Tijdschrift voor Forensische Psychiatrie en Psychologie

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Aflevering 1, 2024 Alle samenvattingen uitklappen

Effectiviteit in de praktijk

Een uitdagende maar boeiende zoektocht naar Wat Werkt binnen Forensische Zorg

Auteurs Kasia Uzieblo en Robbert-Jan Verkes

Kasia Uzieblo
Prof. dr. Kasia Uzieblo is professor in Forensische en Criminologische Psychologie, Vrije Universiteit Brussel, en ze is de Vlaamse coördinator van de anonieme hulplijn 1712.

Robbert-Jan Verkes
Prof. dr. Robbert-Jan Verkes, hoogleraar forensische psychiatrie, Radboud Universiteit Nijmegen, is als psychiater verbonden aan de afdeling Psychiatrie van het Radboudumc, de sectie Strafrecht en Criminologie van de Radboud Universiteit en de forensisch psychiatrische polikliniek Kairos te Nijmegen.

Access_open Werkt forensische behandeling?

Een compilatie van onderzoek naar behandeleffectiviteit in de Nederlandse klinische forensische zorg

Trefwoorden behandeleffectiviteit, tbs, klinische forensische zorg, Randomized Controlled Trial, lerende praktijk
Auteurs Vivienne de Vogel, Marije Keulen-de Vos, Stefan Bogaerts e.a.

    The effectiveness of treatment in forensic clinical care has not been convincingly proven despite the fact that society demands and expects it to be so. They are often surprised that we cannot state definitively if forensic care is effective. However, it is complicated to properly study treatment effectiveness. Three recent international meta-analyses tentatively concluded that treatment in forensic care leads to positive outcomes, especially when multimodal treatment is offered. Most studies that were included in these meta-analyses, however, had serious methodological limitations and more research is needed to make definitive statements about treatment effectiveness. As part of the ‘Learning project’ (in Dutch: ‘de Lerende Praktijk’) of the Expertise center for Forensic Psychiatry, we have examined what research on effectiveness in Dutch forensic clinical care has been conducted in recent years. The aim of this compilation is to provide an overview of the results and to learn from them for future research, both in terms of content and type of research. All forensic care facilities that provide clinical care were approached to provide published effectiveness studies since 2005. In total, we had 70 documents, including 55 studies from which we subsequently selected studies based on a number of characteristics, such as purpose and study population. In total, six randomized clinical trials (RCTs) examined the effectiveness of treatment in comparison to a control group. Of these six RCTs, methodological quality was assessed using the Mixed Method Appraisal Tool, version 2018. The quality was generally judged to be adequate. In addition, there were several studies that, despite not having the explicit goal of measuring treatment effectiveness, are interesting to discuss. This article summarizes the main findings and provides recommendations for future research.

Vivienne de Vogel
Prof. dr. Vivienne de Vogel is bijzonder hoogleraar Forensische Zorg aan de Universiteit Maastricht, lector Werken in Justitieel Kader aan de Hogeschool Utrecht en onderzoeker in de Van der Hoeven Kliniek, de Forensische Zorgspecialisten, Utrecht.

Marije Keulen-de Vos
Dr. Marije Keulen-de Vos is senior wetenschappelijk onderzoeker bij Forensisch Psychiatrisch Centrum (FPC) de Rooyse Wissel, Venray.

Stefan Bogaerts
Prof. dr. Stefan Bogaerts is hoogleraar Forensische Psychologie aan de Universiteit Tilburg en hoofd onderzoek bij Fivoor.

Erik Bulten
Dr. Erik Bulten is Hoofd afdelingen Diagnostiek en Onderzoek bij de Pompestichting en onderzoeker aan de Radboud Universiteit.

Monique Delforterie
Monique Delforterie is onderzoeker bij Trajectum, Zwolle.

Erwin Schuringa
Erwin Schuringa is senior onderzoeker bij FPC Dr. S. van Mesdag, Groningen.

