The effectiveness of an additive informal social network intervention for forensic psychiatric outpatients: results of a randomized controlled trial

Swinkels, Lise; Pol, Thimo M. van der; Twisk, Jos W. R.; Harmsel, J. F. ter; Dekker, Jack; Popma, Arne

doi:10.3389/fpsyt.2023.1129492

Cited by 3 publications

(2 citation statements)

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“…Next, in line with a recent mixed methods study investigating a group befriending program in patients with severe mental illnesses (Botero-Rodríguez et al, 2021), predominantly positive experiences of participants were found with regard to new social experiences, such as the development of social bonds and social support. In addition, we found that four commonly defined types of social support -informational, emotional, instrumental and companionship support -were recognized by patients and coaches during the informal social network intervention (Langford et al, 1997) In line with the model, these qualitative results could offer an explanation (i.e., working mechanism) for the preliminary quantitative results of the RCT showing positive effects of the informal social network intervention, compared to TAU, on relevant treatment outcomes and criminal behavior in forensic outpatients (Swinkels et al, 2023c). However, it should be noted that the qualitative results (i.e., social bonds and support leading to positive feelings and different perspectives) cannot not be extrapolated to all patients.…”

Section: Discussionsupporting

confidence: 57%

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Stitching the social fabric of society

Swinkels

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Forensic psychiatric patients often have complex care needs for which effective multimodal treatment is required. At the same time, evidence-based interventions are scarce and can be improved. A supportive social network has been extensively related to increased mental health and wellbeing and reduced criminal recidivism in general and psychiatric populations. Therefore, the central aim of this dissertation was to examine whether an additive informal social network intervention could improve treatment outcomes among forensic psychiatric outpatients. The findings revealed that social network interventions could be effective in improving supportive social networks and treatment outcomes in psychiatric patients. For forensic psychiatric outpatients, social network interventions in which community volunteers engage in supportive relationship and social activities with outpatients, are feasible and promising in reducing hospitalization duration and criminal behavior. Altogether, the findings in this dissertation indicate that a collaboration paradigm between forensic psychiatric care and informal care could further improve treatment outcomes in patients with complex problems and care needs. However, since patient engagement was challenging, barriers and facilitators should be considered to optimize the implementation of social network interventions for individual patients in forensic psychiatric care. We hope that this research will encourage clinicians to incorporate informal social network interventions into treatment programs and guide policy makers. Furthermore, we emphasize that future research is needed to determine which patients benefit from which types of social network interventions to better understand and optimize the effectiveness of these interventions in forensic psychiatric care.

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Section: Discussionsupporting

confidence: 57%

“…More details about the RCT can be found in our published study protocol ; results are presented elsewhere (Swinkels et al, 2023c). The study was approved by the Medical Ethics Committee of the Amsterdam University Medical Center (NL60308.029.17) and preregistered at the Netherlands Trial Register (NTR7163, date of registration: 16/04/2018).…”

Section: Methodsmentioning

confidence: 99%

Stitching the social fabric of society

Swinkels

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Patients’ and volunteer coaches’ experiences with an informal social network intervention in forensic psychiatric care: a qualitative analysis

