183 Summary and General discussion 7 SUMMARY OF MAIN FINDINGS In chapter 2 we provided an overview of the effectiveness of interventions targeting social network enhancement in real life on social network characteristics and mental health outcomes in psychiatric patients. In addition, potential moderators of treatment effects were explored. A systematic review and meta-analysis was conducted, including 33 clinical trials that compared social network interventions to controls groups. Furthermore, all treatment outcomes reported in these trials were examined using three-level random effectsmodels.Wedemonstrated small-to-moderateeffects of social network interventions on social network characteristics (i.e., positive social network and positive social support), general functioning, mental health treatment adherence, and substance use outcomes (i.e., days of substance use and abstinence). However, no effects were found on other mental health outcomes, such as psychiatric functioning, psychological functioning, and criminal behavior. Furthermore, we found evidence of moderators of treatment effects, such as sex and assessment timepoints. Effects on psychiatric functioning were stronger in samples with relatively more female patients. Effects on general functioning were largest at follow-up assessments, whereas effects on mental health treatment adherence were largest at post-assessments. Although modest, we concluded that the treatment effects should be considered meaningful, as social network interventions were mostly studied in addition to treatment as usual among psychiatric populations with complex problems. In general, a focus on social network enhancement in addition to mental health treatment could improve treatment outcomes in psychiatric patients. However, our review yielded a scarcity of clinical trials examining the effects of social network interventions in forensic psychiatric patients (i.e., only two studies in people with substance use disorders who were returning from prison, one study in people with a severe mental illness and criminal histories, and one study in people who were returning from prison after being charged with a sexual offense were found), which underscored the need to explore its effectiveness among forensic patients. In chapter 3, the study protocol of a mono-center, open-label RCT, comparing two parallel treatment groups: treatment as usual (TAU) with an additive informal social network intervention versus TAU alone, is presented. We described the additive social network intervention, entitled forensic network coaching (FNC), performed by trained volunteer coaches who were matched to forensic psychiatric outpatients in the community. In the intervention, volunteer coaches and patients were encouraged to meet each other every 2 weeks for 12 months and to develop a social relationship. Additionally, social network-related goals were tailored to the needs of the patients. The primary aim of the
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