The effect of the Community Reinforcement Approach on the treatment of resocializing forensic psychiatric patients

The population of a medium security ward consists of mentally disturbed people
with a (criminal) judicial title. The population is heterogenous in (judicial)
titles, comitted crimes, and psychiatric disorders. An important mutual factor
in this population is substance misuse. The percentage of addicted people in
the forensic psychiatric field varies from 40 to 70%. For this reason we chose
to add specific therapeutic interventions from the Community Reinforcement
Approach (a treatment modality coming from the addiction care) to the treatment
as usual. With the Community Reinforcement Approach (CRA) the focus of the
treatment lies with the strengethening of the social skills and the stimulation
of a pro-social network. Within the addiction care CRA is well tested and
proven to be effective. Because of the specific focus on a swift reentry in
society, and maintaining an independant household, and network, our
expectations are that CRA can be an important supplement to the treatment as
usual.

The aim of the study is to see if the (psycho)social functioning and the
quality of life of forensic psychiatric patients improves when treated
according to a forensic CRA-protocol

Outcome variables. (psycho)social functioning, quality of life, and reoffending
Design. To establish the effectiveness of CRA a observational non-controlled
study will be done. For the duration of two years the CRA module will be added
to the existing treatment. Measurements will take place at admission, every
three months untill release, at release, and one year after release.
Measurements consist of questionnaires and observation scales.

The Community Reinforcement Approach

Time-investement patient:

Admission: 1,5 hours
Every three months: 1,5 hours
Discharge: 1,5 hours
Follow-up: 2 hours