et al. 2023

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Background: Improving supportive social networks in forensic psychiatric patients is deemed important due to the protective effects of such networks on both mental health problems and criminal recidivism. Informal interventions targeted at social network enhancement by community volunteers showed positive effects in various patient and offender populations. However, these interventions have not specifically been studied in forensic psychiatric populations. Therefore, forensic psychiatric outpatients’ and volunteer coaches’ experiences with an informal social network intervention were explored in this study. Methods: This qualitative study was based on semi-structured interviews conducted alongside an RCT. Forensic outpatients allocated to the additive informal social network intervention, and volunteer coaches, were interviewed 12 months after baseline assessment. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to identify and report patterns in the data. Results: We included 22 patients and 14 coaches in the study. The analysis of interviews revealed five main themes reflecting patients’ and coaches’ experiences: (1) dealing with patient receptivity, (2) developing social bonds, (3) receiving social support, (4) achieving meaningful change, and (5) using a personalized approach. Patient receptivity, including willingness, attitudes, and timing, was a common reported barrier affecting patients’ engagement in the intervention. Both patients’ and coaches’ experiences confirmed that the intervention can be meaningful in developing new social bonds between them, in which patients received social support. Despite, experiences of meaningful and sustainable changes in patients’ social situations were not clearly demonstrated. Coaches’ experiences revealed broadened worldviews and an enhanced sense of fulfillment and purpose. Finally, a personalized, relationship-oriented rather than goal-oriented approach was feasible and preferable. Conclusion: This qualitative study showed positive experiences of both forensic psychiatric outpatients and volunteer coaches with an informal social network intervention in addition to forensic psychiatric care. Notwithstanding the limitations, the study suggests that these additive interventions provide an opportunity for forensic outpatients to experience new positive social interactions with individuals in the community, which can initiate personal development. Barriers and facilitators to engagement are discussed to improve further development and implementation of the intervention. Trial registration: This study is registered at the Netherlands Trial Register (NTR7163, registration date: 16/04/2018).

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Patients’ and volunteer coaches’ experiences with an informal social network intervention in forensic psychiatric care: a qualitative analysis

Swinkels¹,

Koning

Pol³

et al. 2022

Preprint

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Background Improving supportive social networks in forensic psychiatric patients is deemed important due to the protective effects of such networks on both mental health problems and criminal recidivism. Informal interventions targeted at social network enhancement by volunteers in the community showed positive effects in various patient and offender populations. However, these interventions have not specifically been studied in forensic psychiatric populations. Therefore, forensic psychiatric outpatients’ and volunteer coaches’ experiences with an informal social network intervention were explored in this study. Methods This qualitative study was based on semi-structured interviews that were conducted alongside an RCT. Forensic outpatients randomized to the additive informal social network intervention arm of the RCT, and volunteer coaches, were interviewed 12 months after baseline assessment. Interviews were audio-recorded and transcribed verbatim. Reflexive thematic analysis was used to identify and report patterns in the data. Results We included 22 patients and 14 coaches in the study. The analysis of interviews revealed five main themes reflecting patients’ and coaches’ experiences: 1) dealing with patient receptivity, 2) developing social bonds, 3) receiving social support, 4) achieving meaningful change, and 5) using a personalized approach. Patient receptivity, including willingness, attitudes, and timing, was a common reported barrier affecting patients’ engagement in the intervention. Both patients’ and coaches’ experiences confirmed that the intervention can be meaningful in developing new social bonds between them, in which patients received social support. Despite, experiences of meaningful and sustainable changes in patients’ social situations were not clearly demonstrated. Coaches’ experiences revealed broadened worldviews and an enhanced sense of fulfillment and purpose. Finally, a personalized, relationship-oriented rather than goal-oriented approach was feasible and preferable. Conclusions This qualitative study showed positive experiences of both forensic psychiatric outpatients and volunteer coaches with an informal social network intervention in addition to forensic psychiatric care. Notwithstanding the limitations, the study suggests that additive informal social network interventions provide an opportunity for forensic outpatients to experience new positive social interactions with individuals in the community, which can initiate personal development. Barriers and facilitators to engagement are discussed to improve further development and implementation of the intervention. Trial registration: This study is registered at the Netherlands Trial Register (NTR7163, date of registration: 16/04/2018).

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The effectiveness of an additive informal social network intervention for forensic psychiatric outpatients: results of a randomized controlled trial

Cited by 3 publications

References 67 publications

Stitching the social fabric of society

Stitching the social fabric of society

Patients’ and volunteer coaches’ experiences with an informal social network intervention in forensic psychiatric care: a qualitative analysis

Patients’ and volunteer coaches’ experiences with an informal social network intervention in forensic psychiatric care: a qualitative analysis

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