Table 2 Treatment Stages of Forensic Outpatient Systemic Therapy (FAST) and Differences and Similarities Between FASTb and FASTr

1. Preliminary referral (one month)

During this stage, all information needed to start a FAST trajectory is gathered by the professional. This phase consists of the registration, including viewing file information, contacting the referrer, and taking care of an intake interview. The intake interview takes place at the homes of the client and his/her caregiver(s) or at the treatment site of de Waag.

Intake is face-to-face in both conditions.

2. Pre-treatment (one month)

During this phase, making contact and motivation are central concepts. This phase is aimed at establishing contact, motivating, empowerment, making a safety plan and drawing up a treatment plan in the form of an Empirical Intervention Cycle Summary (EIS). In the EIS, a problem analysis is described, the recidivism risk is established and then monitored, as are motivation and safety for the juvenile, caregiver(s) and professionals. Every two weeks, the family discusses which general or optional sub-goals have the highest priority. At least three goals are worked on every two weeks. Preferably, attention is paid to realizing changes aimed at the family/ caregiver(s) in combination with changes aimed at the social domain (education and contact with friends) and individual domain (criminogenic needs) of the juvenile. When the sub-goals are met, new FAST goals are prioritized. In addition, professionals always pay attention to what is needed to guarantee or improve the safety of everyone and received support of the family members. An important goal is to improve the quality of contact and to reduce conflicts between caregiver(s) and the juvenile. Next, analysis circles are used to determine which interventions are most appropriate and will be implemented over the next two weeks.

First appointment after intake is face-to-face in both conditions.

3. Treatment (two to eight months)

In this stage, customized treatment is offered by working on standard FAST and optional FAST goals (addressed in supplementary modules). Regular FAST treatment consists of the Family-module, which first focusses on safety and connection, by using safety and crisis plans, and by learning to use a signaling plan. In addition, social support is organized via the network of the family. Second, parenting skills are improved. Selection of specific family modules is based on the needs of the caregiver. To do so, the EIS is evaluated and, if needed, changed every two weeks with the family and during the FAST intervision to determine the quality and to monitor the progress of the treatment. It is also assessed whether the interventions have actually led to change or whether they should be applied for a longer period of time

FASTr does not make use of eHealth or the GRIP-app. In FASTb, family modules are offered (partly) through Minddistrict.

4. Completion

The goals of the FAST treatment that were applicable to the juvenile and the family have been (largely) achieved. This will be confirmed by the presence of a future plan (focused on relapse prevention) and achieved results that are recognized by the FAST professional, the caregiver(s), referrer, and the juvenile.

The final session is face-to-face in both conditions.

5. Aftercare (one to three months, depending on risk level)

In the aftercare phase, the family works on their future plan with the support of significant others in their environment. In this phase, the FAST professional checks whether the juvenile and caregiver(s) are able to adhere to the plan for the future and whether the results can be maintained. Aftercare sessions will take place monthly.

Aftercare is completely online in FASTb, unless necessary to meet clients face-to-face.