5 110 CHAPTER 5 risk-relevant features, formed hypotheses about these features’ interrelationships, monitored them through ESM, discussed the resulting reports, and integrated findings in further case formulation. In this study, this approach is referred to as a blended ESM procedure. The following research questions were formulated to assess the added value of personalized information to forensic case formulation as well as the process of collecting this information: 1) What do participants consider the possible value for forensic case formulation of ESM measurement of risk-relevant features?; 2) How do participants experience the graphs reflecting patterns in the dynamic course of riskrelevant features, in terms of ease of understanding and interpretation, in the feedback reports (bar graphs, time series plots, and network graphs)?; 3) To what degree do participants experience effects of ESM assessments on their emotions, sexual feelings, and sexual behavior?; 4) How burdensome do participants perceive ESM assessment regarding the content of items, daily measurement frequency, duration completing a personalized ESM questionnaire, and duration of the entire registering period (two weeks)?; and 5) What is the level of participant adherence to, or compliance with, and engagement with the ESM assessments? 5.2 METHOD 5.2.1 PARTICIPANTS Seven male patients with a history of sexual offenses were invited to participate in this study in order of their admission for forensic outpatient treatment. After being informed about the study by their therapist (JWvdB), potential participants received a brochure about the research goals and procedures and were informed that participation was voluntary and that declining to participate in the study would have no consequences for further treatment. In addition, it was emphasized that consent could be withdrawn at any time without negative consequences. One patient declined the invitation, and another patient withdrew before completing the first ESM measurement. The other five participants completed the ESM assessments between December 2020 and May 2021. The medical ethics review board of the university medical center Groningen (METc UMCG) reviewed the research protocol and considered that the research did not involve an infringement of the physical and/or psychological integrity of the subjects, and that further review of the protocol was not required (METc 2020/298). 5.2.2 MATERIALS 5.2.2.1 Procedure construction personalized ESM questionnaire For the construction of the personalized ESM questionnaires, two scientist-practitioners (JWvdB and DCvdV) independently went through participants’ intake and risk assessment reports. During a consensus meeting, the two scientist-practitioners constructed a
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