Elien Neimeijer

131 tion of individuals with MID-BIF in secure forensic care is hard to determine. To improve treatment outcomes for this target group and working conditions for sociotherapists pro- spective longitudinal research and intervention studies in larger samples are necessary. From the perspective of Bronfenbrenner’s ecological theory (1979), it should be not- ed that various aspects on different system levels (micro-, meso-, exo- and macro-sys- tem) have not been taken into account in this dissertation. Such as contextual factors that directly influence sociotherapists and indirectly clients. An example is the prevailing organisational culture. After all, factors in the meso- and exosystem together determine the quality of the work climate as perceived by sociotherapists. Systems are notoriously hard to influence as the famous quote of Anthony Stafford Beer says: “The purpose of a system is what it does. There is after all, no point in claiming that the purpose of a system is to do what it constantly fails to do” (Beer, 1985, p. 99). To gain insight into the factors that influence group climate as perceived by individuals with MID-BIF and work climate as reported by sociotherapists, it is helpful to view secure forensic treatment from a more holistic, systemic perspective (see chapter 5 and key finding one). Arguably, a more comprehensive measure of work and group climate would also include data from other sources as part of routine monitoring in order to understand fluctuations in the quality of group climate over time. This data could be drawn from a range of sources, including changes in staff and client composition, changes to working practices in the organisation and/or at the living group. These are all factors that might affect work and group climate within secure forensic settings and, therefore, are of im- portance to help clinicians and researchers better understand and interpret work cli- mate and group climate data regarding a particular living group. Given the fact that staff turnover is high in secure forensic settings, group climate can change quite rapidly. This raises the question how reliable and valid group climate measures are when it is moni- tored on a yearly basis, as in the case of our studies. There is no doubt that group climate is a dynamic concept which is important to monitor on a frequent basis. However, this must be balanced against more pragmatic concerns, such as not over-burdening clients and sociotherapists with completion of questionnaires (with the risk of resistance and low completion rates). The frequency and interval of the group climate and work climate measures should be based on consensus and broadly support by the participating clients and professionals. Multiple studies reported significant differences in group climate as perceived by clients and staff (Tonkin, 2015). It is, therefore, recommended that both clients and