Restraint Reduction in Children's Residential Facilities: Implementation at Damar Services

Ms, Jenell Holstead; Lamond, Diane; PsyD, Jim Dalton; Horne, Anita; Crick, Robert

doi:10.1080/08865710903507961

Cited by 9 publications

(31 citation statements)

References 12 publications

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“…This means that leaders change their own leadership practices to highlight organizational commitment and support for TIC [33, 47]. Across trauma informed care initiatives, staff knew TIC was a priority by the way leaders behaved.…”

Section: Resultsmentioning

confidence: 99%

What are effective strategies for implementing trauma-informed care in youth inpatient psychiatric and residential treatment settings? A realist systematic review

Bryson

Gauvin

Jamieson

et al. 2017

Int J Ment Health Syst

117

101

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BackgroundMany young people who receive psychiatric care in inpatient or residential settings in North America have experienced various forms of emotional trauma. Moreover, these settings can exacerbate trauma sequelae. Common practices, such as seclusion and restraint, put young people at risk of retraumatization, development of comorbid psychopathology, injury, and even death. In response, psychiatric and residential facilities have embraced trauma-informed care (TIC), an organizational change strategy which aligns service delivery with treatment principles and discrete interventions designed to reduce rates of retraumatization through responsive and non-coercive staff-client interactions. After more than two decades, a number of TIC frameworks and approaches have shown favorable results. Largely unexamined, however, are the features that lead to successful implementation of TIC, especially in child and adolescent inpatient psychiatric and residential settings.MethodsUsing methods proposed by Pawson et al. (J Health Serv Res Policy 10:21–34, 2005), we conducted a modified five-stage realist systematic review of peer-reviewed TIC literature. We rigorously searched ten electronic databases for peer reviewed publications appearing between 2000 and 2015 linking terms “trauma-informed” and “child*” or “youth,” plus “inpatient” or “residential” plus “psych*” or “mental.” After screening 693 unique abstracts, we selected 13 articles which described TIC interventions in youth psychiatric or residential settings. We designed a theoretically-based evaluative framework using the active implementation cycles of the National Implementation Research Network (NIRN) to discern which foci were associated with effective TIC implementation. Excluded were statewide mental health initiatives and TIC implementations in outpatient mental health, child welfare, and education settings. Interventions examined included: Attachment, Self-Regulation, and Competency Framework; Six Core Strategies; Collaborative Problem Solving; Sanctuary Model; Risking Connection; and the Fairy Tale Model.ResultsFive factors were instrumental in implementing trauma informed care across a spectrum of initiatives: senior leadership commitment, sufficient staff support, amplifying the voices of patients and families, aligning policy and programming with trauma informed principles, and using data to help motivate change.ConclusionsReduction or elimination of coercive measures may be achieved by explicitly targeting specific coercive measures or by implementing broader therapeutic models. Additional research is needed to evaluate the efficacy of both approaches.Electronic supplementary materialThe online version of this article (doi:10.1186/s13033-017-0137-3) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

What are effective strategies for implementing trauma-informed care in youth inpatient psychiatric and residential treatment settings? A realist systematic review

Bryson

Gauvin

Jamieson

et al. 2017

Int J Ment Health Syst

117

101

View full text Add to dashboard Cite

show abstract

“…Staff members were initially resistive and concerned that there would be an increase in staff injury without being able to use restraints as often. As of 2004, 88 clients had been restrained a total of 5,000 times, an average of 56 restraints per client (Holstead, Lamond, Dalton, Horne & Crick, 2010). First a Resource Management Team was created to train certain individuals in behavior management and intervention techniques.…”

Section: P 4)mentioning

confidence: 99%

“…They were responsible for all hands-on instruction and coaching of staff during critical moments. A Quality Plus program was also created to help executive administrators, directors, managers, counselors and direct care staff to better monitor their progress towards their goals on a monthly basis (Holstead et al, 2010).…”

Section: P 4)mentioning

confidence: 99%

“…Staff members were also taught to be more mindful and present in their own experience related to the critical moment. Eventually, administrators discovered that more mindful staff members were more committed to reducing restraints (Holstead et al, 2010). A Restraint Reduction Committee was also created to focus completely on this task.…”

Section: P 4)mentioning

confidence: 99%

“…They also created a client and staff debriefing policy that ensured all clients were debriefed within one hour of an incident. All staff members were required to meet with a committee member within 48 business hours and discuss behaviors that were witnessed prior to the restraint, with alternative options for future occurrences (Holstead et al, 2010).…”

Section: P 4)mentioning

confidence: 99%

See 2 more Smart Citations

The Attitudes and Knowledge of Residential Treatment Center Staff Members Working with Adolescents Who Have Experienced Trauma

Denison

Gerney²,

Leuken

et al. 2018

Residential Treatment for Children & Youth

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Although many programs are working to reduce and eliminate the use of restraint and seclusion practices, these practices continue to be highly prevalent. A one-hour in-service training on Trauma-Informed Care and sensory-based alternatives for de-escalating behavior was presented to staff members working directly with adolescents with severe emotional and behavioral problems living in a Residential Treatment Center. Staff member attitudes regarding Trauma-Informed Care, the use of restraints, and sensory-based alternatives were measured before and after the in-service training to determine pre-existing staff attitudes and the potential influence of this training on staff attitudes.

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Staff Intervention and Youth Behaviors in a Child Welfare Residence

2015

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Restraint Reduction in Children's Residential Facilities: Implementation at Damar Services

Cited by 9 publications

References 12 publications

What are effective strategies for implementing trauma-informed care in youth inpatient psychiatric and residential treatment settings? A realist systematic review

What are effective strategies for implementing trauma-informed care in youth inpatient psychiatric and residential treatment settings? A realist systematic review

The Attitudes and Knowledge of Residential Treatment Center Staff Members Working with Adolescents Who Have Experienced Trauma

Staff Intervention and Youth Behaviors in a Child Welfare Residence

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