149 Experienced outcomes of MCD Categorized qualitative outcomes of MCD by prison staff Based on the analysis of prison staff answers to two open-ended items after single MCD sessions (Did this MCD session bring you anything? and What do you take from this MCD session to your workplace?), we constructed a categorization of experienced outcomes (Figure 2). 1. Scope of influence 2. Case-related actions 3. Communication and dialogue 4. Mutual understanding and team spirit 5. Self-development and empowerment 6. Moral awareness 7. Significance of MCD 8. Lack of (relevant) outcomes Figure 2. Overview of outcomes after single MCD sessions experienced by participants In the first category scope of influence, participants mentioned increased insight into their responsibilities and limitations. They related their feeling of a lack of influence – to be able to make changes in practice – to their marginal (hierarchal) position. One participant mentioned that ‘the complexity of the dilemma is beyond the level of responsibility of my position’. Other related quotes include ‘Often the solutions lie outside our scope of influence’ and ‘I can’t change much myself, it has to come from my superiors’. Furthermore, insights were mentioned related to feeling restricted by existing rules and procedures; MCD made themmore aware of this, which generated two types of reactions. First, participants showed a deeper understanding of their attitude toward guidelines and protocols. For example, they stated that protocols should not always prevail; a more tailored approach and attention to the situation of prisoners is often required. The second type of reaction shows participants sharing and scaling up their experienced dilemma earlier in the process, also to the appropriate level in the organization. 6