HKT-R Spider reference profiles. A guideline for fact-based decision-making regarding a forensic patients leave.

Purpose: This paper aims to illustrate by means of a case study how HKT-R Spider reference profiles of recidivists and non-recidivists may be supportive in leave decisions. Design/methodology/approach: The authors describe what is known for recidivists and non-recidivists about changes in risk factors during treatment. The HKT-R Spider is introduced. By comparing a case study to group profiles, the authors illustrate how discussions about leave may be rationalised. From a study among 278 patients to explore the profiles, the authors report the inter agreement, and differences between recidivists and non-recidivists of the clinical HKT-R factors. Intra correlation coefficients, Wilcoxon signed ranks test and independent and paired t-tests are applied. To explore which combination of factors are discriminating between both groups, the authors also performed logistic regression analyses at six treatment stages. Findings: The inter agreement reliability and internal consistency of the clinical HKT-R scale were acceptable to good in all six stages studied. The HKT-R Spider and profiles can be used to assist in evidence-informed decision-making about leave. Practical implications: Globally recidivists had somewhat higher levels of clinical risk factors at all six decision moments, but the interpretation of HKT-R Spiders profiles should always be adapted to the individual's context. Originality/value: Applying the HKT-R Spider reference profiles on individual cases may structure and rationalize discussions lead to decisions based on clinical facts. [ABSTRACT FROM AUTHOR]