Elien Neimeijer

120 treatment and support (Ten Brummelaar, Harder, Knorth, Post, & Kalverboer, 2017). Shared decision making is not a goal in itself, but a process that might improve the treat- ment outcomes and quality of life for individuals with MID-BIF in secure forensic care. However, within secure forensic care there is a tension between the participation of indi- viduals and a context where sometimes choice-making is limited. Given the fact that care and treatment in this type of care is based on a civil or criminal law measure, the space for individuals to exert influence is initially limited. Nevertheless, more attention within secure forensic care for individuals with MID-BIF should be paid to the idea that when clients actively participate in the creation and design of their care and treatment process, the chance increases that the clients will benefit more from treatment (Frielink, 2017). Daily clinical practice at the living group is full of (ethical and practical) dilemmas, without easy answers. Reflecting on these dilemmas in a multidisciplinary team is an important way to improve group climate Periodically measuring group climate will support active client participation. In com- bination with measuring work climate as perceived by sociotherapists, it is also possi- ble to reflect on the interaction between group and work climate aspects. Because daily clinical practice at the living group is full of (ethical and practical) dilemmas, without easy answers, reflecting on these dilemmas in a multidisciplinary team is an important way to improve group climate. See for instance the example of moral case deliberation (Spijkerboer, 2019). As the perspective on group climate may differ between clients, sociotherapists, teammanagers, psychologists and policy makers, it is useful to stimulate conversations between these different groups. In this way meaning can be given to the routine outcome monitoring of group climate and work climate. Without giving meaning to and reflecting on the outcomes, the group climate factors (i.e., support, growth, atmos- phere, and repression) are used as a kind of ‘empty’ catch-all terms. When themes such as shared decision-making (Ten Brummelaar et al., 2017), relational working (Schafte- naar, 2018), and a therapeutic group climate (Stams & Van der Helm, 2017) are discussed systematically, professional attitudes regarding changes in clinical practices on the living group may change in a positive direction (Maio, Haddock, & Verplanken, 2018).