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This study assessed the agreement between patient and clinician ratings using the Instrument for Forensic Treatment Evaluation (IFTE) and its self-report version (IFTE-S) in high-security forensic psychiatric centers in Flanders, Belgium. Results showed concordance in domains like protective behavior and resocialization skills, but patients rated their problematic behavior as less severe than clinicians did. Item-level analyses revealed a more differentiated pattern, identifying more concordance on observable items and discordance in subjective or stigmatized behaviors. Discrepancies remained stable over the first 15\u2009months of treatment and were not influenced by primary psychiatric diagnosis. The study underscores the importance of addressing such differences in treatment to enhance shared understanding, promote feedback-informed care, and support patient engagement. 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