Paul Ter Horst
Paul Ter Horst is senior onderzoeker bij De Woenselse Poort, Eindhoven.

Te gek om los te lopen

Het beeld van forensische zorg, professionals en patiënten in Nederlandse fictie, films en series

Trefwoorden forensische zorg, frames, beeldvorming, films en series, professionals
Auteurs Eleni Georgaki, Joni Reef en Michiel van der Wolf

    A forensic patient develops a relationship with his therapist, which allows him to escape from the clinic and reoffend, after which he will once again be detained in the clinic. This is a common plot in Dutch fictional films and series depicting forensic care, while in reality such stories are highly exceptional. Therefore the image of forensic care becomes one-sided, negative and sensationalist, which is of importance as American research shows that the impact of drama on public opinion may be higher than that of news media. The portrayal of patients, professionals and the system of forensic care as a whole in fictional films and series can be classified in frames, which are known from research on (social) media or research on fiction abroad. This exploratory study aims to answer the question what frames are used for forensic care in Dutch fictional films and series. Sixteen productions from the last twenty years have been found and analyzed on the basis of general characteristics, including the plot, as well as the frames used to portray forensic care. Most of the frames used are negative and based on exceptional cases. Patients are portrayed as a ‘wild beast’ or ‘master manipulator’ who have committed capital crimes and/or serious sexual offenses. Most professionals are portrayed as naive, incompetent ‘cuddlers’ and ‘seducible’. Because of this combination the system is portrayed as having ‘more holes than a Swiss cheese’ with a lack of attention for victims. Influencing this image is more important than ever for creating societal support. The escaped forensic patient should make room for the patient who will no longer severely reoffend, which fortunately is a much more frequent character in reality.

Eleni Georgaki
Eleni Georgaki is docent criminologie en onderzoeker aan het Instituut voor Strafrecht & Criminologie van de Universiteit Leiden. Zij is ook filmmaker.

Joni Reef
Dr. Joni Reef is psycholoog en sinds 2010 verbonden aan de faculteit Rechtsgeleerdheid van de Universiteit Leiden, waar ze leidinggeeft aan diverse onderwijs- en onderzoeksprojecten.

Michiel van der Wolf
Prof. dr. mr. Michiel van der Wolf is werkzaam als hoogleraar forensische psychiatrie bij het Instituut voor Strafrecht en Criminologie van de Universiteit Leiden, universitair hoofddocent strafrecht aan de Rijksuniversiteit Groningen, rechter-plaatsvervanger bij de rechtbank Amsterdam en raadsheer-plaatsvervanger bij het gerechtshof Arnhem-Leeuwarden.

Vrij van binnenuit

Een overzicht van trauma-sensitieve yoga binnen detentie

Trefwoorden trauma-sensitieve yoga, detentie, mindfulness, Justitiële Jeugdinrichting, forensische zorg
Auteurs Sabine Geers † en Sanne Hillege-van Woerden

    When treating people in detention, yoga may not immediately come to mind. However, the implementation of yoga relates to the underlying problems of the population and state-of-the-art theoretical treatment models. This overview discusses the potential added value of trauma-sensitive yoga as an intervention in closed forensic settings, mainly in detention.
    Interventions currently implemented in forensic institutions pay less attention to more internalizing problems such as affective problems, anxiety, psychosomatic problems or trauma related problems, and the lack of self-confidence. However, these problems may be related to externalizing and delinquent behavior. Several studies have shown that the forensic population experiences more mental health problems than the general population, including trauma related problems. Trauma-sensitive yoga is a promising body-oriented intervention for psychological problems outside the forensic field.
    The current overview discusses the principles of trauma-sensitive yoga and what mechanisms underlie the possible effect of this body-oriented intervention. To start, we explain how trauma-sensitive yoga can help in dealing with trauma related problems. This overview considers the effects of trauma-sensitive yoga on mental health in the general population and, more specific, the effects in the forensic population. Based on several pilot studies in the Netherlands and in line with international research, it can be cautiously concluded that trauma-sensitive yoga could be of added value to forensic treatment. It can reduce depressive symptoms and experienced stress and promote impulse control and a positive sense of self. Next to several recommendations from these studies on the implementation, recommendations for future research are discussed in order to be able to support the practice of trauma-sensitive yoga in detention.

