Multidisciplinary Routine Outcome Monitoring in Forensic Psychiatry: Concordance Between Clinician and Patient Assessment

Patient involvement in routine outcome monitoring (ROM) is vital for collaborative treatment and understanding differences between patient and clinician perspectives. This study assessed the agreement between patient and clinician ratings using the Instrument for Forensic Treatment Evaluation (IFTE) and its self-report version (IFTE-S) in high-security forensic psychiatric centers in Flanders, Belgium. Results showed concordance in domains like protective behavior and resocialization skills, but patients rated their problematic behavior as less severe than clinicians did. Item-level analyses revealed a more differentiated pattern, identifying more concordance on observable items and discordance in subjective or stigmatized behaviors. Discrepancies remained stable over the first 15 months of treatment and were not influenced by primary psychiatric diagnosis. The study underscores the importance of addressing such differences in treatment to enhance shared understanding, promote feedback-informed care, and support patient engagement. Further longitudinal research is needed to confirm these findings and improve ROM practices in forensic settings.