‘Evidence based practise’ in de tbs Maatschappelijke aspiraties versus empirische realiteit

Abstract

The forensic psychiatric treatment measure of TBS has come under critical public and political scrutiny of late. Unfortunately, perceptions of criminality and expectations regarding assessment and treatment of offenders rarely concur withempirical evidence, and sometimes widely diverge from it. This article summarizessome main scientific findings pertaining to the assessment, treatment anddischarge phases of TBS. It is argued that significant progress has been made inseveral areas, such as risk assessment or the formulation of 'what works' principles,while limitations of the present knowledge base are also identified. Furthermore,it is shown that evidence regarding effective treatment interventionsremains tenuous, though some positive indications of general effectiveness offorensic mental health care are available. Several problematic concepts, suchas diminished responsibility and treatability, are elucidated. Finally, findingsare briefly evaluated in the context of the recent report by the ParliamentaryReview Committee TBS.