98 Chapter 4 psychiatric outpatients. Several important modifications, based on practical implications of previous studies and discussions between the cooperating formal and informal care institutes, were made to the intervention to enhance implementation success specifically for forensic psychiatric outpatients (Siette et al., 2017; Thompson et al., 2016). First, the nature of the relationship between coaches and patients was conceptualized as a friendship relationship with goal-oriented elements (i.e., combination of a relationship- and goal-oriented approach). Coaches were stimulated to primarily establish a reciprocal nonprofessional relationship with patients, since patients were also receiving professional care and often had received extensive professional care in the past. Moreover, supportive social networks of forensic populations often consist of professionals (Skeem et al., 2009). In addition, coaches were encouraged to focus on patient-specific social network-related goals, such as enhancing social support and social participation. Second, coaches received supervision and training with a special focus on their expectations, attitudes and commitment, the characteristics of forensic mental healthcare, and the forensic psychiatric population. Third, coaches were asked to commit to the intervention for 12 months. Lastly, if patients failed to engage in the intervention, multiple attempts were made to explore the barriers and reschedule appointments. To our knowledge, this is the first study exploring the experiences of an additive informal social network intervention for forensic psychiatric outpatients by using qualitative methods alongside an on-going randomized controlled trial (RCT) (Swinkels, van der Pol, Popma, ter Harmsel, & Dekker, 2020). The main aim of the RCT was to examine the effectiveness of the additive intervention on mental wellbeing and other treatment outcomes (e.g., psychiatric functioning and criminal recidivism) among outpatients receiving forensic psychiatric care. The use of qualitative methods allowed us to provide an in-depth understanding of the experiences from multiple perspectives, which is crucial for further development of social network interventions in this specific patient population (Lewin, Glenton, & Oxman, 2009). We explored experiences with an informal social network intervention in both patients and coaches. In this article we outline their experiences with the intervention and describe barriers and facilitators perceived by patients and coaches that influenced engagement in the intervention.
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