Sabine Geers †
Dr. Sabine Geers (21 oktober 1989 - 31 maart 2024) was onderzoeker, docent, projectcoördinator van Prison Yoga Project Nederland en yogatherapeut.

Sanne Hillege-van Woerden
Dr. Sanne Hillege-van Woerden is GZ-psycholoog, pro justitia-rapporteur, bestuurslid van Prison Yoga en buitengewoon raadslid-gedragsdeskundige RSJ.

Personeelskrapte en de inzet van sociale robotica in de forensische zorg

Trefwoorden forensische zorg, sociale robotica, personeelskrapte, technologie, stoplichtmodel
Auteurs Joke Harte, Jip van Gurp, Charlotte Gerritsen e.a.

    Forensic care is provided under political and societal pressure. At the same time this sector faces an increasing lack of qualified personnel. This study describes whether, and if so in which way, social robots can contribute to the quality of forensic care and relieve the burden on staff. As no studies have yet been conducted on the applicability of this technology in forensic care, first literature was searched for studies on experiences with social robots in general mental health care. Subsequently, by means of desk research, forensic treatment methods were identified for which social robotics could currently be used. For three tasks for which potential for social robots was seen prototypes were developed, namely ADL, Companionship and Early Recognition Method. Two focus groups in which a total of twelve employees from the forensic field discussed the applicability of these prototypes as well as social robotics in general in forensic care. The participants saw various opportunities for social robots to contribute to the quality of treatment. It was concluded that the use of robots should be seen as a supplement to or deepening of current care, and not as a replacement for care as it is currently provided by humans. It is also emphasized that the implementation of social robotics in forensic care requires specialized knowledge and skills from the already heavily burdened forensic care providers.

Joke Harte
Prof. dr. Joke M. Harte is als hoogleraar Evaluatie juridische gedragsinterventies werkzaam bij de afdeling Criminologie van de Rechtenfaculteit van de Vrije Universiteit Amsterdam.

Jip van Gurp
Jip J. van Gurp MSc is als promovendus werkzaam bij de afdeling Criminologie van de Rechtenfaculteit van de Vrije Universiteit Amsterdam. In het verleden werkte zij als junior onderzoeker bij de afdeling Computer Science van de Vrije Universiteit Amsterdam.

Charlotte Gerritsen
Dr. mr. Charlotte Gerritsen is als universitair hoofddocent AI & Behaviour werkzaam bij de afdeling Computer Science van de Vrije Universiteit Amsterdam.

Koen Hindriks
Prof. dr. Koen V. Hindriks is als hoogleraar Sociale Kunstmatige Intelligentie werkzaam bij de afdeling Computer Science van de Vrije Universiteit Amsterdam.

‘Laat mij maar gewoon doorgaan’

Over nazorg in de eerste uren na een incident

Trefwoorden professioneel welzijn, nazorg, trauma, incidenten, Tetris
Auteurs Nienke Verstegen, Rogier ter Hall en Vivienne de Vogel

    Forensic mental health professionals are often confronted with potentially traumatic events, such as aggressive or self-harming behaviour of clients. Therefore, adequate preventive policies are important. This includes the aftercare that is provided in the first hours after a potentially traumatic event occurred. Recent studies pointed out that playing the computer game Tetris shortly after exposure to a potentially traumatic event may lead to fewer intrusive memories. Based on these insights, the peer support team of De Forensische Zorgspecialisten developed a toolbox, including the game Tetris, to promote selfcare in the first hours after a potentially traumatic event occurred. In this paper, we describe the experience of four professionals with the toolbox. These professionals point out that it is not self-evident to find time for recovery in the first hours after an incident. ‘Just let me get on with my job’ is a frequently heard phrase. The stimulation of colleagues is needed to use the toolbox and take time for selfcare. Playing Tetris – or engaging in other activities such as going out for a walk or playing a board game with colleagues – can help to release tension and gain a better idea of what is needed for recovery. Existing guidelines point at the responsibility individual professionals have to unwind after being exposed to potentially traumatic events. The experience from clinicians that are described in this article demonstrate that this is not solely the responsibility of individual employees. It can be difficult for professionals to find time to unwind after potentially traumatic events have occurred. This means that organizations have an important task to motivate their employees to devote attention to recovery during work.

