5 120 CHAPTER 5 at all, n = 2; no burden, n = 2; very much burdensome, n = 1). All participants indicate that the length of the entire measurement (two-week period) not burdensome (not at all a burden, n = 3; no burden, n = 2). Participants perceived the five-time daily scoring differently (no burden at all, n = 1; no burden, n = 1; neutral, n = 1; burdensome, n = 1; very burdensome, n = 1). However, they did not have to adjust their normal activities or daily routine because of the measurement events (no adjustments at all, n = 2; no adjustments, n = 3). Overall, participants consider scoring their ESM questions on smartphone to be user-friendly (neutral, n = 2; agree, n = 1; strongly agree, n = 2). 5.3.3.3 Adherence to and engagement with ESM monitoring Adherence and engagement in ESM monitoring was measured by log data, TWEETS, the online questionnaire, and the semi-structured interview. The log data revealed that participants had completed an average of 83.2% of the ESM entries (range 69-97%). TWEETS scores at t3 revealed that all participants agreed or strongly agreed that the answering the ESM questions had become a part of their daily routine. Although all but one participant agreed that answering the ESM items was easy to do, most participants did not enjoy ESM monitoring, and at t3, three participants disagreed that ESM monitoring suited them. In the online evaluation questionnaire, participants indicated the following causes for not responding to text messages: I did not have my smartphone with me (n = 2), I was sleeping (n = 2), I could not bring myself to do it (n = 1), I was busy with another activity (n = 3), I did not hear the smartphone (n = 2), and “other reason” (n = 1). Consistent with the outcome of the online questionnaire, participants mentioned during the semi-structured interview that being at work and in the company of others as reasons for skipping an ESM round. Some noticed that it would help if time intervals of the ESM measurement could be adjusted to accommodate work or therapy schedules (e.g., start times, end times, breaks). 5.4 DISCUSSION This study examined the degree to which personalized ESM monitoring and the interpretation and discussion of feedback reports was feasible and could contribute to forensic case formulation in adult men with a history of sexual offenses. Participants were generally positive about the added value to forensic case formulation. They indicated that the blended ESM procedure increased insight in the patterns of risk-relevant features and their (probable) relationship with sexual reoffending. Furthermore, compared to the bar graphs and time series plots, the use of the network chart during the feedback session resulted in new (or supported previously formulated) working hypotheses about the development and maintenance of the risk of sexual offending. In addition, some participants indicated that daily ESM measurement made them more conscious
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