The effectiveness of treatment in forensic clinical care has not been convincingly proven despite the fact that society demands and expects it to be so. They are often surprised that we cannot state definitively if forensic care is effective. However, it is complicated to properly study treatment effectiveness. Three recent international meta-analyses tentatively concluded that treatment in forensic care leads to positive outcomes, especially when multimodal treatment is offered. Most studies that were included in these meta-analyses, however, had serious methodological limitations and more research is needed to make definitive statements about treatment effectiveness. As part of the ‘Learning project’ (in Dutch: ‘de Lerende Praktijk’) of the Expertise center for Forensic Psychiatry, we have examined what research on effectiveness in Dutch forensic clinical care has been conducted in recent years. The aim of this compilation is to provide an overview of the results and to learn from them for future research, both in terms of content and type of research. All forensic care facilities that provide clinical care were approached to provide published effectiveness studies since 2005. In total, we had 70 documents, including 55 studies from which we subsequently selected studies based on a number of characteristics, such as purpose and study population. In total, six randomized clinical trials (RCTs) examined the effectiveness of treatment in comparison to a control group. Of these six RCTs, methodological quality was assessed using the Mixed Method Appraisal Tool, version 2018. The quality was generally judged to be adequate. In addition, there were several studies that, despite not having the explicit goal of measuring treatment effectiveness, are interesting to discuss. This article summarizes the main findings and provides recommendations for future research.

A forensic patient develops a relationship with his therapist, which allows him to escape from the clinic and reoffend, after which he will once again be detained in the clinic. This is a common plot in Dutch fictional films and series depicting forensic care, while in reality such stories are highly exceptional. Therefore the image of forensic care becomes one-sided, negative and sensationalist, which is of importance as American research shows that the impact of drama on public opinion may be higher than that of news media. The portrayal of patients, professionals and the system of forensic care as a whole in fictional films and series can be classified in frames, which are known from research on (social) media or research on fiction abroad. This exploratory study aims to answer the question what frames are used for forensic care in Dutch fictional films and series. Sixteen productions from the last twenty years have been found and analyzed on the basis of general characteristics, including the plot, as well as the frames used to portray forensic care. Most of the frames used are negative and based on exceptional cases. Patients are portrayed as a ‘wild beast’ or ‘master manipulator’ who have committed capital crimes and/or serious sexual offenses. Most professionals are portrayed as naive, incompetent ‘cuddlers’ and ‘seducible’. Because of this combination the system is portrayed as having ‘more holes than a Swiss cheese’ with a lack of attention for victims. Influencing this image is more important than ever for creating societal support. The escaped forensic patient should make room for the patient who will no longer severely reoffend, which fortunately is a much more frequent character in reality.

When treating people in detention, yoga may not immediately come to mind. However, the implementation of yoga relates to the underlying problems of the population and state-of-the-art theoretical treatment models. This overview discusses the potential added value of trauma-sensitive yoga as an intervention in closed forensic settings, mainly in detention.
Interventions currently implemented in forensic institutions pay less attention to more internalizing problems such as affective problems, anxiety, psychosomatic problems or trauma related problems, and the lack of self-confidence. However, these problems may be related to externalizing and delinquent behavior. Several studies have shown that the forensic population experiences more mental health problems than the general population, including trauma related problems. Trauma-sensitive yoga is a promising body-oriented intervention for psychological problems outside the forensic field.
The current overview discusses the principles of trauma-sensitive yoga and what mechanisms underlie the possible effect of this body-oriented intervention. To start, we explain how trauma-sensitive yoga can help in dealing with trauma related problems. This overview considers the effects of trauma-sensitive yoga on mental health in the general population and, more specific, the effects in the forensic population. Based on several pilot studies in the Netherlands and in line with international research, it can be cautiously concluded that trauma-sensitive yoga could be of added value to forensic treatment. It can reduce depressive symptoms and experienced stress and promote impulse control and a positive sense of self. Next to several recommendations from these studies on the implementation, recommendations for future research are discussed in order to be able to support the practice of trauma-sensitive yoga in detention.

Forensic care is provided under political and societal pressure. At the same time this sector faces an increasing lack of qualified personnel. This study describes whether, and if so in which way, social robots can contribute to the quality of forensic care and relieve the burden on staff. As no studies have yet been conducted on the applicability of this technology in forensic care, first literature was searched for studies on experiences with social robots in general mental health care. Subsequently, by means of desk research, forensic treatment methods were identified for which social robotics could currently be used. For three tasks for which potential for social robots was seen prototypes were developed, namely ADL, Companionship and Early Recognition Method. Two focus groups in which a total of twelve employees from the forensic field discussed the applicability of these prototypes as well as social robotics in general in forensic care. The participants saw various opportunities for social robots to contribute to the quality of treatment. It was concluded that the use of robots should be seen as a supplement to or deepening of current care, and not as a replacement for care as it is currently provided by humans. It is also emphasized that the implementation of social robotics in forensic care requires specialized knowledge and skills from the already heavily burdened forensic care providers.

Forensic mental health professionals are often confronted with potentially traumatic events, such as aggressive or self-harming behaviour of clients. Therefore, adequate preventive policies are important. This includes the aftercare that is provided in the first hours after a potentially traumatic event occurred. Recent studies pointed out that playing the computer game Tetris shortly after exposure to a potentially traumatic event may lead to fewer intrusive memories. Based on these insights, the peer support team of De Forensische Zorgspecialisten developed a toolbox, including the game Tetris, to promote selfcare in the first hours after a potentially traumatic event occurred. In this paper, we describe the experience of four professionals with the toolbox. These professionals point out that it is not self-evident to find time for recovery in the first hours after an incident. ‘Just let me get on with my job’ is a frequently heard phrase. The stimulation of colleagues is needed to use the toolbox and take time for selfcare. Playing Tetris – or engaging in other activities such as going out for a walk or playing a board game with colleagues – can help to release tension and gain a better idea of what is needed for recovery. Existing guidelines point at the responsibility individual professionals have to unwind after being exposed to potentially traumatic events. The experience from clinicians that are described in this article demonstrate that this is not solely the responsibility of individual employees. It can be difficult for professionals to find time to unwind after potentially traumatic events have occurred. This means that organizations have an important task to motivate their employees to devote attention to recovery during work.