Elien Neimeijer

133 During these periods she benefits from the proximity of her sociotherapists who sets limits for her, reassure her, identify stressors for her and put things into perspective for her. She remains highly context-dependent to prevent tension build-up and risky behaviour. The process of establishing and maintaining contact will require contin- ued patience, tact and persistence from the sociotherapists working with her. The pitfall is to give up and get tired in this process. Lauren needs a long term reliable environment, which does not reject her, in order to ultimately be able to experience more grip and stability from herself. Therefore, extra support is offered to the socio- therapeutic team in terms of education, training, coaching on the job and intervision during team meetings. Although Lauren’s behaviour can be explained by her history with adverse experiences and disharmonious developmental profile, intensive sup- port of the sociotherapeutic team is necessary to keep this in mind in the daily sup- port of Lauren. In addition, the team must be supported in the continuous transla- tion that must be made in order to see the basic need behind Lauren’s behaviour and to be able to respond adequately to this, despite the strong dynamics in behaviour that Lauren shows. This requires close collaboration between all disciplines involved with Lauren. A risk with regard to the future is that an erroneous image is created, namely that Lauren has grown, receives less support and again has to deal with a more complex context. The ‘good behaviour - more freedom’ principle is often used within clinical forensic care. The distance to sociotherapists who offers her safety will then become too great to be able to maintain and control herself. Her coping skills will fall short to such an extent that she will only be able to shorten the distance through problem behaviour. Following this, containment and thus further escalation will start the negative vicious circle again. By stating that she is better able to function because her context provides adequate and proactive holding and limits, this risk is significantly reduced. The risks will potentially always remain and incidents and escalations must therefore keep her context alert in order to continue to give her the proximity and direction she needs. ‘It is going well, so we do not change anything’ should be the credo. For the future it is clear that Lauren has to rely on a sheltered living environment with 24-hour support in the care for individuals with intellec- tual disabilities and comorbid severe psychopathology. At the moment, it is being mapped out which organisation and living environments are eligible for Lauren’s complex and intensive care needs.