Samenvatting

INTRODUCTION
Forensic mental health nurses work in a very dynamic field. Their main concerns are ‘security versus therapy’, ‘dangerousness’ and ‘management of violence’ (Mason & Lovell 2008, Mason, King & Dulson 2009). On the interface of security
and treatment professionals in forensic mental health care are confronted with two conflicting perspectives, namely the necessity of psychiatric treatment and care on the one hand, and the public outcry for more severe restrictions to prevent society from risk behaviour of the patient on the other hand. Nurses are members of a multidisciplinary treatment team in which therapeutic goals are set with emphasis on the management of violence and the path to future rehabilitation. At the same time these nurses fulfill a prominent role regarding safety; they prevent patients causing dangerous situations, e.g., threatening or abusing others (Caplan 1993, Martin 2001, Mason & Lovell 2008). Within this context of treatment and security, forensic mental health nurses in particular are confronted on a daily basis with mentally disturbed patients who are involuntary admitted to a place where they don’t want to stay.
These patients live in groups on forensic units in which many interactions between patients and nurses take place under sometimes stressful conditions (Martin & Daffern 2006). Forensic patients must learn to cope with their own disturbing behaviours and with those of their fellow patients. One of the treatment goals is to develop the capacity to participate constructively in social interactions with fellow patients and with nurses, e.g., participating in ward meetings with other patients (Rask & Levander 2001). Nurses have to manage the interactions within the therapeutic environment in order to create and maintain a safe living and learning environment for all patients. Nurses invest in building a therapeutic relationship with patients to work collaboratively on these goals and to tailor nursing care to the individual problems and needs of patients (Rask & Brunt 2006, Mason & Lovell 2008). In this process the occurrence
of aggressive incidents causes threatening and sometimes even dangerous situations on the wards.