158 Chapter 5 patients allocated to the TAU arm of the trial. However, participants received information about the randomization procedure beforehand and agreed with the conditions of the trial, including the possibility to be allocated to TAU. Although we cannot completely rule out this bias, we did not encounter higher study dropout rates in TAU. In contrast, slightly more dropout was found in the additive intervention group (i.e., 24% in TAU+FNC vs. 18% in TAU). Furthermore, on the ethical aspect, clinicians of patients in both treatment groups were regularly (i.e., after each follow-up assessments) urged by the researchers to discuss social network-related needs with their patients. Implications for research and practice Regardless of the limitations, informal social network interventions are accessible and low-cost interventions that could provide a meaningful addition to current clinical practice for forensic outpatients with complex needs given its potential to improve treatment outcomes of hospitalization and criminal recidivism. Evidently, this is not a one-fits-all intervention, as the compliance as well as the effects may vary between individual patients (Swinkels et al., 2023a). Therefore, a flexible implementation responding to patients’ abilities and needs, such as the frequency and type of contact, duration of the intervention period (i.e., open-ended or not), and the personalized process of matching patients to volunteers based on preferences and characteristics, seemed important requirements. In our trial setting, in which patients had to be matched within a preferred timeframe and patient-coach dyads were intended to meet regularly over a period of 12 months, it was more complicated to respond to patient preferences. Clinical settings allow for a more flexible implementation. Therefore, outcomes and compliance levels might improve in clinical settings. Furthermore, based on our exploratory findings frommoderator analyses, we cannot yet determine which patients are more likely to benefit from the additive intervention. Nevertheless, our findings could encourage clinicians to explore its potential for individual patients, particularly in patients without primary substance use disorders, patients with comorbid disorders, and males. Future research is needed to examine how effects of informal social network interventions can be further improved and which forensic psychiatric patients might benefit from additive informal social network interventions. Moreover, research is recommended to determine how to adapt these interventions for subgroups of patients with unfavorable outcomes found in our study (i.e., patients with substance use disorders, patients without comorbid disorders, and females). It would be worth exploring whether the effectiveness could be improved by extending the duration of the intervention, allowing patients and volunteers more time to develop a supportive relationship. However, we do acknowledge
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