Elien Neimeijer

11 within a secure forensic setting is imposed. Secure forensic treatment is usually organised in such a way that 8 to 12 individu- als live together in a living group, supported by trained sociotherapists. Individuals are staying on these living groups for a certain period of time and receive treatment and sup- port 24 hours a day by a team of professionals. Sociotherapists support clients during daily routines, work and educational activities, individual and group therapy sessions and leisure activities. They work in collaboration with psychologists, psychiatrists and psychotherapists, who supervise the sociotherapists and provide additional one-to-one treatment. Depending on the risks and needs, clients of some units have more autonomy, while in other units clients receive one to one guidance throughout the day. Based on the risk of (re)offending, legal status and treatment phase, clients move to living groups with different levels of restrictions and security. The goal of treatment is to rehabilitate individ- uals and prepare them to return to society and to offer perspective. Rehabilitation can also mean that individuals are directed to assisted or semi-independent living environments. Therapy - security paradox Offending behaviour and criminal recidivism can be effectively reduced within or af- ter a secure forensic setting if treatment is supportive, evidence-based, responsive and based on relational care (Fazel, Fimińska, Cocks, & Coid, 2016; Hachtel, Vogel, & Huber, 2019). Secure forensic treatment creates a difficult dual role for professionals, not only providing care and building a therapeutic relationship with the individual client, but also being responsible for protecting others, assessing risks and managing control over the autonomy of the individual client (i.e., therapy-security paradox ; Inglis, 2010; Jacob, 2012). Restriction of freedom does not always come from the clients’ (e.g., restriction to prevent self-harm) or immediate danger to others, but also from the interest of the safety of society as a whole (Clercx et al., 2020). The impact of involuntary admission and treatment on the therapeutic relationship is widely recognised as diminishing treatment outcomes, a topic which is often being critically discussed (Arnold et al., 2019). More awareness arises that coercive measures during compulsory treatment can also have harmful effects (De Valk, 2019). The more coercion during treatment in secure (forensic) settings - as was seen in the case of Lauren in the form of daily seclusions – the more risk of escalation, aggression and recidivism