[Between Closeness and Distance: A New Instrument Proves Its Value in Forensic Psychiatry Practice]

Professional proximity is considered an important component and prerequisite for a working alliance between practitioners and patients in therapeutic contexts. Professional distance is protected by professional and criminal law in therapeutic relationships due to specific vulnerabilities and hierarchical constellations, which is why particular attention must be paid to this. In the forensic context, additional protection requirements of the clienteles and sovereign tasks of the institutions such as ensuring security require even greater attention. It is therefore essential to always focus on maintaining a balance. For this reason, a seminar on the topic of "Professional closeness and distance in dealing with patients in forensic psychiatry" was introduced in 2020 at the forensic hospital at the Ansbach District Hospital (Bavaria, Germany) and has been held on an ongoing basis. In the meantime, the offer has also been extended to the Center for Inpatient Forensic Therapy Rheinau, University Hospital of Psychiatry Zurich (Switzerland). All employees from all professional groups are requested to participate at least once. As a quality assurance measure, the seminar serves to impart legal, psychiatric and psychological principles as well as to encourage self-reflection and development of sensitivity for the topic. Clinical experience shows that a de-tabooing has taken place and that a better balance has been achieved among professional groups and at various hierarchical levels. Transparency within the forensic hospital has increased. More attention is paid to the topic when new employees are being trained. Problems are discussed more openly. Various graduated intervention options can be used. A quantitative evaluation cannot yet be referred to in this case; detailed qualitative reports would also only be possible with broader application to ensure reliable anonymity. This report should therefore be understood as a first step toward a new discussion: according to current clinical impression, the instrument has proved its worth in practice.