157 Effectiveness of a social network intervention 5 period, which probably affected treatment efficacy. Furthermore, we included a group of patients with a wide range of psychiatric diagnoses, which complicates interpretation of the findings across diagnostic groups. There were challenges in the implementation of the intervention that may also hinder applicability, such as the availability of volunteers who matched the specific characteristics and needs of patients, preventing patients to start with the intervention conform protocol (i.e., within 2 months after their baseline assessment). Besides, the goal-oriented intervention protocol Of course, a network coach! was not often used and was not considered feasible (Swinkels et al., 2023a). Moreover, patients were found unwilling or unable to (timely) start with the intervention. Consequently, the overall treatment effects (i.e., intention-to-treat effects) should be interpreted with caution, as these effects include considerable different levels of compliance and cannot be extrapolated to the sample as a whole. Therefore, the effects across patients with different levels of compliance provided a more realistic insight about treatment effectiveness. In addition, regarding the measurement of outcomes, caution must be applied to our measurement of criminal recidivism. In the current study, we used self-reported data to define criminal recidivism, which may be sensitive to under- and overreporting, raising questions about the validity of our findings (Junger-Tas & Marshall, 1999; van der Laan & Blom, 2006). It was not feasible to collect and define criminal recidivism based on official data from the Police Information Service and Justice Documentation System, due to time constraints and the long processing time required to obtain valid data, respectively. However, previous research demonstrated that all measures of criminal recidivism have limitations and should therefore preferably be used conjointly (Junger-Tas & Marshall, 1999; van der Laan & Blom, 2006). Efforts were made to minimize response bias by conducting one-to-one assessments, emphasizing patient privacy and confidentiality, and choosing a short response period of 6 months. Nevertheless, the overdispersion observed in the outcome of criminal behavior, although present in both treatment groups, could be an indication of overreporting. Furthermore, the outcomes of hospitalization from official medical records (i.e., number and days) could be limited, as these outcomes are based solely on hospitalizations within the mental healthcare institute where this study was conducted. Finally, we want to acknowledge the ethical concerns and the corresponding deviations from the intended interventions that may arose because of the trial context. We compared TAU with an additive informal social network intervention to TAU alone in a complex patient group with limited social support, which could have caused disappointment in
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