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2016-49: Care Program for Outpatients (call 2016-49)

Over the years, the Expertise center for Forensic Psychiatry (EFP) in the Netherlands has developed several care programs for forensic psychiatric patients that refer to a standard approach to diagnostic assessments, risk assessment, treatment and rehabilitation in a particular group of patients such as psychotic-, personality disorder-, and addicted patients. Most of these programs refer to inpatient populations and settings. Outpatients and their services are, however, markedly different from inpatient populations and services, for example with regard to referrals, length of treatment, professional staff, and diagnostic assessment.  

A standard care program for forensic outpatients has been developed by four outpatient services across the Netherlands in 2016-2018. Various outpatient services were invited to share information regarding best practice, and an international literature search was conducted to examine evidence based practices. Next, an initial draft of a standard outpatient care program was created and presented to practioners after which revisions were made.

The current care program provides a decision algorithm and guidelines for practioners working in forensic outpatient services. Cornerstones of the program are the risk-need-responsivity principles [RNR model] in which treatment is tailored to risk levels and dynamic risk factors, and matched to patient characteristics. Dynamic risk factors are assessed with the newly developed FARE, or Forensic Outpatient Risk Assessment (Van Horn et al., 2016; see also KFZ 2015-38). A case example illustrates all decisions that practioners have to make with regard to intake procedures, (risk) assessment, treatment, and follow-up. The care program concludes with chapters on the importance of the therapeutic relationship, ethical dilemmas, and advice on how to implement the program.

Aims of the care program are to reduce violent behaviour and increase an individual’s well being or quality of life. The document ought to be considered as a work in progress prompted by new developments and insights.

Executive party

The program was developed by Stichting Transfore, FPP de Horst, AFPN Assen, and Kairos on behalf of the Quality of Forensic Care program (in Dutch: Kwaliteit Forensische Zorg, KFZ).