Elien Neimeijer

119 degree of understanding of their position by the professionals working with them (Lord, Priest, & McGowan, 2016). Viewing the world from the client’s perspective can help broaden clinical professionals’ as well as researchers’ reference frame in order to under- stand and improve the quality of treatment. Norcross and Wampold (2011) for example stated that monitoring of the therapeutic process (including obtaining client feedback) is effective in improving therapeutic alliance and treatment processes. By means of assessing group climate and giving staff feedback about the results, a voice was given to a target group whose voice is not often heard in scientific research. Clinical implications The GCI outcomes, as presented in this dissertation, may provide relevant insights into what steps could be taken to improve group climate as perceived by individuals with MID-BIF. In combination with the use of the Living Group Work Climate Instrument (LGWCI) to measure work climate as perceived by sociotherapists, we noticed that group climate is influenced by professional behaviour of sociotherapists (see chapter 5). Measuring group climate with the GCI and work climate with the LGWCI, and discuss- ing the results with both clients and sociotherapists, appeared to act as an ‘intervention’ in itself to create awareness and plans for improvement in daily practices. This process of measuring, providing feedback, analyzing and discussing the GCI outcomes and making improvement plans can be described as a Plan-Do-Check-Act (PDCA; Deming, 1986) cycle which encourages sociotherapists to reflect on their professional behaviour and act accordingly. It was seen in clinical practice that sociotherapists reflected on how they function as a team, consider potential improvements, and develop plans about how new goals should be implemented at their living group. The GCI is important for monitoring the quality of group climate on a regular basis but can be also be used to evaluate the effectiveness of interventions (the A in PDCA) that aim to improve group climate for this target group and work conditions and training purposes for sociotherapists. To be able to understand how group climate can be improved for the benefit of both clients and sociotherapists, it is important to give clients a voice in this process. The above is in line with a growing awareness that involving and listening to clients in decisions that affect them (i.e. shared decision making) is important to achieve better