122 Chapter 4 some patients. In other words, the social bond between dyads could encourage an onset of personal development in forensic psychiatric patients with chronic and severe mental problems (Bradshaw & Haddock, 1998). In addition, the conceptualization of the relationship between patient-coach dyads that extends on a continuum from a natural friendship to a professional relationship could explain the results (Thompson et al., 2016). In our study this relationship was found to match the definitions on the friendship end of this spectrum. If a bond was established between dyads, this bond was often perceived as open, reciprocal, and sociable. Moreover, most dyads were not involved in a goal-oriented approach where change was monitored. Nevertheless, different from the patients’ experiences with meaningful change, participation in the intervention did contribute to a sense of fulfillment and purpose, as well as an expansion of worldview and stigma reduction in coaches. These findings are in accordance with previous studies examining motivations and experiences of volunteers with befriending interventions for patients with mental problems (Botero-Rodríguez et al., 2021; Cassidy, Thompson, El-Nagib, Hickling, & Priebe, 2019; Stacer & Roberts, 2018). This study has several limitations. Firstly, even though dropout rates were similar to those found in other befriending studies, the findings may be somewhat limited due to the lack of engagement in the intervention. Secondly, it is important to bear in mind the possible biases in participants’ responses. We interviewed participants about their experiences with the intervention over a 12-month period, which could be a long follow-up period. Participants may have had difficulty recalling experiences. Further, we interviewed patients with low levels of education and/or potential intellectual disabilities. Subsequently, patients might have had difficulty understanding questions and responding to open-ended questions of the semi-structured interviews. We considered these potential difficulties during data collection by using more directive follow-up questions to open-ended questions. We believed this encouraged patients to respond. However, a note of caution is due here regarding our methods of data collection, since a more directive method of questioning could lead to more biased responses (e.g., socially desirable response). Furthermore, patients also sometimes had difficulty understanding the difference between parole officers, clinicians, informal care employees, and researchers. Although researchers carefully explained their role before starting with the interview and invested in a good atmosphere, this may have negatively influenced the openness of patients during the interviews. Lastly, we were able to include only one female patient in this study, as other female patients withdrew consent or were unreachable. Therefore, these findings might not reflect experiences of female outpatients in forensic psychiatric care. However, the
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