Elien Neimeijer

115 pact on the therapeutic relationship (De Valk, Van der Helm, Beld, Schaftenaar, Kuiper, & Stams, 2015; Doyle & Jones, 2013; Gillespie & Flowers, 2009; Hachtel et al., 2019; Van der Helm, 2011). Repressive elements, such as disproportionate sanctions on undesired behaviour, can then also predominate. Research has shown that repression does not work (De Valk, 2019; Hachtel et al., 2019). An institutional culture of restraint and depri- vation of liberty with too much emphasis on safety (control) can arise for several reasons such as that professionals want to protect themselves from stress or from fear and anger (Martin & Street, 2003; Van der Helm & Schaftenaar, 2014). This can create an excessive number of rules or abuse of power (i.e., a punitive context; Gillespie & Flowers, 2009). The client’s perception about the therapeutic relationship is considered by researchers as one of the strongest predictors of treatment outcome (Coffey, 2006; Goldsmith, Lewis, Dunn, & Bentall, 2015). The core business in secure forensic care is therefore to form and maintain therapeutic relationships, in which professionals help clients to develop skills to deal with problems and provide for participation in society (Schaftenaar, 2015). Emphasizing the ‘healthy sides’ of clients and their environment becomes a valuable addition to the traditionally risk-oriented vision in secure forensic treatment The importance of therapeutic relationships and the fact that clients in secure forensic care spend most of their time at the living group, supervised by trained sociotherapists, makes it imperative to focus on group climate. Secure forensic treatment works better when clients are supported on a daily basis in a responsive and sensitive way by trained sociotherapists, and rely on their therapeutic relationship (Stams & Van der Helm, 2017). Although the formation of therapeutic relationships in an environment focused on safe- ty is complicated and sometimes considered problematic (Hanrath, 2013). An under- exposed target group in this context are individuals with mild intellectual disability or borderline intellectual functioning (MID-BIF). This chapter summarizes the main findings of the studies presented in this disser- tation, which focused on group climate in a secure forensic setting for individuals with MID-BIF. The first aim of this dissertation was to assess whether it was possible to meas- ure the quality of group climate, as perceived by individuals with MID-BIF, in a reliable and valid way (chapter 2). Another aim was to gain a more in-depth account of group climate as perceived by this target group (chapter 4). This dissertation also explored