Unreliability in Forensic Outpatient Treatment: Differences Between Violent and Sexual Offenders and Their Clinical Implications

This poster presents the findings of a study conducted at a psychotherapeutic outpatient clinic in Munich, where violent and sexual offenders are referred by the judiciary for specialized forensic outpatient treatment to prevent violence and enhance victim protection. A key prerequisite for participation is the probationers' willingness and reliability. The research explores whether violent (n = 176) and sexual offenders (n = 327) differ in treatment unreliability and investigates possible explanations for observed disparities in treatment provision. Results indicate significantly greater unreliability—defined as the ratio of canceled and missed appointments to total treatment sessions—among violent offenders. In this group, unreliability was positively associated with both the risk of recidivism (as defined by Hanson et al.'s five-level risk and needs system) and the presence of antisocial personality disorder (ICD-10 F60.2). No corresponding correlations were found among sexual offenders. Higher unreliability was also associated with younger age in both violent and sexual offenders, with a stronger association in the violent offender group. These findings suggest the need to anticipate higher dropout and no-show rates among violent offenders, particularly those with elevated recidivism risk and/or antisocial traits and/or younger age. In response, an SMS-based appointment reminder system has recently been implemented and is scheduled for evaluation.