Nienke Verstegen
Dr. Nienke Verstegen is onderzoeker bij De Forensische Zorgspecialisten en universitair docent aan de Universiteit Utrecht.

Rogier ter Hall
Rogier ter Hall is coördinator Kwaliteit, Arbo & Veiligheid bij de gemeente Utrecht.

Vivienne de Vogel
Prof. dr. Vivienne de Vogel is bijzonder hoogleraar Forensische Zorg aan de Universiteit Maastricht, lector Werken in Justitieel Kader aan de Hogeschool Utrecht en onderzoeker in de Van der Hoeven Kliniek, de Forensische Zorgspecialisten, Utrecht.

KFZ(J)-Symposium, 9 november 2023

Auteurs Maaike van Dooren

Maaike van Dooren
Maaike van Dooren is onderzoeker in de Van der Hoeven Kliniek, de Forensische Zorgspecialisten, Utrecht.

Vera Oosterhuis
Vera Oosterhuis MSc, criminoloog, promoveert aan de Universiteit Leiden en bij het Wetenschappelijk Onderzoek- en Datacentrum (WODC) van het ministerie van Justitie en Veiligheid.

Wietse Bouwsma
Wietse Bouwsma is werkzaam als Directeur zorg bij Zinso, forensisch orthopedagoog en voorzitter van Forensisch Forum.

Martijn Kalk
Martijn Kalk is werkzaam als zorgcoördinator Woonvoorziening de Torenstraat bij Zinso en is verantwoordelijk voor de PR & Communicatie bij Forensisch Forum.

Merijne Groeneweg
Merijne Groeneweg is buitenpromovenda aan de Universiteit Leiden. Tevens is zij als jurist verbonden aan de klinische observatieteams in Forensisch Centrum Teylingereind.

Leonard van der Kolk
Drs. Leonard van der Kolk Ad. is ervaringsdeskundige bij HerstelXL van GGZ WNB en science practitioner bij Tranzo, Tilburg University.

Werken in gedwongen kader

Auteurs Jacqueline Bosker en Anneke Menger

Jacqueline Bosker
Jacqueline Bosker is lector Werken in Justitieel Kader bij Hogeschool Utrecht. Samen met Anneke Menger vormt zij de redactie van het boek Werken in Gedwongen Kader.

Anneke Menger
Anneke Menger is oud-lector Werken in Justitieel Kader bij Hogeschool Utrecht. Samen met Jacqueline Bosker vormt zij de redactie van het boek Werken in Gedwongen Kader.

Petra Schaftenaar
Dr. Petra Schaftenaar is eigenaar van Metis Zorg en werkt vandaaruit als trainer en onderzoeker. Zij geeft les en werkt aan projecten in de forensische en klinische zorg. Zij heeft ruim 25 jaar werkervaring in de forensische psychiatrie.

Erik Bulten
Dr. Erik Bulten is Hoofd afdelingen Diagnostiek en Onderzoek bij de Pompestichting en onderzoeker aan de Radboud Universiteit.

Wineke Smid
Dr. Wineke Smid is hoofd van de afdeling onderzoek bij de Forensische Zorgspecialisten, Van der Hoeven kliniek, Utrecht en bestuurder van het Platform Forensische Seksuologie.

Jiska Jonas-van Dijk
Dr. Jiska Jonas-van Dijk is universitair docent bij de vakgroep Psychology of Conflict, Risk and Safety aan de Universiteit Twente.