Elien Neimeijer

130 ied by using different research sources (i.e., literature, clients and sociotherapists per- ceptions) and methods (quantitative and qualitative study designs) which is viewed by researchers as the most adequate approach to study complex constructs. In this section we will discuss some methodological issues on the quantitative and qualitative studies. Another strength is that clients were actively involved in all studies by completing the GCI and/or were interviewed to explore their perceptions in greater detail. This ties in with the increasing interest in the contribution that individuals with MID-BIF can make by expressing their opinions and perceptions about the treatment they undergo (Brown, Duff, Karatzias, & Horsburgh, 2011). Apart from its strengths, this dissertation has a number of limitations that should also be mentioned. It is relatively difficult to investigate group climate because of the breadth of this multifactorial construct, even referred to as ‘intangible’ (WHO, 1953). Our studies show promising results in that group climate can be measured in a reliable and valid manner in individuals with MID-BIF, though it is still difficult to fully capture this ‘fuzzy’ and complex construct in a questionnaire such as the GCI. Most of the group climate research is quantitative in nature. This contributes to the identification of a range of factors that influence and/or are associated with group climate but does not add to the conceptualization of group climate. After 50 years of group climate research, there is still a lack of conceptual clarity around the aspects and factors that influence group climate (Doyle et al., 2017). Group climate can be measured in a reliable and valid manner in individuals with MID-BIF, though it is still difficult to fully capture this ‘fuzzy’ and complex construct in a questionnaire The cross-sectional studies presented in this dissertation should be considered as a first step towards understanding the effects of group climate as perceived by individuals with MID-BIF in secure forensic care. Within this study design it was intended to give an in- dication whether there are associations between group climate, aggressive incidents, and use of coercive measures on the one hand and between group- and work climate on the other hand. It was not possible to account for fluctuations in group climate over time and to explore associations between interventions and group climate outcomes. Also, this dissertation offers no causal explanations and generalization of the results is therefore lim- ited. To what extent the findings of the qualitative study are representative for the popula-