te maken met client... more Behandelaren in de reguliere geestelijke gezondheidszorg krijgen steeds vaker te maken met clienten met psychopathische trekken of een antisociale persoonlijkheidsstoornis (ASPS), die al dan niet gepaard kan gaan met agressie of verward gedrag. Dit kan leiden tot een zekere terughoudendheid om met deze clienten een behandelrelatie aan te gaan. Kennis over forensische theorieen/modellen en instrumenten voor het beoordelen van veiligheidsrisico’s en zorgbehoeften kan deze drempel mogelijk verlagen. Het Risk-Need-Responsivity-model biedt handvatten om het behandelbeleid en de behandelinhoud vorm te geven op basis van risicotaxatie-uitkomsten, bijvoorbeeld met de FARE (Forensisch Ambulante Risico Evaluatie). Ook werken met personen met verward en agressief gedrag vereist kennis over de doelgroep en van instrumenten om de veiligheid en de zorgbehoefte op adequate wijze in te kunnen schatten. Deze bijdrage biedt een overzicht van instrumenten om (acute) veiligheidsrisico’s en zorgbehoefte...
Background Antisocial behavior during adolescence can have long-lasting negative effects and lead... more Background Antisocial behavior during adolescence can have long-lasting negative effects and leads to high societal costs. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles aged 12–21 showing severe antisocial behavior. The intensity, content and duration of FAST can be adjusted to the needs of the juvenile and their caregiver(s), which is considered crucial for effective treatment. Next to the regular version of FAST (FASTr), a blended version (FASTb) in which face-to-face contacts are replaced by minimally 50% online contacts over the duration of intervention was developed during the Covid-19 pandemic. The current study will investigate whether FASTb is equally effective as FASTr, and through which mechanisms of change, for whom, and under which conditions FASTr and FASTb work. Methods A randomized controlled trial (RCT) will be carried out. Participants (N = 200) will be randomly assigned to FASTb (n = 100) ...
In opdracht van KFZ werd onderzoek gedaan naar de statische en dynamische risico- en beschermende... more In opdracht van KFZ werd onderzoek gedaan naar de statische en dynamische risico- en beschermende factoren die het sterkst met recidive samenhangen. Het uitgangspunt was om, vertrekkend vanuit het RNR-model, een kernset van factoren te identificeren die voor het grootste deel van de ambulante forensische populatie zou gelden. De projectgroep heeft gekozen voor een multi-method design (meta-analyses, secundaire data-analyse op prospectieve data, veldonderzoek) waarbij de focus lag op de empirische onderbouwing van de kernset. In dit hoofdstuk worden kort de bevindingen weergegeven van de deelstudies die ten behoeve van de opdracht werden uitgevoerd.
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