124 Chapter 4 criteria for additive befriending interventions with a more goal-oriented approach for forensic outpatients. At baseline of the RCT, we included patients who (1) reported not being fully satisfied with their social network, and (2) were identified with limitations in the area of social network and social participation by a clinician and a researcher. However, revisiting these criteria in light of our qualitative results, it seems likely that self-reported feelings of social dissatisfaction in patients and an identified lack of social self-sufficiency, did not mean that patients were also willing and well-equipped to enhance social networks. It is possible that basic needs and skills of forensic outpatients should be addressed more thoroughly before a patient can begin with goal-oriented social network enhancement (Korevaar et al., 2010). Additionally, in contrast to ratings of clinicians and researchers at baseline, we found that several patients emphasized having sufficient social relationships and friends and being self-sufficient to enhance social networks. This discrepancy between patients and professionals resonate with results of one previous study examining reentering prisoners’ and professionals’ perspectives of social support (Pettus-Davis, Scheyett, & Lewis, 2014). On the one hand, the assessment of positive support was explained as a complicated and time-consuming process for professionals. On the other hand, researchers concluded that reentering prisoners need assistance from professionals to differentiate between positive and negative sources of support in their networks. These findings could suggest that both the positive and negative social network should be assessed more thoroughly before the start of the intervention. Given the barriers to engagement found in our study, future research could compare characteristics of different compliance groups to determine which patients might profit from an additive informal social network intervention. In addition, some patients who initially agreed to participate in the intervention eventually were unwilling to meet with a coach and reported having enough people in their social network. In future research, it might be possible to explore whether patients would be more receptive to social network enhancement by a natural network member, compared to a volunteer coach. Finally, further research should be conducted to determine which approaches, sources (i.e., professional or informal), and types of social support are more effective in improving treatment outcomes, such as criminal recidivism, in forensic outpatients. This could also contribute to the development of valid and useful strategies to assess protective social networks in clinical practice.
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