Elien Neimeijer

12 may occur (Kowalinski, Schneeberger, Lang, & Huber, 2017; Parhar, Wormith, Derkzen, & Beauregard, 2008; Ros, Van der Helm, Wissink, Schaftenaar, & Stams, 2013). Also, coercive measures (i.e., seclusion, restraint) may be (re)traumatizing for the clients but also for sociotherapists (Lambert, Barton-Bellessa, & Hogan, 2015). The feeling of being coerced into therapy decreases the therapeutic alliance (between client and sociotherapists) and atmosphere on the living group, which results in lasting harmful effects on a client’s motivation for treatment and treatment outcomes in differ- ent domains (Arnold et al., 2019; Chieze, Hurst, Kaiser, & Sentissi, 2019; De Valk, 2019; Roest et al., 2016). In addition, coercive measures may not always provide the intended protection and may even increase the risks of escalation resulting in a coercive cycle of interaction between clients and sociotherapists (Patterson, & Bank, 1989; Sameroff, 2009). In the example of Lauren, the daily seclusions led to more frequent and severe self-harm, suicidality and aggressive incidents. In general, it has been shown that treat- ment in a secure setting does not necessarily have the assumed positive effects on aggres- sion, suicidality, and absconding (Huber et al., 2016; Schneeberger et al., 2017). Secure forensic treatment implies a difficult dual role for professionals, not only providing care and building a therapeutic relationship with the individual client, but also being responible for protecting others, assessing risks and managing control over the autonomy of the client However, compulsory treatment does not necessarily have to result in negative treat- ment outcomes. Compulsory secure (forensic) treatment is considered to work if there is a therapeutic group climate with fulfilment of psychological basic needs such as connectedness, competence, autonomy through shared decision-making and a good quality of the relationship between (socio)therapist and client (Hachtel et al., 2019; Ryan & Deci, 2017; Schaftenaar, 2018). Therefore, reducing (feelings of ) coercion may improve treatment outcomes and prevent expulsion from secure settings. Health care professionals should therefore be encouraged to find the right balance in their dual-role relationship with the client. A caring, fair, and trust-evoking quality of therapeutic in- terventions blended with a firm (authoritative) but not authoritarian or punitive control seems to be necessary to motivation for change in therapy and the ability and skills to (being able to) change (Van der Helm, Kuiper, & Stams, 2018). This can help to motivate clients to engage and stay in therapy and reduce offending behaviour or recidivism, de-