Werkt forensische behandeling?

Abstract

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.